Guttmann Institute

Barcelona, Spain

Guttmann Institute

Barcelona, Spain
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Martinez-Assucena A.,Hospital Requena | Marnetoft S.-U.,Mid Sweden University | Rovira T.R.,Guttmann Institute | Hernandez-San-Miguel J.,University of Valencia
Critical Reviews in Physical and Rehabilitation Medicine | Year: 2010

Multiple sclerosis (MS) often leads to different levels of severity and progression of impairment and disability and to dissimilar levels of limitation in activities and participation in different social domains, with varying impacts on quality of life (QoL) among people with MS (PwMS). Results have shown that, for PwMS, prioritizing goal setting may enhance adherence to treatment. Interdisciplinary rehabilitation may prolong the functional status level of PwMS, may result in transient improvement in the aspects of impairment features, may increase their participation in activities, and may improve their QoL, even when disease progression is not modified. Single rehabilitation packages of comprehensive care have proven beneficial, such as physiotherapy, which enhances aerobic capacity, strength, pain, mood, mobility, and QoL. Occupational therapy can help reduce the impact of impairment on QoL, especially fatigue. Neuropsychological interventions, such as learning and memory remediation, psychological intervention for depressive disorders, and acquistion of coping skills and self-management techniques help PwMS to adjust to disease and disability. Speech therapy can improve intelligibility of communication. Learning swallowing techniques can help prevent material from entering the airway. Clean intermittent self-catheterization can help prevent urinary tract infections. Power wheelchairs enhance occupational performance and energy conservation. Further vocational rehabilitation settings and research are required for more appropriate interventions due to high unemployment rates among PwMS. Comprehensive care for PwMS should include planning for future independent living and long-term care needs. © 2010 Begell House, Inc.


Faller J.,University of Graz | Solis-Escalante T.,University of Graz | Costa U.,Guttmann Institute | Opisso E.,Guttmann Institute | And 3 more authors.
International IEEE/EMBS Conference on Neural Engineering, NER | Year: 2013

Co-adaptive training paradigms for event-related desynchronization (ERD) based brain-computer interfaces (BCI) have proven effective for system setup and training of healthy users. However, there is little evidence as to whether co-adaptive ERD based BCI training paradigms could also benefit severely disabled users, including persons with spinal cord injury (SCI). Here, we present a preliminary study involving individuals with SCI at cervical level. In a cue-paced paradigm, our co-adaptive BCI analyzes the electroencephalogram from three bipolar derivations (C3, Cz, and C4), while the user alternately performs right hand movement imagery (MI), left hand MI and relax with eyes open. After less than five minutes of data collection, the BCI auto-calibrates and provides feedback for the MI task that can be classified better against relax with eyes open. The BCI then regularly recalibrates the underlying classifier model. In every calibration step, the system performs rigorous outlier rejection, selects the one out of six predefined logarithmic bandpower features (9 to 14 and 16 to 26Hz for the bipolars at C3, Cz and C4) that shows highest discriminability, and trains a linear discriminant analysis classifier. In under 30 min of training, all six tetraplegic users reached better than chance (p=0.01) online ERD based BCI control at an overall mean accuracy of 69.5 ± 6.4 %. These positive findings encourage us to evaluate the efficacy of adaptive BCI systems in users who have functional disability as a result of pathologies other than SCI. © 2013 IEEE.

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