FDA's "Innovation Pathway". How the HandTutor system can teach patients to use a bionic hand

The Food & Drug Administration FDA launches Medical Device "Innovation Pathway". This initiative aims to speed the introduction of breakthrough medical devices. The first project is the brain-controlled, upper-extremity prosthetic. This project follows on from the DARPA-funded prosthetic bionic arm and hand project. The initiative aims to speed the introduction of a military project to create a prosthetic arm http://bit.ly/gv2bmp.
The HandTutor system measures isolated and coordinated finger and wrist movement. The dedicated rehabilitation software allows for movement guidance to show the patient how to move their hand or prosthetic and augmented feedback to show that the prosthetic is moving. A combination of guidance and visual augmented feedback allows for learning motor movement.

Bimanual Upper Limb Training in stroke

In the January edition BMC neurology http://bit.ly/eEXL5d Dr. Sleimen-Malkoun and her team from Institut des Sciences du Mouvement CNRS & Université de
la Méditerranée, Marseille, France and Laveran, Service de Réhabilitation Fonctionnelle, 13 Marseille, France discuss bimanual training strategies to help clinicians to adapt therapy in order
to maximize rehabilitation benefits.

The HandTutor and ArmTutor systems incorporates virtual functional task practice that includes bilateral training techniques that allow for intensive practice using both upper limbs.
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Evidence for neuroplasticity

Neurological damage and stroke in particular, is the leading cause of long term disability worldwide. In just the last two decades, science has begun to appreciate the central nervous system's attempts to repair itself through a process termed neuroplasticity. Recent advances in non-invasive functional neuroimaging techniques, such as positron emission tomography (PET), functional MRI (fMRI) and near-infrared spectroscopy (NIRS), have enabled the study of brain activity in humans after stroke. Presented in brief are landmark papers that describe how adaptive changes occur in the human brain after focal neurological damage. These changes are thought to be due to re-organisation of neural networks following the brain injury and are thought to play a role in recovery of function following stroke.

Cross-sectional studies at chronic stages of stroke have demonstrated that the pattern of brain activation is different between paretic and normal hand movements, and suggested that long-term recovery is facilitated by compensation, recruitment and reorganization of cortical motor function in both damaged and non-damaged hemispheres (Chollet et al., 1991; Weiller et al., 1992; Cramer et al., 1997; Cao et al., 1998; Ward et al., 2003a).
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Subsequent longitudinal studies from subacute to chronic stages (before and after rehabilitation following intensive physical and occupational therapy) have revealed a dynamic, bihemispheric reorganization of motor network. (Marshall et al., 2000; Calautti et al., 2001; Feydy et al., 2002; Ward et al, 2003b).
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