Could virtual reality neurofeedback help stroke survivors recover?
USC researcher Sook-Lei Liew awarded two-year American Heart Association Innovative Research Grant to find out.
BY JOHN HOBBS MA ’14
To accomplish this task, your brain will send a signal that will pass from neuron to neuron all the way down your arm to your hand to your fingers, which will grasp the latte, bring it to your lips and, ah, frothy, caffeinated goodness.
When someone suffers a stroke, the brain is damaged, and many of the neurons needed to control movement can be either damaged or missing altogether, making it difficult or impossible to move their limbs.
While traditional therapies might focus on having the patient practice moving their arms, hands and fingers to reactivate damaged neural pathways, this can be a nonstarter for someone with severe motor impairment who can’t move at all.
A better treatment might lie inside a VR headset, according to USC researcher Sook-Lei Liew, who was just awarded a $150,000 Innovative Research Grant from the American Heart Association to explore the possibility of using the immersive world of virtual reality to create a brain-computer interface to treat stroke survivors.
“To regain movement ability after a stroke, survivors need to strengthen pathways from the brain to the muscles of the hand,” Liew explained. “This is difficult for people with severe motor impairments because they can’t see their hand move when they try to move it.”
To give stroke survivors the necessary visual feedback, Liew developed REINVENT — “Rehabilitation Environment using the Integration of Neuromuscular-based Virtual Enhancements for Neural Training” — which uses virtual reality as well as brain and muscle sensors to show hand movement in the virtual world when the patient has used the correct brain and muscle signals even if the patient cannot move his or her hand in the real world.
“Our long-term goal would be for patients with severe motor impairment after stroke to be able to use REINVENT immediately after their stroke, in their hospital rooms in between therapy sessions and even when discharged home if they are still experiencing motor impairments,” Liew said.
She added that even more importantly than being innovative, REINVENT is both portable and cost-effective, which could lead to more widespread adoption if successful.
“REINVENT and other portable home programs allow the patients to augment traditional therapy with additional practice by themselves in a motivating environment even if they have little to no movement.”
The American Heart Association Innovative Grant began this month and will fund Liew’s REINVENT research through the end of 2017.
Liew is an assistant professor with joint appointments at the USC Chan Division of Occupational Science and Occupational Therapy, the USC Division of Biokinesiology and Physical Therapy and in the neurology department at the Keck School of Medicine of USC.
She joined the USC faculty in January 2015 and runs the Neural Plasticity and Neurorehabilitation Laboratory, which focuses on helping stroke survivors recover.
Who knew medical records had a ‘social life’?
Two USC researchers show how paper records impact interactions with health care practitioners
Also published at USC News
For more than a decade, electronic health records have been hailed as a means of improving health care quality, safety and efficiency. Yet in spite of the ongoing transition to electronic records throughout America’s health care system, two USC researchers are interested in their traditional hard-copy format and the value, if underappreciated, they still hold.
Occupational science doctorate candidate Amber Angell and her mentor, Assistant Professor Olga Solomon, of the USC Chan Division of Occupational Science and Occupational Therapy examined data from Solomon’s multidisciplinary urban ethnographic study, “Autism in Urban Context,” funded by the National Institute for Mental Health.
For approximately three years, Solomon and her research team followed 23 African American families with children diagnosed with autism spectrum disorder living in Los Angeles County — interviewing, observing and video-recording them in their homes, in doctor’s offices, in their children’s schools and out in the community.
The researchers asked nuanced questions about how the families, who face persistent disparities in autism diagnosis and interventions, used their child’s health records when seeking and acquiring autism services, how the records impacted their interactions with health care practitioners and how the records affected the families’ own meanings and experiences.
Angell and Solomon discovered what they subsequently termed the “social life” of paper records — the ways in which records are not strictly confined to medical contexts but instead literally traveled in cars, buses, bags and backpacks into homes, schools, clinics and throughout the community. For example, parents brought thick, chronologically ordered binders filled with records and documents to meetings in schools and doctor’s offices, often as a way of validating their own knowledge and expertise to professionals.
Angell and Solomon also learned how the subtleties of written descriptions in records can have consequences beyond the delivery of care. Descriptions of parents’ employment status, for example, positively or negatively influenced clinicians’ perceptions of them. For parents actively trying to project a “good parenting” persona, that task became more or less difficult simply because of descriptions in medical records.
Until recently, clinicians haven’t had to think much about how patients or families might feel about what’s written in their records.
The researchers’ findings were published in a Social Science & Medicine article which, in December, received the 2015 Diana Forsythe Award from the American Medical Informatics Association. The winning article, “The Social Life of Health Records: Understanding Families’ Experiences of Autism,” was selected as a co-recipient from more than 30 other nominations. The award is named in memory of Forsythe, a pioneer of medical informatics — the interdisciplinary field of how data is used and managed in biomedical research, clinical care and public health.
The USC researchers insist that recognizing the “social life” of health records, regardless of digital or analog formats, is critical for improving family–practitioner relationships.
“Until recently, clinicians haven’t had to think much about how patients or families might feel about what’s written in their records,” Angell said. “Now, as electronic health records are changing how patients and families engage with their records, this is something for clinicians to take into consideration.”
Four alumnae award-winners cap 2015 OTAC conference
The USC Chan Division of Occupational Science and Occupational Therapy was well represented at the 39th annual conference of the Occupational Therapy Association of California (OTAC) in Sacramento.
Four alumnae were recognized for their outstanding achievements at the annual OTAC awards ceremony: Lisa Test MA ’89, OTD ’09 received the Lifetime Achievement Award, clinical instructor Julie Bissell MA ’79, OTD ’12 received the Award of Excellence, assistant clinical professor Chantelle Rice BS ’07, MA ’08, OTD ’09 received the OT Practice Award and fieldwork education coordinator and clinical instructor Karen Park MA ’02, OTD ’13 received the Fieldwork Educator Award.
59 Trojans were also scheduled to present their work at conference sessions and poster displays throughout the three-day conference, and on the evening of Oct. 23 nearly 100 alumni, students and friends celebrated USC’s longstanding relationship with OTAC at a Trojan Family Reception hosted in the Hyatt Regency Sacramento hotel.
The 2016 OTAC conference is scheduled for October 27–30, 2016, at the Hilton Pasadena and Pasadena Convention Center.
Assistant professor Jenny Martínez makes for a Good Neighbor
By Jenny Martínez OTD, OTR/L
The Good Neighbors-funded STAR program connected me with a USC research laboratory during my senior year in high school. I worked in the Alcohol and Brain Research Laboratory under Dr. Ronald Alkana and Dr. Daryl Davies. I spent several hours each day during and after school in the lab engaging in various research-related activities. I learned to read research articles, operated lab equipment, collected data for my research project, developed research posters and presented my work. I also received a stipend to work in the lab full-time during the summer with graduate students and STAR alumni mentors.
The STAR program gave me early, immersive and unparalleled exposure to the scientific process and academia that would have otherwise been out of my reach. I met people who helped me apply to college, taught me about college and graduate school, shared their experiences with me and supported me as I made decisions about my education. I find that I am continuing to build on the base of networking, research and professional skills that I started developing in STAR even to this day as an occupational therapist and faculty member here at USC.
Programs like these make higher education and professional careers accessible. They are truly worthwhile efforts toward addressing the devastating effects that a decreased availability of social capital, finances, and access to high-quality resources can have. These initiatives teach new knowledge, provide meaningful experiences, increase confidence and socialize students to professional skills and behaviors, all while expanding support networks that will be there even beyond college admission.
USC’s 21st Good Neighbors campaign, with a fundraising goal of $1.6 million, runs through the month of October.
After 27 years as division chair, Florence Clark to step down from administrative duties
The respected researcher, educator and leader to focus full-time on scholarship and division initiatives.
Florence Clark PhD, OTR/L, FAOTA, associate dean and chair of the USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, after much reflection, has decided to step down from her administrative positions after the 2015-16 academic year. The announcement was made to USC Chan faculty, staff and students in a memorandum distributed October 14 by Avishai Sadan DMD, MBA, dean of the Ostrow School of Dentistry of USC within which the USC Chan Division of Occupational Science and Occupational Therapy is administratively operated.
Dr. Clark joined USC’s faculty in 1976 as an assistant professor in what was then known as the Department of Occupational Therapy. In 1983 she was promoted to the rank of associate professor, and in 1989 was appointed department chair at the rank of professor. Due to a strategic administrative realignment, in 2006 the department expanded to become a division within the USC School of Dentistry, and Dr. Clark was appointed the inaugural associate dean of the newly created division.
Dr. Clark was installed as the first Mrs. T.H. Chan Professor in Occupational Science and Occupational Therapy, an endowed faculty position created in 2014 by the unprecedented $20 million gift made by USC Trustee Ronnie C. Chan and his family, which also formally named the division as the USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy. Dr. Clark will continue to hold this named professorship.
“It has been a tremendous honor to serve as our division’s associate dean and chair,” said Dr. Clark. “I am so grateful for the many accomplishments, friendships, discoveries and joys that have imbued my personal and professional life, and I am invigorated to return to being a full-time scientist and educator on our faculty.”
During Dr. Clark’s 27 years of leadership, the USC Chan Division has grown exponentially: its budget today is 22 times larger than what it was in 1989, the faculty size has grown from seven members to more than 80 full-time members and extramural research funding has increased to more than $27 million of cumulative federal support.
During her tenure as chair, Dr. Clark also served one term as president of the American Occupational Therapy Association, acquired more than $10 million of federal research funding on most grants of which she served as principal investigator and was instrumental in securing the Chan family’s naming gift, the first and largest of its kind made to any occupational therapy program in the history of the field.
“We have been very fortunate to benefit from her leadership,” wrote Dean Sadan in the announcement. “I look forward to … her continued accomplishments as she returns to life as a full-time academic.”