The Next Step in Pediatric Rehabilitative Boots

ASQ grant helps Miami University students develop
breakthrough design to benefit children with cerebral palsy

MILWAUKEE, July 18, 2005 ­ A grant from the
American Society for Quality (ASQ) Biomedical
Division awarded to Miami University of Ohio has
led to the design of a new and improved active
orthotic boot for children afflicted with
cerebral palsy (CP). The prototype, designed to
assist patients in their rehabilitation process,
was unveiled at ASQ’s World Conference in May
2005 by the team of students from the
university’s manufacturing and mechanical engineering department.

“Children who have spastic diplegia CP often will
walk on their toes,” said Michael Bailey-Van
Kuren, Ph.D., assistant professor at Miami
University. “Many methods of rehabilitation, with
existing problems, are applied to curb this form
of cerebral palsy. With new materials and
controls technology, new design, and new system
components, we hope our orthotic boot leads to
improved rehabilitative therapy.”

Recognizing a need for improvement in
rehabilitative orthotic boots, and working with
healthcare professionals, Bailey-Van Kuren led a
team of three students to develop a prototype
that seeks to advance the rehabilitation of
children with CP. Spastic diplegia, a commonly
occurring form of CP, often requires surgery in
later years to lengthen calf muscles.

Current orthotic boots provide stability without
actuation. The new device incorporates actuators
and a microcontroller that will monitor patient
feedback through foot angle and pressure exerted
against the boot. As each step is taken, the
microcontroller will analyze pressure and input
signals while providing output voltage to the
system actuators. The magnitude and duration of
the system output can be tuned and customized for
each patient according to the recommendations of
a professional pediatric physical therapist.

The new active orthotic boot hopes to alleviate
several problems that exist in the rehabilitation
process of children with spastic diplegia CP. One
is the inability of therapists to effectively
enforce daily stretching routines for patients.
Second, dynamic ankle foot orthotic (DAFO) braces
hold the patient’s foot in a stretched position
that prevents the ability to walk normally.
Third, the current design and serial casting
cause (s) itching, loss in muscle strength and
discomfort to the user. Also, in order to achieve
the ultimate goal of normal patient walking, the
boot must be equipped to measure results and track progress.

A system of components with enhanced designs has
been created for the current orthotic boot to
overcome existing problems. The system actuators
have the ability to move and stretch leg muscles
as part of a daily physical therapy routine.
Shape Memory Alloys (SMA) has been implemented to
provide the structure and motion needed for
therapy and the flexibility for added comfort.
System sensors, placed at the ball of the foot,
will differentiate when the patient is sitting
versus standing and monitor the interaction
between the user and boot. The electrical system
and configuration will help rehabilitate the
patient by constantly monitoring and adjusting to
the therapist input incorporated in the microcontroller program.

As the prototype and new active orthotic boot
take the next step – refinement of the original
concept – and ultimately completion, Bailey-Van
Kuren is proud of the work completed by his team
of students. “The new device could improve home
therapy for children with cerebral palsy and be
applied to other rehabilitative devices,” added Bailey-Van Kuren.

To highlight the potential of quality to benefit
humanity, ASQ provides grants and knowledge
transfer to improve our communities and life.
Headquartered in Milwaukee, Wisconsin, ASQ is the
world’s leading authority on quality. With more
than 100,000 individual and organizational
members, ASQ offers technologies, concepts,
tools, and training to quality professionals,
quality practitioners, and everyday consumers,
encouraging all to Make Good Great®.

For more information, visit http://www.asq.org. Find out more about cerebral palsy treatments and therapies at 4MyChild.

Work by the South Australian Cerebral Palsy Research Group, a joint initiative of the University of Adelaide and the Women’s and Children’s Hospital, is included in the latest progress report of the Dana Alliance for Brain Initiatives, which highlights the top findings in brain research.

The research, which was earlier published in the British Medical Journal, supports the theory that exposure to certain viral infections shortly before and after birth can trigger brain damage and the development of cerebral palsy.

The study involved 443 children with cerebral palsy and 883 control babies born to Caucasian mothers between 1986 and 1999. Small dried blood samples taken within a few days of birth were used to test for the presence of neurotropic viruses, a group of viruses including the herpes virus, which can all cross the placenta and infect the fetus.

Exposure to viral infection was common in all newborn babies, especially in preterm babies, implying that infection before birth may also be linked to preterm delivery. Herpes group B viruses were found more often in babies who were later diagnosed with cerebral palsy than in control babies. In fact, the risk of cerebral palsy was nearly doubled with exposure to herpes group B viruses.

“This is the first study to positively link viral exposure during pregnancy with cerebral palsy,” Dr Gibson said. “However, only a few of the fetuses that were exposed developed CP, and this suggests that some are more genetically susceptible. We are investigating this.” Further studies also are investigating the possible causes of the link.

If you think your baby was exposed to herpes virus and developed cerebral palsy please contact 4MyChild Care Specialists for help. Read more about the causes of cerebral palsy in children.

Kishor Tahiliani and his wife, Priti, plan to raise £18,000 for stem cell injections that they believe will give their daughter, Vaishnavi, known as Shonia, a more normal life.

The treatment is not yet available in the UK but a hospital in China has made a breakthrough in treating cerebral palsy. The procedure involves injecting stem cells into the spinal cord fluid. The stem cells then flow directly into the brain.

The treatment at Tiantan Puhua Neurosurgical Hospital in Beijing has already helped 19-year-old Gabor Bocskai from Hungary to walk, sit up, swim, concentrate for longer, see better and speak.

Mr Tahiliani, 34, who works in hotel management, said: “This is the best treatment for her. There are cerebral palsy children who were totally blind and now they can see, that’s in Mexico.”

Read the entire article. Find out more about stem cell research and cerebral palsy.

From the BBC’s website:
Botox injection helps boy to walk

Oliver was diagnosed with cerebral palsy.
A four-year-old boy who was told he would never walk unaided has taken his first steps just a month after being given a revolutionary treatment.
Oliver Smith from Rothwell, Northants, had his muscles injected with botox in April to help him walk.

Oliver was diagnosed with cerebral palsy when he was 18 months old and had only ever been able to walk with the help of splints and walking sticks.

His mother Sarah, 24, said: “He looked like the cat that got the cream.”

She said: “It was unbelievable, there was no warning. It was not prompted, he just let go and did it.”

He has started to move between equipment and furniture at school without sticks which is great.

Sarah Smith

Oliver suffers from spasms which cause the muscles in his legs to become tight and make walking difficult.

The botox injections work by relaxing the tendons in his calves, allowing him to put his feet flat on the ground.

To read entire article please visit: http://news.bbc.co.uk/2/hi/uk_news/england/northamptonshire/6617743.stm

World-Class Stem Cell Treatment Facility Follows up Parkinson’s Successes with Another Medical Triumph, Brings New Hope of Effective Treatment for Thousands with CP

BEIJING, April 19, 2007 — Tiantan Puhua Neurosurgical Hospital, the world’s leading center for effective treatment of Parkinson’s disease and stroke, today here announced a breakthrough in the worldwide treatment of Cerebral Palsy (CP) by introducing neural stem cells through a safe, non-evasive procedure to 19-year-old Gabor Bocskai from Hungary.

The stem cells are introduced into the patient’s spinal cord fluid (via Lumbar Puncture) and by the spinal fluid circulation goes directly into the brain. The successful procedure, performed at China’s top stem cell facility, makes Mr. Bocskai the first teenage European CP patient to see rapid improvement through stem cell therapy. Unedited videos taken before and after Mr. Bocskai’s injections dramatically demonstrate the profound improvement in his 19-year battle to walk, write, focus his eyes, concentrate and overcome the many other detrimental effects resulting from the CP he acquired at birth. More details and the videos have been published on China’s leading Stem Cell News site at http://www.stemcellschina.com.

Some of Mr. Bocskai’s most noticeable and immediate physical improvements after the eight-week stem cell therapy program include improved vision, increased eye focus and better concentration on one subject. He also reported clearer writing, enhanced muscle tone, the ability to sit up unsupported and a new capability to walk and swim in an unassisted manner. As a lifelong quadriplegic with paralysis in his lower limbs, Mr. Bocskai was never able to walk independently, using a wheelchair for transportation. Within four months of the initial treatment, he stated that he was able to walk with the help of a walker and no other support, and at a rate three times faster than ever before with increased maneuverability in his legs and torso. Even his speech became clearer and faster.

To read complete article visit http://www.ereleases.com/pr/20070419006.html

Sara Gauthier / For The Sudbury Star

With wide, curious eyes, Jenna Fournier looks around at all the people gathered in the gymnasium at St. Jerome School.

The cameras in particular seem to grab her attention.

Jenna, 5, is an example of what Botox can do for children with spastic cerebral palsy.

“Botox, for us, is a miracle drug,” says her mom, Jennifer Collin. “So, we’re hoping it lasts a long, long time.”

The little girl turns her head toward her mother and leans in. Her forehead rests on her mom’s and their noses touch.

A slight smile appears on Jenna’s face.

“If it wasn’t for the Botox, she’d probably be in a wheelchair right now,” says Collin. “She would not be independent the way she is.
And she’s walking with canes now, too. In the past two years, she went from not walking with a walker, to running with a walker, to walking.”

Jenna started getting the Botox injections when she was just 18 months.

To read complete article visit The Sudbury Star

University of Michigan kinesiology department is offering therapy for adults and teenagers with cerebral palsy- online!
Called Project ULTrA (Upper Limb Training and Assessment), the program allows therapy to take place in front of a computer screen using streamed video and works on upper limb strength, flexibility and movement. The software uses virtual trainers AS WELL AS real-life experts at the Motor Control Lab to complete movement-based therapy programs. The program also collects data to determine how well the in-home therapy is working.

If you wold like more information about Project ULTrA you can contact

Colleen Lewis, Ph. D.
Laboratory Phone: (734)-763-5829
E-mail: ultra@umich.edu

Postal Address

The Division of Kinesiology
University of Michigan
401 Washtenaw Ave.
Ann Arbor , MI , 48109-2214

website: http://www.med.umich.edu/opm/newspage/2007/hmultra.htm

In depth look at the surgery: http://www.pediatric-orthopedics.com/Treatments/Perc_Lengthening/perc_lengthening.html

Cytomegalovirus is commonly found and is part of the herpes family of viruses. CMV infects between 50 to 80 percent of all U.S. adults by age 40. There is no cure for it and there are rarely symptoms.

About 10 to 15 percent of newborns with congenital CMV end up with a long-term disability like developmental disabilities, cerebral palsy and deafness. CMV also can damage the placenta, leading to miscarriage.

Research is now being done in labs on guinea pigs to find a vaccine, and results have been promising. The vaccine helps stop the infection from crossing the placenta and infecting unborn babies. The virus is often undetected in pregnant women and the vaccine is given before pregnancy.

Studies on humans are set to begin shortly.

We are a small company in Haifa, Israel who developed a music instrument for
therapy. Our main focus was cognitive disabilities, Autism, CP (cerebral palsy) and
rehabilitation. Please refer to our website at analog-tone.com.

The Soundgen as a therapy tool showed very promising performance. It could be put to use to achieve various therapy objectives. We are interested in finding a group that could carry a pilot with the Soundgen in the Dallas Fort Worth area; however, we are open to get suggestions from other states, areas in USA. The population that we are looking at is kids with Autism, CP
and Rett syndrome. The group should be involved with an educational academy or school, and provide both occupational and music therapy services.

Contact:
Farah Jubran
Manager and Chief Engineer
011-972-4-8102691
011-972-52-2998864