Each year, around 15 million people suffer a new cardiovascular insult, with a mortality rate around 30 percent. Another third of these people suffer permanent physical disorders, which cannot be fully rehabilitated by standard therapy.
A prolonged period of mobility reduction not only affects the patient’s quality of life, but can also entail more serious complications such as pneumonia, thrombosis and contractures. For this reason, it is particularly important to provide the most effective and efficient therapy.
This is exactly why recoveriX was developed–to allow a faster and better chance of recovery!
recoveriX is an innovative and unique brain-computer interface (BCI) system, which was developed especially for the rehabilitation of stroke patients. It should help the patient regain the function of the upper and lower extremities, in addition to standard therapy. It can be used in the acute, sub-acute, or chronic state.
A BCI is a device that can allow communication or device control without movement. Instead, a BCI bypasses the brain’s normal output pathways of peripheral nerves and muscles, and detects mental activity through direct measures of brain activity (usually the EEG).
The principle of the system is based on motor imagery, which is measured with the EEG. Since the imagination of a movement in the motor cortex produces activity almost identical to an actual movement, a BCI can use this motor imagery to influence the paretic muscles caused by stroke.
The combination of three different treatment approaches maximizes the chances of successful therapy:
The patient is asked to imagine an upper or lower extremity movement (e.g. dorsiflexion). The signals from this motor imagery are measured with an EEG cap and passed through a biological signal amplifier to a PC or laptop. The signals are then evaluated by the recoveriX system which provides two different kinds of feedback - virtual reality and FES.
If the system detects correct movement imagery, the patient gets real time feedback from an avatar. The patient must sit in front of a screen (similar to mirror therapy) that shows the avatar. For example, if the patient imagines left wrist dorsiflexion, then the avatar will perform the same movement.
Two electrodes are placed on a specific muscle group – e.g. the dorsiflexors. If the user imagines the expected movement, feedback is also provided through the Functional Electrical Stimulation (FES), which activates the muscles that the patient’s damaged motor system can no longer activate through natural means.
A recoveriX therapy session just requires a table where you can place the system, which needs a little more space than a laptop with an extra monitor. The patient only needs to sit in front of the table. The exact position depends on which muscle areas need to be trained.
Once the patient is seated, the therapist or other system operator can load each patient’s anamnesis, including results from prior recoveriX sessions. Next, an EEG cap must be mounted on the head, and the electrodes have to be filled with a small amount of gel to produce a good signal. The monitor provides feedback about the signal quality of each electrode. The therapist can also choose which muscle groups to train.
Then, the electrodes for the FES are placed on the specific muscle group, and the pulse width, the amplitude and the frequency of the electric pulse are configured for each patient so that his/her muscel can be contracted correctly.
This setup process only takes about five to ten minutes. Each therapy run takes about ten minutes, and we recommend at least two to three runs per therapy session or more if the patient is willing. Usually, a complete therapy session should not last more than an hour.
First, practice mode should be used so the patient becomes familiar with the system. The patient learns to perform motor imagery and experience FES-based feedback. In this mode, the patient gets feedback even if the motor imagery is not performed correctly.
This mode is for trained patients. The feedback occurs only when the subject correctly imagines the expected movement. For example, if the patient imagines wrist dorsiflexion for two seconds, the system would provide avatar and FES feedback accordingly, meaning that the feedback would end prematurely if the patient stops imagining movement early.
Most patients who survived a stroke could use recoveriX. Patients need to have enough cognitive ability to remember and act on instructions. Other important criteria for recoveriX users include:
Every patient gets a complete diagnosis, which we use to determine whether RecoveriX therapy is appropriate.
Measuring brain waves becomes very easy with our specially developed EEG cap. There are 16 active electrodes on the cap, which means that the signal from each electrode is pre-amplified. This provides great signal quality with fewer artifacts. More importantly, unlike conventional passive electrodes, there is no need to abrade the skin with active electrodes, which greatly reduces the time and inconvenience of preparing the EEG cap.
The measured brain signal is increased again with the bio-signal amplifier, and then transmitted to the PC.