Overview

Description

CALENDAR DESCRIPTION:

This course is aimed at students interested in neuromuscular rehabilitation. Students will learn about the pathological origins of movement disorders associated with impaired function of sensory and motor systems. The course will be focused on the stages and strategies for recovery of voluntary control of essential functions. The range of rehabilitation interventions available to assist recovery and restore voluntary control will be explored, with special emphasis on advanced techniques to restore control of movement and bodily functions in paralyzed people.

COURSE DETAILS:

Target students are senior biomedical physiology, kinesiology and biomedical engineering majors interested in

1. The human body’s intrinsic capacity and physiological limitations for recovery from severe neurological trauma or disease that cause paralysis, movement disorders and/or sensory deficits
2. Current and emerging approaches that can restore or replace key functions of affected muscles or organs
3. Insights on clinical trials, regulatory requirements & commercialization pathway for innovative therapies. 

The course explores a wide range of rehabilitation options and their risks, ethics, costs & benefits. Emphasis will be placed on advanced neuroprosthetic therapies that use targeted electrical stimulation to protect, restore or enhance voluntary control of basic functions and/or support independence in activities of daily living.

TOPICS:    

• Review of neuromuscular mechanisms for normal movement control
• Pathologies that affect sensory and motor functions
  • Brain, spinal cord, spinal roots, peripheral nerves, muscles; somatic & autonomic
• Capacity for self-repair and regeneration after injury of peripheral vs. central neural systems
  • Acute vs. chronic consequences of neurological injury or disease
• Assessment of functional loss
  • Classification standards for impairment vs. disability
• Approaches to restoring or replacing lost or diminished neuromuscular function
  • Physiotherapy - pharmacotherapy - surgical reconstruction - targeted electrical stimulation
• Neural prostheses      
  • Guidelines for safe and effective electrical stimulation of excitable tissues
  • Approaches designed for temporary or permanent interfacing with the nervous system
  • External vs. partially implanted vs. fully implanted neurostimulation systems
• Neuromodulation for treatment of chronic pain, epilepsy, movement disorders
• Preventing or restoring impaired motor/sensory function with functional electrical stimulation
• Neuroprosthetic approaches for voluntary control of artificial limbs
  • Open-loop vs. closed-loop control
  • Tapping available command signal sources for prosthesis control
  • Sensors and sensory feedback sources for prosthesis control
• The path to commercialization of therapeutic innovations
  • R&D, funding sources, pre-clinical & clinical validation of safety & efficacy, regulatory approval
• Determinants of commercial viability and market success                
  • Functionality vs. availability vs. cost: meeting expectations of patients, physicians and payers

COURSE-LEVEL EDUCATIONAL GOALS:

• Describe differences and similarities in the regenerative capacity of peripheral neurons vs. central neurons after injury.
• Describe reasons for differences in the acute and chronic consequences of brain injuries.
• Discuss current classification standards for impairment vs. disability after injury or disease.
• Design basic therapeutic plans for restoring or replacing lost neuromuscular function using physiotherapy, pharmacotherapy, reconstructive surgery and/or targeted electrical stimulation.
• Apply accepted guidelines for safe and effective electrical stimulation of excitable tissues.
• For a given impairment, evaluate the relative benefits and drawbacks of neurostimulation systems that use totally external vs. partially implanted vs. fully implanted components.
• Describe current uses of neuromodulation for treatment of chronic pain, epilepsy and movement disorders.
• Evaluate possibilities for using neuromodulation to treat additional neurological disorders.
• Describe uses of functional electrical stimulation to protect muscles from disuse atrophy or to restore muscle strength in disused muscles.
• Describe neuroprosthetic systems that enhance voluntary control of artificial limbs by amputees.
• Explain the roles and uses of sensors and sensory feedback for prosthesis control.
• Describe regulatory requirements to develop, test and commercialize a therapeutic innovation.
• Analyze the basic determinants of commercial viability and market success for a new therapy.
• Apply knowledge learned in class to diagnose and “treat” new patient scenarios in exams.
• Apply knowledge learned in class to evaluate new therapeutic solutions first described in exams.

Grading

Materials

REQUIRED READING:

RECOMMENDED READING: