Activation of a Rhythmic Lower Limb Movement Pattern during the Use of a Multimodal Brain-Computer Interface: A Case Study of a Clinically Complete Spinal Cord Injury.

Brain-computer interfaces (BCIs) that integrate virtual reality with tactile feedback are increasingly relevant for neurorehabilitation in spinal cord injury (SCI). In our previous case study employing a BCI-based virtual reality neurorehabilitation protocol, a patient with complete T4 SCI experienced reduced pain and emergence of non-spastic lower limb movements after 10 sessions. However, it is still unclear whether these effects can be sustained, enhanced, and replicated, as well as the neural mechanisms that underlie them. The present report outlines the outcomes of extending the previous protocol with 24 more sessions (14 months, in total). Clinical, behavioral, and neurophysiological data were analyzed. The protocol maintained or reduced pain levels, increased self-reported quality of life, and was frequently associated with the appearance of non-spastic lower limb movements when the patient was engaged and not experiencing stressful events. Neural activity analysis revealed that changes in pain were encoded in the theta frequency band by the left frontal electrode F3. Examination of the lower limbs revealed alternating movements resembling a gait pattern. These results suggest that sustained use of this BCI protocol leads to enhanced quality of life, reduced and stable pain levels, and may result in the emergence of rhythmic patterns of lower limb muscle activity reminiscent of gait.

Embodiment Comfort Levels During Motor Imagery Training Combined With Immersive Virtual Reality in a Spinal Cord Injury Patient.

Brain-machine interfaces combining visual, auditory, and tactile feedback have been previously used to generate embodiment experiences during spinal cord injury (SCI) rehabilitation. It is not known if adding temperature to these modalities can result in discomfort with embodiment experiences. Here, comfort levels with the embodiment experiences were investigated in an intervention that required a chronic pain SCI patient to generate lower limb motor imagery commands in an immersive environment combining visual (virtual reality -VR), auditory, tactile, and thermal feedback. Assessments were made pre-/ post-, throughout the intervention (Weeks 0-5), and at 7 weeks follow up. Overall, high levels of embodiment in the adapted three-domain scale of embodiment were found throughout the sessions. No significant adverse effects of VR were reported. Although sessions induced only a modest reduction in pain levels, an overall reduction occurred in all pain scales (Faces, Intensity, and Verbal) at follow up. A high degree of comfort in the comfort scale for the thermal-tactile sleeve, in both the thermal and tactile feedback components of the sleeve was reported. This study supports the feasibility of combining multimodal stimulation involving visual (VR), auditory, tactile, and thermal feedback to generate embodiment experiences in neurorehabilitation programs.

A New Methodology for Use by a Single Caregiver to Bathe Bedridden Elderly Persons Using Advanced Mechatronic Systems.

In the framework of this paper, we aimed to propose a methodology for giving baths to elderly, bedridden persons, when this task is performed by a single caregiver. Usually, two caregivers are required for nursing a bedridden patient, especially when certain important tasks are needed (e.g., bathing the patient), but this is not always possible. The entire study considers the primary user's perspective-the caregiver-who is responsible for a wide range of tasks; thus, suffering physical and psychological exhaustion over time. A physical prototype has been developed for allowing caregivers to perform tests in a life-like environment, by means of the device and the methodology. This technology, therefore, will represent an important contribution to the quality of life of caregivers. Considering an increase in the share of the elderly population and the related problems that arise in daily care, this project intends to be beneficial contemporarily. The presented methodology has been successfully tested and validated.

Bath-Ambience-A Mechatronic System for Assisting the Caregivers of Bedridden People.

The health of older people is receiving special attention and dedication nowadays, with the aim of increasing their general wellbeing and quality of life. Studies into different aspects of the care of the elderly have found that emphasis should be given to solving problems related to bathing in different situations and environments. In particular, it is important to develop new assistive technologies to streamline and ease the burden of a caregiver's daily tasks. Generally-speaking, in the case of bedridden patients, bathing is typically carried out manually by a caregiver, using towels, sponges, and a water basin. Nevertheless, this apparently simple task needs some precautions in order to avoid the risk of microbial infections, falls and other injuries. With that in mind, this paper presents the design of a portable washing system, called Bath-Ambience, which enables bedridden patients to be bathed efficiently without having to be moved from their position. This portable system can be installed in different situations, both in a domestic setting, and in specialized institutions, and allows the caregiver to perform the bathing tasks without compromising health and safety, thereby making it possible to offer a comfortable and hygienic procedure to patients, improving their quality of life. This paper presents the design of the portable Bath-Ambience washing system, which provides efficient assistance for bathing bedridden patients without moving them to another place. This system is mainly dedicated for integration a smart home application in to allow bathing everywhere.