October 2012

Meditation for Caregivers

Meditation’s Proven Benefits for Caregivers and Older Adults

Gyms and spas have been boasting the benefits of meditation and yoga for quite some time, and many people find it to be a great outlet for reducing stress. Two recent studies–one focusing on senior adults and the other focusing on caregivers of Alzheimer’s patients–show that meditation does indeed reduce stress and loneliness.

The first study was conducted by Carnegie Mellon University’s J. David Creswell and provides the first evidence that mindfulness meditation reduces loneliness in older adults. Loneliness has been proven to be a major risk factor for health problems, such as cardiovascular disease and Alzheimer’s, and death in our senior population. Attempts at community based programs such as community centers and senior socialization programs have been largely ineffective, so the idea that meditation could be a fix for the problem is encouraging.

“We always tell people to quit smoking for health reasons, but rarely do we think about loneliness in the same way,” said Creswell, assistant professor of psychology within CMU’s Dietrich College of Humanities and Social Sciences. “We know that loneliness is a major risk factor for health problems and mortality in older adults. This research suggests that mindfulness meditation training is a promising intervention for improving the health of older adults.”

In the study, researchers studied 40 healthy adults ranging in age from 55-85 who had an interest in learning about mindfulness meditation techniques. Each was assessed at the beginning of the study, and again at the end, using an established loneliness scale. Blood samples were also collected. Half of the participants received the 8-week Mindfulness-Based Stress Reduction (MBSR) program. They spent two hours each week learning body awareness techniques, which they practiced 30 minutes each day. They also attended a day long retreat.

The results were interesting. In addition to reporting decreased loneliness, the group that participated in the MBSR program also had lower levels of pro-inflammatory gene expression in their immune cells than they did at the beginning of the program.

“Reductions in the expression of inflammation-related genes were particularly significant because inflammation contributes to a wide variety of the health threats including cancer, cardiovascular diseases and neurodegenerative diseases,” said study collaborator Steven Cole, professor of medicine and psychiatry and biobehavioral sciences at the UCLA School of Medicine. “These results provide some of the first indications that immune cell gene expression profiles can be modulated by a psychological intervention.”

Mindfulness Meditation for Caregivers

The second study took place at UCLA and was led by Dr. Helen Lavretsky, a senior author, professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and director of the UCLA’s Late-Life Depression, Stress, and Wellness Research Program. The study looked at the stress levels in family caregivers of Alzheimer’s patients and the benefits of yoga for their day-to-day life.

“We know that chronic stress places caregivers at a higher risk for developing depression,” she said “On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress.”

The study participants were randomly placed in two groups. One group was taught the 12-minute yoga practice, which included Kirtan Kriya Meditation (KKM). The yoga practice was done each day at the same time for eight weeks. The second group listened to instrumental music on a relaxation CD for 12 minutes each day, also at the same time each day. Blood samples were taken at the beginning and end of the study. The results showed that 68 genes responded differently after the KKM practice, which resulted in a lower immune system inflammation response. When inflammation is continually activated, it contributes to many problems.

“The goal of the study was to determine if meditation might alter the activity of inflammatory and antiviral proteins that shape immune cell gene expression,” said Lavretsky. “Our analysis showed a reduced activity of those proteins linked directly to increased inflammation. This is encouraging news. Caregivers often don’t have the time, energy, or contacts that could bring them a little relief from the stress of taking care of a loved one with dementia, so practicing a brief form of yogic meditation, which is easy to learn, is a useful too.”

Mindfulness and yogic chanting–our view of health and medicine keeps getting broader and more all-encompassing every day!


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Universal Design Inclusive Playground

Universal Design Makes Playgrounds Inclusive of Disabilities

For parents like Laurie Schulze, the playground is not often a place associated with fun and happy memories. Her daughter, Leah, has spina bifida and was unable to enjoy the majority of the playground equipment that was designed without kids in wheelchairs in mind. But all of that changed on a beautiful sunny day in Westerville, Ohio, when Laurie and Leah found an inclusive playground.

“It was very emotional because it wasn’t just Leah playing,” Schulze said. “There were other children with disabilities with their families. Just to see her jumping in and participating was so great. Words can’t describe how wonderful that felt.”

The playground at Millstone Creek Park is one of about 100 inclusive playgrounds in the United States, and was built with the intention of allowing children of all ages and learning levels, including those with disabilities, to enjoy the benefits of play.

“Everything melted together and it was just amazing to see everyone playing together,” Schulze said. “There were happy smiling faces everywhere. It was wonderful chaos.”

Universally Accessible Playground for Kids with Disabilities

The Importance of Inclusive Playgrounds

Inclusive playgrounds address the needs of all children, including those with autism, hearing impairments, cerebral palsy, spina bifida and other challenges, according to information in a recent report titled Inclusive Play Design Guide from Playworld Systems, a leading playground equipment manufacturer.

“From birth until death, play is a vital part of human development,” said JC Boushh, a Design for Play expert. “For children, especially, play is how they come to understand the world around them. Play provides those things that you can’t get anywhere else.”

According Mara Kaplan, lead expert for Let Kids Play and mother of a child with disabilities, play can even help mitigate stereotypes and biases that many adults and children have about children with disabilities.

“A typically developing child who’s never seen a child with a disability will just start playing with them because they haven’t been told that person is different or weird or strange,” she said.

While the Americans with Disabilities Act does have established guidelines for specifications on playgrounds, the guidelines don’t promise a fun playground that is inclusive for all kids. The guidelines and standards aren’t always followed, and the ADA just updated the guidelines with better design practices for playgrounds.

“The requirements are now much better defined and much more enforceable,” Boushh said. “We came up with the idea of an inclusive playground, but no one really defined it. Only now are people starting to really understand what inclusion is.”

“Most kids with disabilities have been outside the scope of play,” he added. “There was nothing for them to do once they got to the playground. Now, the idea is to design playgrounds that are inclusive not just for mobility impairments but also for cognitive and sensory disabilities.”

The Inclusive Play Design Guide helps playground designers better understand what kids need, and defines inclusion so that effective playgrounds can be built and managed. A range of experts, from landscape architects to parents of children with disabilities, were consulted before the Inclusive Play Design Guide was written.

Universal Design Accessible Playground Equipment

The Cost of Inclusive Playgrounds

The cost of building a normal playground is estimated to be around $100,000. The cost to build an inclusive playground is between $500,000 and $1 million. The playground at Millstone Creek Park was largely funded by community fundraising and the effort of parents like Laurie Schultz.

“The majority, about 75 percent of the funding, comes from outside sources,” Boushh said. “Most are funded by grants and fundraisers.

“There is often money from the city, park district, or school,” Kaplan said. “People fund-raise and raise money the way they always have. There is also a lot of support from local foundations and businesses because the playgrounds are built for the community and their needs.”

Experts agree the playgrounds are worth every penny.

“I hope there will be more in the future and that people will make conscious decisions on how to design these playgrounds,” Kaplan said. “It’s no fun to sit on the sidelines and watch siblings and friends play.”

“I am encouraged that I see more of these parks coming,” Schulze said. “Millstone is just amazing because everyone can play together. Every time I drive by it makes me smile.”


Employment First Act Hiring Disabled Workers

The Bipartisan Push to Increase Disability Employment

Democratic Governor Jack Markell from Delaware and Republican Congressman Pete Sessions from Texas are nearly polar opposites ideologically speaking, but that has not stopped the two have from uniting together to help push a public-private initiative to get companies hiring disabled workers. Currently, over 80% of the disabled workforce is unemployed, a number the two agree is out of control.

Governor Jack Markell and Representative Pete Sessions

In mid-July, the National Governors Association (NGA) met in Williamsburg, Virginia. The hot topic of the meeting was the nation’s extremely high unemployment rate, and how to create jobs for the millions of the nation’s unemployed. However, Governor Jack Markell, who was recently selected to head the NGA for the next year, chose to focus on the special needs community.

“There are a lot of people who want to be working in our country, and aren’t given a shot.” stated Gov. Markell, who dubbed his initiative, “A Better Bottom Line: Employing People with Disabilities.”

Governor Markell believes that a targeted initiative “can move the needle” in regards to hiring. He believes that the 80% unemployment rate those with disabilities face is “staggering” and that the solution is outreach and education.

Delaware Governor Jack Markell Employment First Act

Texas Representative Pete Sessions is the chair of the National Republican Campaign Committee (NRCC). His politics are polar opposite of Governor Markell, who is a Democrat and a huge supporter of the Obama campaign. Markell was surprised to find such a passionate ally in Sessions when it came to disability rights.

Representative Sessions has a son with Down syndrome. He has publicly commented on having one son in the upper 2% of academic ability, and one in the lowest 2%. It was the difference between the two that motivated him to become the leading Republican advocate in Congress for those with physical and mental disabilities.

TX Rep Pete Sessions with His Son with Down Syndrome

Sessions stated that his sons, Bill, 22, and Alex, 18, both have needs and goals, they simply have to be met differently. “He can’t be the state wrestling champion like Bill, but he has pride and he wants to be successful, too.” Alex has already overcome obstacles to become an Eagle Scout like his older brother, father and grandfather before him.

It’s a well-known fact that today’s GOP does not celebrate former Republican president George H.W. Bush’s Americans with Disabilities Act, signed in 1990. Sessions is not looking for another government-driven program. On the contrary, he thinks there are far too many at the state and federal level currently. He got behind Markell’s initiative because it’s a public-private initiative that doesn’t force businesses to do anything.

Governor Markell Signing Employment First Act for Disabiltiies

While Markell doesn’t have the personal experience that Sessions has to spur his desire for change, he did have a moment where the light bulb turned on. Markell was attending an event sponsored by Bank of America, when he met a newly hired 25-year-old with Down syndrome. Markell asked the new hire what he did before getting the job with Bank of America, and and the young man responded that for six years he watched TV with his mom and Dad. Markell knew it was time for change.

Delaware Governor Markell Signs Disability Employment First Act

While it has taken a while for Markell to bring the issue into focus, he signed the Employment First Act (House Bill 319) into law in Delaware, which requires state agencies that supply services to the disabled to also consider hiring them. This is the first step in what Markell and Sessions hope will be many of positive change for workers with disabilities.


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Lifeguard Nick Malafronte Paralyzed and Learning to Walk

Young Lifeguard Paralyzed While Diving, Ready to Walk Again

Last year, Nick Malafronte was a happy 19-year-old working as a lifeguard at Island Grove Park in Abington. He had just completed his first year at Westfield State University and was spending time with a friend, throwing a ball around on the dock, when he landed in a shallow area of water and broke two vertebrae as he hit the bottom. Despite being told he would never walk again, Malafronte is determined to beat the odds.

Nick Malafronte Before Paralyzing Diving Accident

The story of how Malafronte became paralyzed from the chest down is an all too common story. Every year, 12,000 spinal cord injuries take place. Of those, 8.2% are sports related, and it is believed that two-thirds of all sports related spinal cord injuries happen in or around water.

The injury led Melafronte to Dan Cummings, founder of Journey Forward, a rehabilitation facility in Canton, where he is a client. Cummings has a similar story, having become paralyzed after diving off a boat into shallow water, also at age 19. Melafronte sees Cummings as a sort of inspiration now.

“When I met Dan and heard his story, I saw what’s possible,” said Melafronte. “Dan told me it doesn’t happen overnight, and to never give up. He said it would be a game of inches, and to keep fighting. He told me it’s all about the three D’s — determination, desire, and dedication. I always carry that with me.”

Paralyzed Nick Malafronte Learning to Walk

Melafronte is using a piece of equipment called the Lokomat, which is a computerized machine that uses robotic technology to walk paralyzed individuals using a harness and pulley system. The computer tracks movement and lets the trainer know if the patient’s muscles are doing any of the work or if the machine is causing the movement.

“The first time I used the Lokomat, I was pumped. It was really cool,” he said. “It feels kind of normal. I can feel the weight in my legs.”

The therapists at Journey Forward have Melafronte sitting up on his own during workouts that focus on his arms and upper body, and his dad is thrilled with the results. “I have seen so much more movement in Nick’s arms and strength in his upper body. What he can do with his arms now is fantastic.”

Cummings sees something of himself in Melafronte. “We had similar injuries at the same age in a similar way,” he said. “He has the right attitude; he’s a hard worker, and he firmly believes in himself. He knows he can accomplish anything. That’s just how I was.”

Nick Malafronte Paralyzed and in Walk Therapy on Lokomat

Cummings was also told he would never walk or feed himself again, and despite all odds, he learned to dress himself, tie his own shoes, be independent at home, and drive his car. He eventually found a program called Project Walk, which pushed him harder to achieve his goals. After four years at Project Walk, Cummings walked out with the aid of a walker and had a new goal: to provide the same type of program in Massachusetts.

“What I learned at Project Walk and have proven through my own success is that exercise is absolutely essential to any level of recovery for any injury,” he said. “It doesn’t reverse the injury — it just makes it possible to get better.”

Cummings found a private donor, and armed with $350,000, he set out to start his non-profit program. Journey Forward opened with two staff members and eleven clients, and has grown to have 16 employees and 58 clients. They even have a waiting list.

The work that Cummings has done has enabled Melafronte to achieve some of his goals, and he’s working hard on achieving the remaining ones. Therapists have told him that if he keeps up the hard work he’ll be able to move to a non-motorized wheelchair and start driving again. He also recently got into the pool for the first time after his accident, and completed the skydiving trip he and friends were planning before the accident.


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Spina Bifida Fetal Surgeon Scott Adzick on Right

Fetal Surgery for Spina Bifida: Good News 10 Years Later

In most spina bifida cases, the children have the hole exposing the spine closed after birth. However, about ten years ago some doctors began controversial surgeries that closed the hole in utero, with the hope that some of the disabling effects of spina bifida could be reversed.

For over a decade, pioneering hospitals including The Children’s Hospital of Philadelphia, Vanderbilt University Medical Center, and the University of California, San Francisco (UCSF) have offered the elective in utero surgery. Many believe that the in utero surgery will be the preferred treatment, especially after the first federally funded human trial had such promising results, which were released in 2011.

Dr Scott Adzick Spina Bifida Fetal Surgeon

Last year, the National Institute of Health announced the success of the surgery in regards to offsetting some of the negative effects of spina bifida following the human trial. Once the clinical trial results were made public, other hospitals began showing interest in performing the fetal treatments as well. However, after seeing the rigorous process first hand, many hospitals opt to refer their patients to CHOP instead.

Offering the fetal treatments requires an extensive amount of infrastructure and involves very detailed selection requirements to institute the availability of the surgeries, according to Dr. Scott Adzick, the Department of Surgery Chief at the Children’s Hospital of Philadelphia (CHOP). Dr. Adzick is also one of the pioneers of the fetal surgery. CHOP is one of the largest full-service fetal diagnosis centers in the world. It also has a special delivery unit that evaluates over 1,000 mothers and fetuses per year to determine their candidacy for the surgery. Of those, only 150, on average, are selected to be surgery recipients.

“We have very strict criteria. We feel strongly that fetal surgery should not be done beyond 26 weeks of gestation because research has shown it does not have a significant benefit [after this point,]” Adzick said.

Each hospital has different protocols in place to determine who is a good fit for the surgery. At CHOP, factors such as high blood pressure, diabetes, and some genetic disorders will disqualify a mother and unborn baby from being candidates for the fetal surgery. The National Institute of Health is expected to release guidelines sometime in the near future that will help make the selection process more standardized from hospital to hospital.

Fetal Surgery for Spina Bifida Performed by Doctor Scott Adzick

When asked if the in utero surgery will be the preferred treatment for spina bifida at some point in the future, Adzick replied, “I think it already is the preferred treatment. For candidates, it is the best standard of care option if the mother understands the risks,” he said. “There have been incontrovertible findings that there is a benefit to treating the condition this way.”

Last year, Stephanie Dunn found out that her son was going to be born with spina bifida. Shortly after the diagnosis, Dunn heard of the in utero surgery, but hesitated as she would be required to stay at CHOP before and after the surgery, and she had two young daughters to care for.

Gary Dunn Received Spina Bifida Fetal Surgery

Eventually, the mother and full-time teacher decided to commit. She had the surgery in May 2011, and stayed in Philadelphia until Gary’s birth in August while her family was back home in Florida. At eight months of age, Gary had to have a shunt placed in his head to drain fluid building up on the brain. This is a common affect of spina bifida, but one that some surgery patients are lucky enough to avoid.

Gary Dunn with Sisters Post Spina Bifida Surgery

“Everything we’ve been through has given us a stronger bond,” Dunn said. “He is so happy, but I keep thinking of what could be coming. I still don’t know if he is going to walk or not. How will I support his confidence?”

What Dunn had that the parents from ten years earlier did not was an amazing support group comprised of ten years worth of children and parents that have experienced fetal surgery first hand. Every year, the CHOP holds an annual fetal surgery reunion, and this past June, over 1,300 patients of the 12,000 fetal surgeries came out to enjoy the festivities and show support to each other.

CHOP Fetal Surgery Family Reunion

“The fetal family reunion is our team’s favorite day of the year,” said Adzick. “As the field of fetal surgery and therapy continues to advance, specifically in light of our recent developments in fetal surgery for spina bifida, we look forward to treating more and more babies before they are born.”


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Achilles Walking Robot Mimics Human Gait

New Robot Accurately Mimics Human Walking Gait

A team of researchers from the University of Arizona has successfully produced a robotic set of legs, nicknamed Achilles, that they believe is the first to walk in a biologically accurate manner. The walking gait is remarkably human-like, largely due to neural architecture, musculoskeletal architecture, and sensory feedback pathways that are based off of humans, but simplified and built into the robotic legs.

A key factor in the human walking system is the central pattern generator, or CPG, which is a neural network in the lumbar region of the spinal cord. This area of the spinal cord generates the rhythmic muscle signals need to walk. The CPG produces and controls the muscle signals by gathering information from the various areas of the body that respond.

Achilles Walking Robot Design

CPG, in its simplest form, is what is referred to as a half-centre. The half-centre consists of two neurons that fire their signals alternatively to produce a rhythm. This rhythm is what allows us to walk without thinking about the action. In the robot, designers placed an artificial half-centre as well as the sensors that deliver the information back to the half-centres. One of the most important sensors is the load sensor, which senses the force that is in the limb when the leg is pressed against a stepping surface.

Achilles Human Walking Gait Robot

The researchers believe that babies begin life with a simple half-centre, similar to the one they placed in the robot. They hypothesize that over time the infant learns a network for more complex walking pattern. Past studies have shown that infants will exhibit a walking pattern when placed on a treadmill well before they learn to walk. With this theory, the reason for the walking gate in young infants would be owed to the half-centre that is already in place.

The study was co-authored by Dr. Theresa Klein. According to Dr. Klein, “Interestingly, we were able to produce a walking gait, without balance, which mimicked human walking with only a simple half-centre controlling the hips and a set of reflex responses controlling the lower limb. This underlying network may also form the core of the CPG and may explain how people with spinal cord injuries can regain walking ability if properly stimulated in the months after the injury.”

View the short video below from the Institute of Physics:


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Aquatic Stabilizer Apparatus for Cerebral Palsy Swimming

‘Magical’ Invention Helps Swimmers with Cerebral Palsy

David Blaski, a former magician turned senior clinical occupational therapist at Franciscan Omni Health and Fitness in Schererville, Indiana, helps patients recover skills needed for daily living. He met a young patient who loved the water, but had legs that crisscrossed in the pool. With a bit of creativity, he developed a patented solution that will benefit many children with cerebral palsy.

“(The girl’s) therapist lamented that they always had orthotics to reduce this condition for walking, but there was nothing for the pool,” Blaski said.

The young girl’s situation prompted Blaski to sketch out an idea for an apparatus that would make up for the loss of muscle tone commonly seen in cerebral palsy patients. With the help of his brother Kevin Blaski, he began constructing a prototype of his invention.

David Blaski's Aquatic Stabilizer Apparatus for Cerebral Palsy

“Some kids with cerebral palsy have difficulty with muscle tone, which causes the scissoring of the legs,” David Blaski said. “In this position, it’s hard for them to learn gait patterns and normal movement patterns. It almost freezes their bodies.”

The device, which is currently called the Aquatic Stabilizer Apparatus, helps align the body so that the arms and legs can be used more efficiently. While initially the buoyancy was a challenge, the brothers found a formula that worked, and even made the device useful for resistance swimming for regular swimmers.

Four children currently use the device in their aquatic therapy program at Franciscan Omni Health and Fitness, but Blaski will never forget the first child that he witnessed utilize the device.

“We videotaped it — it was amazing,” he said. “It was a jaw–dropping experience. To see this child who previously was unable to ambulate now able to tread water.”

Cerebral Palsy Aquatic Stabilizer Apparatus

The device is getting attention, and the brothers hope that a manufacturer will take interest and produce the device so that other children can benefit from aquatic therapy. The device won the 38th Annual Maddak Award for Best Innovation of the Year. Maddak is the largest U.S. manufacturer of assistive devices and other rehabilitation products.

“We didn’t want to start a company to manufacture this,” he said. “There’s a lot of good companies out there, so we’re looking for an established company who will manufacture it and sell it to the general public.”

Blaski is also holding a competition to help find a perfect official name for the device. The winner will win a custom fitted ASA unit as a reward.


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GT3D Glasses Operates Computer with Eye Tracking

Eye-Tracking Device Gives People with Disabilities Affordable Control

Multiple sclerosis, Parkinson’s disease, muscular dystrophy, amputations, and spinal cord injuries rob millions of people of the ability to interact with their surroundings. Computer usage can be a near impossibility, as these diseases and injuries typically affect mobility and the use of the arms and hands greatly. Good news is on the way, as a device that costs under $65 may provide this group of people with the ability to control their computers and interact with their surroundings using only their eyes.

IOP Publishing’s Journal of Neural Engineering showcased the new technology that is made of an eye-tracking device and “smart” software that allows the eye to act as a mouse, providing users with the ability to move a cursor on the screen.

The device, which was developed by researchers at the Imperial College in London, is known as the GT3D device. The reason it is so affordable is because it is made with off-the-shelf items that you wouldn’t expect to see in such a high tech gadget. The device uses two fast video game console cameras that cost around $30 each. These cameras are attached outside of the line of vision to a pair of $5 glasses.

GT3D Eye Tracking Mouse Controller Glasses

The cameras take a continual stream of photos that are used to determine where the pupil of the eye is directed. The researchers then used calibrations to work out where the person was looking on the screen. The researchers also utilized more precise calibrations to figure out a 3D gaze. With this information, they were able to determine how far into the distance the person was looking.

Another added bonus to this new device is that it’s solved what has been considered the “Midas touch problem.” In short, users could move a mouse arrow around a screen, but could not click on any icons easily. In past devices, users had to stare at icons or blink, and the results were less than accurate. With the GT3D device, users wink to click. Being that a wink is a voluntary action, unlike staring or blinking, it is considerably more timely and accurate.

Control a Computer with Your Eyes with GT3D Glasses

The researchers had study subjects play Pong without using hand controllers of any kind to see how quickly they learned to control the game paddles. Dr. Aldo Faisal, Lecturer in Neurotechnology at Imperial’s Department of Bioengineering and the Department of Computing, noted that six of the trial users had never used their eyes to control input previously, and scored within 20 percent of able bodied users after an impressively short 10 minutes of playtime.

According to Dr. Faisal, “Crucially, we have achieved two things: we have built a 3D eye-tracking system hundreds of times cheaper than commercial systems and used it to build a real-time brain machine interface that allows patients to interact more smoothly and more quickly than existing invasive technologies that are tens of thousands of times more expensive. This is frugal innovation; developing smarter software and piggy-backing existing hardware to create devices that can help people worldwide independent of their healthcare circumstances.”

And if you thought the GT3D was already incredibly affordable, this extra good news is really going to blow your mind! According to Dr. Faisal, “We originally created the device for £39.80 ($64) but recent falls in the price of video game console cameras mean we could now actually make the same device for about £20 ($32).” That’s exciting news, indeed!


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