Research at PTRS

Investigator: Gad Alon, PhD, PT SOM Faculty Profile GPILS Faculty Profile

 

Therapeutic Technologies Laboratory

For the past decade we have been focusing on translating the rapidly growing bio-engineering and electro-physiological knowledge of functional electrical stimulation (FES) into clinical practice. The long term goal is to maximize functional recovery following damage to the central nervous system (CNS). Our current focus is on converging various technologies using the unique advantages of each in the hope of maximizing recovery of upper extremity and locomotor ability.

Grant Support

Current Research Support
Source: Industry supported by Restorative Therapies Inc.
Title: FES Based Motorized Cycle Effects On Chronic Stroke: A Feasibility Study.
Principal Investigator: Gad Alon
Period: 2008-2009

Projects

• FES based motorized cycle effects on chronic stroke

  Direct evidence that multi-muscle FES combined with motorized cycle system can specifically enhance lower extremity recovery of stroke survivors has only began to emerge. The purpose of this study is to test the feasibility of providing an 8 weeks training protocol for chronic stroke survivors using multi-muscle FES synchronized with motorized cycle system and collect preliminary data on performance changes of selected impairments and ambulation deficits. We are recruiting 10 chronic ambulatory stroke survivors. Patients undergo initial screening to ascertain that they meet all inclusion criteria. Admitted subjects are trained to cycle on the RT300-S™, while FES is activating the plantar flexors, dorsiflexors, quadriceps, and hamstrings of the paretic lower extremity. Each training session last 31.5 min and patients come to the PTRS department 3 times per week for a total of 8 weeks. Study outcome measures are collected pre-and post training and include changes of paretic lower extremity global strength, active range of motion at the ankle and knee, and fasting blood glucose. In addition, changes in performing the Get-up and go test, walking velocity both over ground and on a treadmill are documented. Significant pre-post changes of each outcome measure will be tested using paired t-test or Wilcoxon signed ranks test for parametric and non-parametric data respectively (α=0.05). The data will enable calculations of the training protocol’s effect size and sample size needed for a controlled randomized clinical trial.

Video: FES Cycle Demo

(Click the play button)

 

Collaboration

University of Maryland, School of Medicine
Vincent Conroy DscPT

University of Maryland Medical Center
Thomas Donner, M.D., Medical Director University of Maryland Joslin Diabetes Center

University of Maryland School of Dentistry, Biomedical Sciences
Joel Greenspan, Ph.D. Research Project: Gonadal Steroid Hormone Modulation of Pain-related Cortical Activity

American Heart Association (0575060) “Electrical stimulation dosing and neural mechanisms of recovery in subacute stroke” Stephen J. Page PI.

NIH R01 CA120950-01A1 “Efficacy of electrical stimulation for dysphagia in Head & Neck cancer patients”. Susan E. Langmore PI.

Recent Publications

• Alon G. Defining and measuring residual deficits of the upper extremity following cerebral vascular accident (CVA): A new perspective. (Accepted for publication Topics in Stroke Rehabilitation January, 2009)
• Kim T, Gordes KL, Alon G. Utilization of Physical Therapy in Home Health Care Under the Prospective Payment System. (Accepted for publication Journal geriatric Physical Therapy January, 2009)
• Alon G, Levitt AF, McCarthy PA. Functional Electrical Stimulation (FES) May Modify the Poor Prognosis of Stroke Survivors with Severe Motor Loss of the Upper Extremity: A Preliminary Study. Amer J Physical Med Rehabil 2008;87:627-636
• Alon G, Levitt AF, McCarthy PA. Functional electrical stimulation (FES) enhancement of upper extremity functional recovery during ischemic stroke rehabilitation: A pilot study. Neurorehabil Neural Repair 2007;21:207-215.
• Benjamin SJ, Flood JN, Bechtel R, Alon G. Measurement of soft tissue temperature and impedance following the application of transdermal direct current. Physiotherapy 2007;93:114-120.
• Alon G, Smith GV. Tolerance and conditioning to neuro-muscular electrical stimulation within and between sessions and gender. Journal Sports Science & Medicine 2005;4:395-405.
• Gullapalli RP, Maitra R, Roys SR, Smith GV, Alon G, Greenspan J. Reliability estimation of grouped functional imaging data using penalized maximum likelihood. Magn Reson Med 2005;53:1126-1134.
• Alon G. Training dosage and timing of electrical stimulation may be the key for maximizing the effects of NMES in neuro-rehabilitation. In: Soroker N, Ring H, editors. Advances in Physical and Rehabilitation Medicine: Monduzzi Editore; 2003. p. 441-447.
• Alon G, Ring H. Gait and hand function enhancement following training with a multi-segment hybrid-orthosis stimulation system in stroke patients. J Stroke & Cerebrovascular Disease 2003;12(5):209-216.
• Alon G, Stibrant-Sunnerhagen K, Geurts ACH, Ohry A. A home-based, self-administered stimulation program to improve selected hand functions of chronic stroke. NeuroRehabilitation 2003;18:215-225.
• Smith GV, Alon G, Roys SR, Gullapalli RP. Functional MRI determination of a dose-response relationship to lower extremity neuromuscular electrical stimulation in healthy subjects. Exp Brain Res 2003;150(1):33-9.
• Alon G, McBride S. Selected functional gains for subjects with C5 tetraplegia using the NESS Handmaster neuroprosthesis. Arch Phys Med Rehabil 2003;84:119-124.
• Gorman PH, Alon G, Kornhauser SH. Electrotherapy: Medical Treatment Using Electrical Currents. In O’Young BJ, Young MA, Stiens SA: Physical Medicine & Rehabilitation Secrets, 3rd ed. Hanley & Belfus, 2007, pp.225-232.
• Gorman PH, Alon G, Peckham, PH. Functional Electrical Stimulation in Neurorehabilitation. In: Selzer ME: Neural Repair and Rehabilitation. Cambridge University Press, Chapter 43, 2006.