Tackling Rehabilitation Issues in the Laboratory and in the Clinic

Investigators in rehabilitation medicine at NewYork-Presbyterian and Columbia University are seeking to enhance the understanding of the body’s healing processes and develop new approaches to restore function and mobility faster and more effectively than ever before.

A Focus on Fish

Columbia University scientist Joanna Smeeton, PhD, and her team are using a zebrafish arthritis model to better understand joint regeneration and gain insights that might be applicable to people. Why the zebrafish? Its joints are not dissimilar to human joints, and investigators can induce arthritis in the animal that is similar to human arthritis. The transparency of the zebrafish allows the investigators to view changes in the jaw joint and ligaments. Its genome has also been sequenced, making it an excellent model to study regeneration. This model is a major step toward gaining a better understanding of tissue regeneration and healing.

Building a Better Robot Hand

Joel Stein, MD, Chairman of Rehabilitation and Regenerative Medicine at NewYork-Presbyterian, and Columbia University mechanical engineering professor Matei Ciocarlie, PhD, received a four-year $1.2 million federal grant for a project entitled Adaptive Robotic Hand Orthosis with Multimodal Sensing and Continuous Learning. The researchers are developing a continuously learning robotic hand brace with peripheral sensors that detect the use of a patient's upper arm muscles by electromyography and adapt the movement of the orthosis to the user's anticipated needs. Dr. Stein and Dr. Ciocarlie had already produced a powerful hand orthosis to be used by stroke survivors; this more advanced model could further improve user control of the device. It is intended for patients with hemiplegia during post-stroke therapy and throughout a survivor's life to help accomplish daily tasks such as grasping a glass or grooming.

The Ethics of Rehabilitation

Should everyone engage in rehabilitation? Who should make decisions for cognitively impaired patients? Patients with cognitive deficits and low levels of consciousness due to traumatic brain injury, degenerative conditions, or other causes may not fully understand why they are engaging in rehabilitation or experience the same benefits as individuals with better neurologic function. These are important questions and issues being addressed by Debjani Mukherjee, PhD, who was recently recruited to Weill Cornell Medicine to work with other rehabilitation ethicists and neurologists to address the best ways to rehabilitate patients with low levels of consciousness.

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