recoveriX PRO Neurotechnology | g.tec medical engineering GmbH

COMPLETE NEUROREHABILITATION SOLUTION

recoveriX Neurotechnology is a BCI-based closed-loop stroke rehabilitation system to train upper or lower extremities of patients who suffer from motor impairments due to stroke. It is ready to be used in your hospital or rehabilitation center to treat stroke patients.

recoveriX is the first brain-computer interface rehabilitation system that pairs mental activities (specifically, the imagination of movement) with visual and tactile feedback in real-time. If a subject imagines a joint movement and receives visual feedback through a virtual avatar, and tactile feedback through electrical muscle stimulation at the same time, then this rewarding feedback encourages the patient to imagine the movement correctly.

Beyond facilitating patient compliance, the simultaneous activation of both sensory and motor functions is essential in brain plasticity. That is, if the brain areas that control movements are active at the same time that feedback is provided, the brain areas should recover more effectively. On the other hand, if the patient receives feedback while not imagining hand movement, recovery will be poor.

PRODUCT HIGHLIGHTS

Hand therapy mode
Foot therapy mode (research mode)
Classification accuracy to quantify patient's performance
Easy, online EEG quality control
Real-time event-related desynchronization maps
Real-time functional stimulation of hands and legs
Mirror neuron system activation with a virtual avatar
Easy to understand instructions for the patient
Fully guided therapy runs for 45 minutes
CE certified medical product

TECHNICAL SPECIFICATIONS

Active EEG electrodes for perfect data quality16
Wireless EEG headset resolution 24 Bit
Functional electrical stimulator current1-60 mA
Battery life EEG headset>8 hours
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SYSTEM COMPONENTS

recoveriX PRO Neurotechnology comes with a personal computer that controls the components and accessories of the device. The external monitor is placed in front of the patient. The visual feedback shows the patient’s hands in a first-person perspective or feet in a mirror perspective. Two Functional Electrical Stimulators are stimulating the muscles, performing the dorsiflexion of both joints.

Finally, an EEG cap with 16 channels is included and allows a wireless charging and a fast switch from one patient’s cap to the other.

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MONITORING PATIENTS' PARTICIPATION

Patients may may misunderstand the instructions to imagine (or try to perform) specific movements while receiving feedback. Patients may be tired, depressed (including post-stroke depression), distracted, or perform compensatory strategies such as imagining the shoulder. If the patient does not imagine the movement, therapy will be less effective, leading to poorer outcomes.

recoveriX PRO gives an real-time feedback showing if the patient is doing every motor imagination correctly. This usually leads to a much higher level of motivation.

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MOTOR IMAGERY WITH REAL-TIME FUNCTIONAL ELECTRICAL STIMULATION

In this video shows how a patient is treated with recoveriX. The avatar on the screen indicates the hand movement that the patient should imagine. Then the BCI system is able to pick up the sensorimotor cortex is activated and it triggers a functional electrical stimulation of the corresponding hand. We are treating both, the left and the right hand to active both hemispheres. In the video you can see that the right hand was affected by the stroke and the index finger shows some spasticity. The left and right movement is produced by the electrical stimulator.

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recoveriX combines seven established standard therapies recommended by organizations such as the American Stroke Association and the Canadian Stroke Association for stroke patients. Better yet, recoveriX integrates cognitive tasks with movement exercises, which makes the therapy more successful for multiple sclerosis patients as well as stroke patients.

This unique rehabilitation approach of recoveriX promotes neuroplasticity in the brain, allowing the brain to build new pathways to relearn lost motor functions.

MOTOR IMAGERY

Motor Imagery is a cognitive technique in which a person imagines a hand, foot or other movement without actually becoming physically active. recoveriX ensures that actual movements only take place with the corresponding mental imagery.

VIRTUAL REALITY

In this method, patients have to follow the avatar’s instructions by simply imitating what is visualized and spoken. The recoveriX avatar can perform the movements that the patients imagine to increase motivation.

FUNCTIONAL ELECTRICAL STIMULATION

In FES therapy, electrodes specifically stimulate the dorsiflexors of the forearms or legs. When recoveriX recognizes a correct movement pattern, real-time stimulation of these muscles occurs, resulting in actual hand or foot movements.

 

MIRROR NEURON THERAPY

In this method, patients have to follow the avatar’s instructions by simply imitating what is visualized and spoken. The recoveriX avatar can perform the movements that the patients imagine to increase motivation.

BILATERAL TRAINING

recoveriX encourages the patient to practice motor imagery of both sides of the body, e.g. the affected right foot or the left hand. This approach is designed to support the
activation of both hemispheres of the brain.

CONSTRAINT-INDUCED MOVEMENT THERAPY

During recoveriX therapy, the healthy limb is constrained to stimulate the impaired limb. Patients must repeatedly imagine the movements of both the healthy and the impaired sides.

TASK-BASED TRAINING

By imagining the movement, the patient controls the avatar and can trigger actual movement through electrostimulation. If performed correctly, the hand or foot is raised and the patient can touch a small virtual ball.

CLINICAL IMPROVEMENT FROM THE MS STUDY

A group study showed that recoveriX was effective for upper and lower limb treatment. Multiple Sclerosis patients improved in standing up and sitting down, balance, walking speed, walking distance, spasticity, MS impact and fatigue. The improvement in fatigue is especially interesting because there is no other treatment available.

clinical improvements from the multiple sclerosis study

Clinical Improvements in the Upper Extremity after Stroke Treatment

CLINICAL IMPROVEMENT IN THE  UPPER EXTREMITY AFTER STROKE TREATMENT

The efficacy of recoveriX upper extremity treatment was shown in a group study with chronic stroke patients. Patients could move their upper extremities better after treatment. The improvement depended on the stroke severity but was always above the clinically important difference. The recoveriX therapy works even 10, 20 or 30 years after the stroke.

CLINICAL IMPROVEMENT IN THE  LOWER EXTREMITY AFTER STROKE TREATMENT

The efficacy of recoveriX lower extremity treatment was shown in a group study with chronic stroke patients. recoveriX patients improved their walking speed on average by 0.19 m/s. The best other treatment option (electromechanical gait training with end effector training) led to 0.11 m/s improvement. Importantly, recoveriX is easier to use and does not need a body weight support system because patients are seated during the recoveriX therapy.

Clinical Improvements in the Lower Extremity after Stroke Treatment

MORE RESULTS FROM THE STUDY…

The clinical effectiveness was shown in a group study with 52 patients who improved in motor functions and spasticity highly significant.

The recoveriX PRO study investigated 52 patients (3.3 years after stroke) with a mean FMA-UE (Fugl-Meyer Assessment of Upper Extremities) at baseline of 17.0 points. The study showed a signifanct improvement of FMA-UE of 4.76*** points.

Severly impaired patients (FMA-UE: 0-28) improved 3.8*** points, moderatley impaired patients (FMA-UE: 29-42) improved 7.99*** points, mildly impaired patients (FMA-UE: 43-66) improved 5.29*** points. People that achieved an average classification accuracy >80 % improved by 6.5 points, people that were below 80 % had an improvement of 2.3 points.

 

The following tests showed additionally a significant improvement: Bartel**, Modified Ashworth Scale Wrist***, Modified Ashworth Scale Fingers***, Box and Block Test of Affected Hand**, Box and Block Test of Healthy Hand***, 9-hole PEG Test of Affected Hand*, 9-hole PEG Test of Healthy Hand***, Fahn Tremor Rating Scale of Affected Hand**, Fahn Tremor Rating Scale of Healthy Hand**, Lower Extremity Fugl Meyer Assessment*, Montreal Cognitive Assessment*, Stroop Color-Word Test**.

Other control studies got on average an improvement of 3.92 points in FMA-UE (FES, robotic movement, visual feedback). *** <0.001, ** <0.01

Stephen et al. (2012) defined the clinically important difference (CID) for moderately to minimally impaired patients in chronic stroke. This CID refers to the UE-FM improvement and is 4.25 to 7.25 points. recoveriX achieved for moderately impaired patients 7.99 points which is higher than the CID. For minimally impared patients, recoveriX achieved 5.29 points which is in the range of the CID. Furthermore, the study showed that recoveriX leads to the same improvement independent of how long ago the stroke happened (Range: 6 month to 31 years).

PRIVATE REHAB PRACTICE

recoveriX can be added into your neurological rehabilitation practice which gives you a competitive advantage. Think about the statistical number of stroke patients in your region and you’ll get a rough idea of how many potential patients you can treat with recoveriX.

By servicing a complete region, you create a unique selling proposition because there is no treatment comparable to recoveriX. The more recoveriX systems you have, the more patients you can treat simultaneously.

FRANCHISE OPPORTUNITY

HOSPITAL OR REHABILITATION CENTER

When patients suffer a stroke or other neurological injury, they are hospitalized. In this acute phase, rehabilitation is most relevant and determine success of the mostly long-lasting recovery process. recoveriX is easy to use and mobile and can be used already with hospitalized patients at bedside.

Afterwards, recoveriX can be used in the rehabilitation center in the sub-acute phase.  recoveriX trains the brain and therefore supplements standard physical therapy in the subacute phase.

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STROKE REHABILIATION - A PRACTICE SESSION

This presentation shows a practical session of recoveriX for stroke therapy. The session includes demonstrations of how stroke patients can use recoveriX to control lower limb exoskeletons or functional electrical stimulation devices through brain-computer interface technology, showcasing its potential for promoting motor recovery and functional independence in individuals recovering from stroke-related impairments.

LOWER LIMB REHABILITATION AFTER STROKE WITH RECOVERIX

This presentation focuses on lower limb stroke rehabilitation using recoveriX, a brain-computer interface technology to facilitate neurorehabilitation by enabling stroke patients to control lower limb exoskeletons or functional electrical stimulation devices through neural signals. Learn about the effectiveness of recoveriX in promoting motor recovery and functional independence in individuals recovering from stroke-related impairments.

HOW TO USE RECOVERIX AFTER STROKE AND FOR MULTIPLE SCLEROSIS

Learn how to use recoveriX, a brain-computer interface (BCI) technology to aid stroke patients and patients with multiple sclerosis (MS) in their rehabilitation journey. This presentation discusses how BCI applications such as recoveriX can facilitate motor recovery and functional rehabilitation by enabling patients to control assistive devices or receive neurofeedback training using their brain signals. Furthermore, the video includes the potential of BCI technology to improve quality of life and promote independence for individuals living with stroke or MS-related impairments.

CLINICAL ROUTINES AROUND THE WORLD

This talk showcases the global integration of recoveriX neurorehabilitation system into clinical routines and various healthcare settings worldwide, emphasizing its effectiveness in promoting motor recovery and functional rehabilitation among patients with neurological conditions such as stroke or spinal cord injury. The presentation illustrates how recoveriX is revolutionizing rehabilitation practices and improving outcomes for individuals undergoing neurorehabilitation across different countries and healthcare systems.

FREQUENTLY ASKED QUESTIONS

Is a disorder of cognition and/or attention an exclusion criteria?

A significant disorder in language, cognition, and/or attention (such as Wernicke’s aphasia or dementia), which prevents the patient from understanding the tasks and/or performing these tasks, is an exclusion criterion.

Is recoveriX therapy also appropriate for people with a history of epilepsy?

The recoveriX treatment can also be used for patients with epilepsy, but the final decision is done by your family doctor.

How much instruction do I need to successfully perform recoveriX therapy?

Patients do not need a separate therapy session for the instruction – they can start with the therapy immediately. The patients only need to learn the general procedure and simple instructions for the therapy session before the first session. The first session is already part of the therapy.

Which movements can be trained with recoveriX?

recoveriX provides functional muscle stimulation of the left and right arm to perform a dorsiflexion and of the left or right foot. This improves lower and upper limb functions.

Can recoveriX be combined with traditional physiotherapy or occupational therapy?

Yes. Actually, recoveriX combines 3 standard therapies into one treatment: (i) functional electrical stimulation, (ii) motor imagery and (iii) mirror neuron therapy. Additional physical therapy can be beneficial for the patient.

When is the most effective time to do recoveriX therapy?

recoveriX can be used for stroke rehabilitation across the acute, sub-acute, and chronic stages, as various patient cases have shown. Our scientific study has shown that recoverX therapy is effective even 10, 20, 30,… years after the stroke or neurological disorder occured.

How often should recoveriX therapy be done?

It is recommended to perform recoveriX therapy for a complete course of 25 therapy sessions, with 3 sessions per week, each lasting for about 1 hour. Of course, it is also possible to participate in other therapies or rehabilitation programs. We know that patients are likely to improve more, the more therapy he/she gets.

Are the improvements long-lasting?

Yes, the improvements are long-lasting and remain permanently.

How long does a recoveriX treatment take?

One recoveriX block contains 25 therapies. 3 therapy sessions per week are recommended. Patients can have up to 2 treatments per day. This is especially useful to reduce exhausting travel time.

For what patients is recoveriX therapy appropriate?

recoveriX is a rehabilitation system specifically developed for patients with neurological deficits. Patients who had a stroke, a traumatic brain injury or another brain injury can do the therpay. Furthermore, patients with hemiplegia, movement impairments resulting from brain damage, pain, spasticity or Multiple Sklerosis can benefit from the therapy.

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