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Spinal Cord Injury and Rehabilitation Engineering/Neuroscience The overall goal of the our work is to develop rehabilitation interventions for improving and restoring lost function after spinal cord injury, head trauma or stroke. Five projects are currently underway:
1) Restoring Standing and Stepping after Spinal Cord Injury through the Use of Intraspinal Microstimulation The restoration of standing and walking after spinal cord injury has the benefits of improving muscle and skin properties, joint health and bone density, and cardiovascular and pulmonary function. Intraspinal microstimulation (ISMS) is a novel electrical stimulation technique that uses very fine, hair-like wires to stimulate the “control center” for standing and stepping in the spinal cord. The microwires are implanted in a relatively small region of the cord (about 5 cm) and patterned stimulation through these wires can generate coordinated muscle contractions in the legs. These contractions produce balanced standing and walking movements. This is a large project focused on: assessing the long-term stability and functionality of ISMS; evaluating the long-term effect of ISMS on the reorganization of neuronal networks within the spinal cord; assessing the long-term effects of ISMS on muscle fibre-type composition; the design of electrode systems for implantation in the spinal cord; and the design of ISMS control paradigms for restoring over-ground, out-of-lab walking after spinal cord injury.
2) Early Detection and Prevention of Deep Tissue Injury (Deep Pressure Ulcers) Wheelchair-dependent individuals and bed-ridden patients are at high risk of developing pressure ulcers. Pressure ulcers can develop at the surface of the skin due to multiple factors including abrasions, moisture and poor nutrition and progress inward. They can also develop at deep bone-muscle interfaces as a result of prolonged periods of pressure which lead to ischemia and subsequent reperfusion as well as physical deformation of deep soft tissue. These latter ulcers develop from the inside out, are very difficult to detect and can cause massive damage prior to exhibiting clear skin signs. The goals of this project are two fold: to develop clinically-feasible methods for the early detection of deep tissue injury and to develop novel electrical stimulation-based interventions that could be applied prophylactically to prevent the formation of these injuries.
3) Reduction of Spasticity after Spinal Cord Injury and Stroke Spasticity is a very debilitating side-effect of spinal cord injury and stroke. It can lead to uncontrolled spasms and compromise the efficiency of residual voluntary function. This project focuses on obtaining a better understanding of the underlying mechanisms of spasticity using computer modeling, and developing surface electrical stimulation as well as operant conditioning training paradigms to reduce spasticity in individuals with spinal cord injury and stroke.
4) Non-invasive Assessment of Spinal Cord Health after Injury and in Response to Rehabilitation Interventions Treatment of spinal cord injury requires proper assessment of spinal cord tissue in order to determine the extent of injury and the biochemical composition of the environment around the injury site. The goal of this project is to develop non-invasive magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques that could allow for morphological and chemical assessment of spinal cord tissue over time. This information will be used to evaluate the progression of the injury, choose appropriate pharmacological or rehabilitative interventions at various time points following injury, and to assess the effect of conventional and novel treatments on the health of the spinal cord.
5) Restoration of Arm Function following Injury or Disease Injuries to the nervous system (e.g., spinal cord injury, stroke) or progressive neurodegenerative diseases (e.g., Parkinson's disease) commonly result in altered neural control of limb movements. Presently, 1.3% of the population in Canada has some type of neurological deficit, many of whom have diminished arm function. The goals of this project are to develop computational methods for understanding the neural control of reaching movements in health and disease, develop rehabilitative approaches for enhancing arm function through the use of operant conditioning and electrical stimulation-based training paradigms, and the assess the effectiveness of these paradigms in inducing long-term reorganizations in the neural circuits controlling arm movement. Funding Our work is funded by the Alberta Heritage Foundation for Medical Research (AHFMR), the Canadian Fund for Innovation (CFI), the Canadian Institutes of Health Research (CIHR), the International Spinal Cord Injury Trust (ISRT), the United State National Institutes of Health (NIH), and the Spinal Cord Injury Treatment Centre Society (SCITCS). Additional Graduate Training Opportunities We have been developing garments with indwelling electrical stimulation electrodes to provide periodical muscle contraction and pressure relief in people with immobilizing diseases or neural injuries. We are now interested in incorporating flexible pressure sensors in these garments to provide real-time feedback information regarding the levels of pressure underneath bony prominences. A student with an engineering background and good programming abilities, interested in clinical applications of new technology and enjoys working in a team environment, will be suitable for this project. The student will have the chance to interact with a large number of investigators with research expertise spanning biomedical engineering, basic animal science, rehabilitation neuroscience and clinical implementation. The work will involve a series of bench work developments and clinical evaluations.
Ideal candidates should have an technical background with interest in clinical applications of new technology and an ability to work in a team setting. Select Publications B. Lau, L. Guevremont and V. K. Mushahwar, "Open- and Closed-loop Control Strategies for Restoring Standing using Intramuscular and Intraspinal Stimulation," IEEE Trans Neural Syst Rehabil Eng, 15: 273-285, 2007. L. Solis, D. Hallihan, R. E. Uwiera, R. B. Thompson, E. Pehowich and V. K. Mushahwar, "Prevention of Pressure-induced Deep Tissue Injury using Intermittent Electrical Stimulation," J Appl Physiol, 102: 1992-2001, 2007. S. M. ElBasiouny and V. K. Mushahwar, "Modulation of Motoneuronal Firing Behavior after Spinal Cord Injury using Intraspinal Microstimulation Current Pulses: A Modeling Study," J Appl Physiol, 103:276-286, 2007. L. Guevremont, J. A. Norton and V. K. Mushahwar, "A Physiologically-based Controller for Generating Overground Locomotion using Functional Electrical Stimulation," J Neurophysiol, 97: 2499-2510, 2007. S. M. ElBasiouny, D. J. Bennett and V. K. Mushahwar, "Simulation of Ca+2 Persistent Inward Currents in Spinal Motoneurons: Mode of Activation and Integration of Synaptic Inputs," J Physiol (Lond), 570.2: 355-374, 2006. J. Bamford, C. T. Putman and V. K. Mushahwar, "Intraspinal Microstimulation Preferentially Recruits Fatigue-Resistant Muscle Fibres and Generates Gradual Force in Rat," J Physiol (Lond), 569.3: 873-884, 2005. R. B. Stein and V. K. Mushahwar, "Reanimating Limb Movements after Injury or Disease," Trends in Neurosci, 28: 518-524, 2005. R. Saigal, C. G. Renzi and V. K. Mushahwar, "Intraspinal Microstimulation Generates Functional Limb Movements after Spinal Cord Injury," IEEE Trans Neural Syst Rehabil Eng, 12: 430-440, 2004. S. Yakovenko, V. K. Mushahwar, V. Vanderhorst, G. Holstege and A. Prochazka, "Spatiotemporal Activation of Lumbosacral Motoneurons in the Locomotor Cycle," J Neurophysiol, 87: 1542-1553, 2002. V. K. Mushahwar, D. F. Collins and A. Prochazka, "Spinal Cord Microstimulation Generates Functional Movements in Chronically Implanted Cats," Exp Neurol, 163(2): 422-429, 2000. V. K. Mushahwar and K. W. Horch, "Selective Activation and Graded Recruitment of Functional Muscle Groups through Spinal Cord Stimulation," Annals NY Acad Sci, 860: 531-535, 1998.
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