Jun 21, 2017, in General News
By Miriam E. Tucker/Medscape
An occupational therapy intervention can help improve HbA1c and improve quality of life in young adults with diabetes, new research finds.
Results from the randomized, controlled Resilient, Empowered Active Living (REAL) diabetes study were presented June 11 here at the annual meeting of the American Diabetes Association (ADA) 2017 Scientific Sessions by Beth Pyatak, PhD, who is both an occupational therapist and a certified diabetes educator at the University of Southern California, Los Angeles.
Occupational therapists are generally thought of in a rehabilitative context, but “It’s an emerging practice area within the past 10 years or so to focus on chronic disease management,” Dr. Pyatak told Medscape Medical News, explaining that the main goal of occupational therapy (OT) is to help people accomplish their daily tasks, of which diabetes management involves many.
Jun 13, 2017, in General News
Assistant professor Sook-Lei Liew MA ’08, PhD ’12 is exploring new brain-computer interfaces that connect stroke survivors to the worlds of tech and medicine.
By Katharine Gammon
For people recovering from a stroke, even the simplest motions can become a struggle. To lift a hand, for example, requires a signal from the brain that travels all the way down an arm to the hand. That’s a lot of moving parts — and when something is damaged, it makes regaining those skills an arduous and slow process.
That could all change, though, with the help of some innovation and advances in virtual reality.
It was almost by chance that USC Chan researcher Sook-Lei Liew started thinking about virtual reality. She was a neuroscientist; so was her husband. When she became a USC faculty member in 2015, her husband got a job in the Mixed Reality Lab at the Institute for Creative Technologies — and, between the two, a brain trust was born between VR and stroke rehab.
For Liew, the light bulbs really started to flash when she attended the Neurotech conference — a big industry-academic partnership featuring the latest in tech advances. Liew had already been working on stroke rehab for awhile and worked on brain-feedback interfaces — devices that essentially allow patients to see what is going on inside their brains.
At the Neurotech conference, something clicked.
“There was a lot of tech, but not a lot of science behind it,” says Liew, who also has joint appointments with the USC Division of Biokinesiology and Physical Therapy and the Department of Neurology and the Mark and Mary Stevens Neuroimaging and Informatics Institute at the Keck School of Medicine of USC.
Liew started to dig into VR research and found some fascinating studies about bodies inside a VR system. One study showed that if you give someone an avatar with long arms in the virtual world, they interact with the real world as if they had long arms. The effect even lasts for 10 or 15 minutes after a person removes the VR headset.
And another study showed if you give someone a child-like body in VR, that person starts to have more child-like features in the real world.
That made Liew wonder something that would change her work forever: “If you give someone a healthy body in VR, will that help them recover their health?”
She launched a project in January 2016, submitting a grant proposal to the American Heart Association and receiving $150,000 to explore the possibility of a VR brain-computer interface to treat stroke survivors. She and her partners (initially her husband but then other researchers) wanted to create something that was low-cost and portable. Her lab, the Neural Plasticity and Neurorehabilitation Laboratory, was home base for the work.
Most brain-computer interfaces used functional magnetic resistance imaging (fMRI), a huge and expensive technology that measures brain activity by detecting changes associated with blood flow. “The problem is that it’s really hard to get somewhere if you have a severe stroke,” Liew says. “Typically you can’t drive, and your mobility is impaired.” That made it all the more vital to get the device to people, rather than have people come to the tool.
The team built a prototype, using a laptop computer, an off-the-shelf VR rig, a $9 swim cap and an open-source brain-computer interface electroencephalogram (EEG) system. Liew used her mother’s sewing machine to connect the electrodes to the cap. The whole system costs less than $5,000. It’s called REINVENT: Rehabilitation Environment using the Integration of Neuromuscular-based Virtual Enhancements for Neural Training.
This is how it works: The system uses virtual reality as well as brain and muscle sensors to show arm and 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 arm or hand in the real world. Over time, they can train the damaged circuits to work again.
So far, the system has only been tested on healthy older adults, but, in the next six months, it will be tested on people recovering from a stroke.
Ryan Spicer, a programmer analyst on the project, pointed out that older adults are generally a population that isn’t thought of as VR adopters — but some of them were very interested. The initial results showed that the healthy older adults were happy to use VR. Spicer says that, in the future, the activities and art could be tailored to each person’s interests.
The team demonstrated the project at the South by Southwest festival earlier this year, and the experience was mind-bending for Liew. “Our booth was across the hall from NASA, and they had a Mars habitat. Whereas we had a system that was sewed together with my mom’s sewing machine,” she says, with a laugh.
Still, she says they received great feedback during the conference. Out of 38 VR demonstrations, REINVENT won a special prize: Special Jury Recognition for Innovative Use of Virtual Reality Technology in the Field of Health.
“Most of the demonstrated uses for VR are gaming or entertainment right now,” Liew points out. “But the future has got to include VR for healthcare too.”
Liew is certain to play a role in shaping the future, thanks to a new federally funded grant that she received in March. The $530,000 award from the NIH National Institute of Child Health and Human Development will fund Liew’s “Big Data Neuroimaging to Predict Motor Behavior After Stroke” study.
Liew and her team will apply advanced computing techniques to a very large database of brain images and behavioral information gathered from thousands of participants worldwide. The ultimate goal is to reveal neural and behavioral biomarkers hidden within the “big data” in order to better predict stroke recovery potential and to personalize rehab treatments. The four-year project will be funded through 2020.
Are people in the future going to be controlling houses and cars with their brains? Liew thinks it’s unlikely. “If you can use your hands, your brain has lots of experience telling your hand to manipulate things,” she says. “The area where VR is the most useful is where they allow us to do things we can’t otherwise do.” That could include, for example, immersive worlds to distract people while they’re getting chemo in the hospital. “It’s a way to take your body out of a situation,” Liew says.
David Krum, a computer scientist on the team, agrees.
“Everyone is excited about entertainment, but there are other uses for VR,” he says. “A lot of companies are more interested in monetizing games. Some of these other applications are a really important social good, but the economics of it are different.”
Liew sees VR as a true interdisciplinary venture: “It’s a blend of tech, industry, science and the clinic,” she says. “It really takes it to a whole new level.”
May 10, 2017, in General News
Alison Cogan MA ’12, PhD ’17 may be a civilian but she deeply appreciates the social and family life of military servicemembers.
Not only is her brother an active duty Marine, Cogan’s dissertation for the occupational science PhD degree she will receive this Friday during the 75th annual commencement ceremony of the USC Chan Division of Occupational Science and Occupational Therapy focused on ways to optimize participation of servicemembers after mild traumatic brain injury.
“I’ve seen how families are affected by the deployment cycle, and the reintegration and readjustment process that follows,” says Cogan, who hails from Philadelphia. These issues, of course, become more complex with brain and bodily injuries.
Cogan will soon begin a two-year Veterans Affairs Advanced Fellowship in Polytrauma/Traumatic Brain Injury at the Washington DC VA Medical Center. There she will hone her skills with using large research databases, building towards her goal of becoming a funded, independent career researcher. Thanks to USC Chan, she’s well on her way.
“USC has given me so many tangibles and intangibles,” Cogan says. “I have learned how to be productive in ways that really matter, from faculty members who know what it takes to be successful.”
May 9, 2017, in General News
Joseph Christian Ungco ’07, ’14, MA ’16, OTD ’17 has a clear vision for the profession’s future. Thanks in part to the occupational therapy doctorate degree he will receive this Friday during the 75th annual commencement ceremony of the USC Chan Division of Occupational Science and Occupational Therapy, Ungco is now bringing it to fruition.
The four-time Trojan and New York native, who is already licensed and working back in Manhattan, is determined to advance occupational therapy’s capacity for meeting the specific health needs of LGBTQ populations, particularly clients who are transgender and otherwise fluid in regards to the gender spectrum.
“The OTD program at USC really empowers people who can see occupational therapy’s distinct value,” Ungco says, “especially in ways that the profession has yet to explore.”
Between interning at the Los Angeles LGBT Center’s Youth Services Program, co-teaching a course on clinical strategies for inclusivity and developing a capstone project, Ungco’s doctoral experience has been a multi-faceted year of innovation and leadership in queer health. Turning one’s passions into actions is at the heart of USC’s OTD program, Ungco says.
“If it doesn’t exist, you can make it a reality.”
For as long as she can remember, Alicia Mendoza MA ’17 has admired the work of Christian missionaries. In occupational therapy she found a career with similar attributes: provision of needed services, expertise for developing community programs and individualized focus on helping people transcend their circumstances, whatever and wherever they may be.
While at USC, the Northern California native has worked with Professor Mary Lawlor on research projects and manuscript writing, has taught students as a classroom assistant and has served as the division’s co-chair of the USC Student-Run Clinic. But the biggest lesson, she says, is fueled by her faith.
“I think I’ve learned how to be with people,” says Mendoza, who will receive her master’s degree in occupational therapy this Friday during the 75th annual commencement ceremony of the USC Chan Division of Occupational Science and Occupational Therapy.
“Jesus spent time with people in their hard places, and it can be painful to just be with people when they’re suffering. But as occupational therapists, sometimes that’s the most powerful thing we can do.”