Rehabilitative Bioengineering Research
We have rapidly emerged as one the strongest programs in Rehabilitative Bioengineering, with a large core of rehabilitation faculty at Marquette and continually growing ties between Marquette University and the Medical College of Wisconsin (MCW). The Department of Biomedical Engineering at Marquette University offers over 6,000 sq. ft of research space for its research efforts in Rehabilitative Bioengineering.
Orthopaedic and Rehabilitation Engineering
Administered through the Orthopaedic and Rehabilitation Engineering Center (OREC), research opportunities exist in motion analysis, orthopaedic biomaterials and rehabilitation engineering. These opportunities are afforded to faculty and students at Marquette University and to faculty, fellows, and residents in the Departments of Orthopaedic Surgery, and Physical Medicine and Rehabilitation at MCW. From a clinical perspective, OREC offers solid support for scientific investigation in the areas of orthopaedic biomechanics, biomaterials and histology, human motion analysis, and rehabilitation engineering. The clinical goal of OREC is to advance the quality of patient care in orthopaedic and rehabilitation medicine. In the rehabilitation area, OREC also has exceptional ties to and a collection of grants from the Shriners Hospital in Chicago.
Research in Human Motion Analysis Laboratory
The human motion analysis laboratory is designed to support a broad range of clinical and research oriented projects. Clinically, it is structured to evaluate adult, foot and ankle, pediatric, sports medicine and total joint patients during ambulation and other activities.
Research in Neurorehabilitation
We also have a special strength in neurorehabilitation, with the foundation being the Falk Neurorehabilitation Engineering Research Center
. We are also a member of the Midwest Rehabilitation Network [funded by a R24 grant from NIH, centered at the Rehabilitation Institute of Chicago (RIC)], which also focuses on neurorehabilitation. The Neurorehabilitation Center serves research and development (R&D) activities in neurorehabilitation, investigating optimal intervention strategies for movement therapy. R&D activities range from basic science (e.g., neuromuscular adaptive mechanisms) to the development and evaluation of innovative therapeutic intervention strategies. Integral to the FNERC are the Neurorobotic and Neuroevaluation Laboratories
, the Neuromechanics Laboratory
, and the Telemonitoring and Teletherapy Laboratory. Target populations are stroke and spinal cord injury, and to a lesser extent cerebral palsy and autism. Some projects specific to this area of research are:
This research is focused on characterizing how able-bodied persons and those suffering neuromotor impairment use sensory feedback to adapt movements in response to changes in operating conditions such as may occur during growth, tool manipulation, aging, and as a consequence of neuromotor injury. Of particular interest is the question of how information from the different senses is integrated into a coherent sense of limb position relative to the body and relative to an object to be manipulated. The objective here is to identify how best to manipulate this feedback to facilitate motor learning and skill acquisition in the able-bodied and to promote motor relearning following neural injury. Research is aimed at increasing our understanding of how the brain learns to control limb movement within novel mechanical environments. Robotic tools and fMRI are combined to answer fundamental questions of how the motor systems of the brain work: what region(s) of the brain are responsible for representing an internal model of the limb’s mechanical environment, and how do people adapt and compensate for injury to these neural systems consequent to hemiparetic stroke.
Neuromechanics following Spinal Chord Injury
This research aims to examine the interface between the human nervous system and the environment based on mechanical measurements of the control of movement, with a focus on spinal cord injury and stroke (contractures, spasticity, locomotion, autonomic dysreflexia). Specifically, research is focused on studying neuromuscular function following spinal cord injury or stroke with the intent of examining new ways of augmenting the ability to move following a neural injury. Studies examine issues related to control of movement, contracture, spasticity and spasms, locomotion, autonomic dysreflexia, exercise and rehabilitation using a combination of electrical stimulation, robotics, biomedical instrumentation and imaging.
Interrelationship of the Autonomic and Motor Systems in Spinal Cord Injury
This project examines how changes in autonomic regulation correspond to changes in motor function. Following spinal cord injury, control of blood pressure nd blood flow can be problematic, resulting in a clinical condition called autonomic dysreflexia. This condition appears to be linked clinically to increased spasticity. An improved understanding of how these systems relate will help in the treatment of these secondary complications and will provide insight into new techniques for treating spinal cord injury.
Changes in Cortical Reorganization in the Stroke Arm
This research focus is to examine whether Botox treatments of the arm produce plastic changes in the brain, particularly when the treatments are applied early post-stroke. Additionally, investigators would like to examine the cortical reorganization for bilateral, reciprocal motor control in stroke (looking at how the brain changes it’s control of walking after stroke and rehabilitation treatments). Finally, investigators would like to examine how brainstem pathways change their levels of excitability post stroke. These studies involve both fMRI and biomechanical measurements.
Telerehabilitation and Performance Assessment
Research is devoted to developing and putting into clinical practice a range of telehealth technologies and modes for wireline and wireless telecommunications. The primary targets are stroke neurorehabilitation and telecoaching for exercise therapy. A number of devices to be used in assisting with rehabilitation and telerehabilitation include:
- TheraJoy Technology
This project stems from an identified need was for technologies for arm rehabilitation that included some of the successful features of both rehabilitation robots and of mass-market input devices. This included the need for computer-assisted motivating rehabilitation (CAMR)-type technologies that provide arm movements over a larger range of motion.
One of the key barriers to telerehabilitation for neurorehabilitation applications is the lack of software tools that are customized to the needs and technologies of the rehabilitation process. UniTherapy, developed in Microsoft’s Visual Studio .Net environment using C# and the DirectX.9 software development kit (SDK) library of multimedia gaming tools, intends to address this need.
- TheraDrive technology
The aim of this work is to create a low-cost, commercially-viable, home-based rehabilitation system that can capitalize on CAMR concepts of steering wheel game therapy and skill training with functional training related to real activity to induce user-dependent CNS plasticity.
Intelligent Telerehab Assistants for Neurorehab - MedPredict
For Intelligent Telerehabilitation Assistants (ITA's) to be effective as intelligent user assistants or rehab prognosis predictors, the ITA needs to have context-awareness, i.e. a continually updated estimate of the state of the biosystem of the client that is based on any new information plus a-priori expectations of healing processes. To address this need, an event-driven dynamic recurrent neurofuzzy framework has been developed to predict prognosis in neurorehabilitation based on available evidence.
- Rehabilitation Robotics Lab
- ADL-specific Training for Upper Extremity Functional Recovery after Stroke
The application of robots in the rehabilitation of the upper extremity as therapy is a relatively new application and research area in biomedical engineering, and one with potentially great impact on daily lives of impaired persons. Research studies with robot-assisted therapy environments have indicated that these environments are able to achieve significant reduction in motor impairment and provide objective functional assessment and intensive training in a semi-autonomous environment. However, they still show less than adequate results in their ability to reduce functional disability in daily life. It has been suggested that CNS recovery after brain damage may be driven not just by repetition but by specific practice variables such as the performance of specific, intensive, and complex movements used to solve motor problems and attain goals. Research focuses on quantifying the effect of ADL-specific task practice on the recovery of upper extremity function after stroke and permanent transfer to daily life.
Ongoing and recently completed projects in Prosthetics Research:
- Mechanical and Perfusion Response of Human Soft Tissue
A rate controlled indentor with Laser Doppler Flowmetry (LDF) system was developed to apply load to the soft tissues of the lower extremity of individuals with varying levels of vascular health so as to identify potential new dynamic measures of vascular health and/or risk of vascular impairment. The repeatability of the resultant data was assessed, and these measures were contrasted with the current clinical gold standard’s, the ankle brachial index (ABI). Additional testing is currently underway on an expanded subject population so as to investigate the clinical utility of this device and the associated measures so as to dynamically assess the vascular health of an individual’s lower extremity tissues.
Functional Assessment of Prosthetic Knee Units for Trans-femoral Amputees
The field of prosthetics is growing ever more complicated as new components are being developed, including microprocessor controlled limbs and knee joints with stance and swing phase controls. Prosthetists and physicians must choose the most appropriate combination of components to provide the best possible care for each of their transfemoral amputee patients. Unfortunately, there are little quantitative data regarding the specific performance parameters of different prosthetic components. As a result, prosthetists must rely on manufacturer’s claims and their own experience in deciding which components are appropriate for their patients. The goal of this study is to provide quantitative (gait analysis) data for the evaluation of two types of prosthetic knee components that are prescribed to provide mechanical stability, the polycentric Total Knee 2000 by Ossur and the single axis 3R80 stance control knee by Otto Bock. Both of these two designs are indicated for use by transfemoral amputees with moderate to high functional levels who wish to maintain active lifestyles. Specifically, this study will investigate the hypothesis that the knee design that is most stable in stance phase will require a larger hip moment to initiate swing phase, thus resulting in a trade off between stance phase stability and swing phase initiation effort. Functional comparison of these two knee designs will reveal which design provides the best stability without resulting in a substantial increase in the effort required to initiate swing phase. In addition, the results of this study may provide valuable information that could be used in designing new prosthetic knee components that minimize trade offs between stance phase stability and swing phase initiation effort.
- Effect of Ankle Orientation on Heel Loading and Knee Moment In Ankle-Foot-Orthoses (AFO) for Individuals Post Stroke
Those who experience lower extremity weakness or paralysis following a stroke often exhibit gait deviations frequently caused by the inability to completely lift their foot upon swing through during gait. An AFO, a lower limb orthosis designed to assist in maintaining proper foot position and provide mediolateral support to the foot, ankle and subtalar joints, is commonly prescribed for individuals post stroke who experience this mobility impairment. The purpose of this research study was to vary ankle position and observe the effect on heel loading and subsequent knee stability during gait for individuals post stroke wearing an AFO.
- Patient-specific Design of Orthopaedic Implants with Engineered Internal Porosity
The development of solid freeform fabrication (SFF) technology, particularly with regard to biocompatible metallic materials, now allows the fabrication of implant geometries that would have been impossible as few as 3 years ago. Although a number of researchers have outlined implant design principles, and numerous fabrication techniques, including the use of SFF, few practical design methods have been proposed . This study attempts to combine patient-specific bone density data with an iterative process by which a gradient density structure is created within the body of a titanium implant. The study objectives are to verify that the resulting bending characteristics of the modified prosthesis with gradient density are predictable, represent an improvement relative to current implants and reduce the stiffness mismatch and bone remodeling that is typically noted in the proximal femur.