Monday, January 06, 2020

New robotic device to help patients with spinal cord injury

Researchers from Columbia University in the US have invented a robotic device that can be used to assist and train people with Spinal Cord Injuries (SCIs). The team consisting of an Indian, said the device delivers forces on the torso when the user performs upper body movements beyond the postural stability limits while sitting.The device can help the patient to sit more stably, an advance which may aid the recovery of patients with SCI.

The robotic device— the Trunk-Support Trainer, or TruST—is a motorised-cable driven belt placed on the torso of people with SCI to determine their control limits of posture, and workspace area while sitting.

The study, published on Monday in the journal Spinal Cord Series and Cases, is the first to measure and define the sitting workspace of patients with SCI based on their active trunk control.

"We designed TruST for people with SCIs who are typically wheelchair users," said study co-author Sunil Agrawal from Columbia University.

"We found that TruST not only prevents patients from falling, but also maximizes trunk movements beyond patients' postural control, or balance limits," he added.

Five subjects participated in a pilot study examining TruST with the Postural Star-Sitting Test.

In this customised postural test, the participants were required to follow a ball with their head and move their trunk as far as possible, without using their hands.

The users repeated the test in eight directions, following which the researchers used the results to compute the sitting workspace of each individual.

TruST was customised for each subject, the researchers said, so that they could apply personalised assistive force fields on the torso while the participants performed the same movements again.

With the new robotic device, the subjects could reach further during the trunk excursions in all eight directions.


According to the study, TruST significantly expanded the sitting workspace around their bodies, on an average of about 25 per cent more.

"The capacity of TruST to deliver continuous force-feedback personalised for the user's postural limits opens new frontiers to implement motor learning-based paradigms to retrain functional sitting in people with SCI. We think TruST is a very promising SCI rehab tool," said study co-author Victor Santamaria, a physical therapist at Columbia University.

Agrawal and his team are now exploring the use of TruST to improve the trunk control of adults and children with SCI.

"The robotic platform will be used to train participants with SCI by challenging them to move their trunk over a larger workspace, with TruST providing assist-as-needed force fields to safely bring the subjects back to their neutral sitting posture. This force field will be adjusted to the needs of the participants over time as they improve their workspace and posture control," Agrawal said. 


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Wednesday, February 13, 2019

Can higher sodium intake treat lightheadedness?

Higher sodium intake should not be used as a treatment for lightheadedness, say researchers challenging current guidelines for sodium consumption. Lightheadedness while standing, known as postural lightheadedness, results from gravitational drop in blood pressure and is common among adults. 

Greater sodium intake is widely viewed as an intervention for preventing lightheadedness when moving from seated to standing positions. However, contrary to this recommendation, researchers  found that higher sodium intake, actually increases dizziness. 

"Our study has clinical and research implications," said a researcher. "Our results serve to caution health practitioners against recommending increased sodium intake as a universal treatment for lightheadedness. Additionally, our results demonstrate the need for additional research to understand the role of sodium, and more broadly of diet, on lightheadedness," he said.

For the study,  the team used data from the completed DASH-Sodium trial, a randomised crossover study that looked at the effects of three different sodium levels (1500, 2300, and 3300 mg/d) on participants' blood pressure for four weeks. 

While the trial showed that lower sodium led to decrease in blood pressure, it also suggested that concerns about lower level of sodium causing dizziness may not be scientifically correct. The study also questioned recommendations to use sodium to treat lightheadedness, an intervention that could have negative effects on cardiovascular health.

"Health practitioners initiating sodium interventions for orthostatic symptoms now have some evidence that sodium might actually worsen symptoms," he said. "Clinicians should check on symptoms after initiation and even question the utility of this approach. More importantly, research is needed to understand the effects of sodium on physical function, particularly in older adults."


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