Stereognosis training system and method for patients with chronic stroke, spinal cord injury or neuropathy

Abstract

Provided is an effective stereognosis training system that integrates hardware and software to provide a simple, reliable, quantitative system to provide tactile rehabilitation and progress monitoring. The system can include an interactive device including a novel set of objects, that are combined with neuromodulatory systems such as wireless closed-loop vagus nerve stimulation to improve neural plasticity and expedite functional recovery. The system can send updates to therapists or clinicians to monitor progress and encourage compliance with prescribed therapy.

1 . A method for treating sensory dysfunction resulting from peripheral nerve damage in a subject having a sensory network and a vagus nerve comprising the steps:
 selecting one or more prescribed rehabilitation tasks of the sensory network;   providing a prescribed rehabilitation task to the subject to perform;   providing a monitoring and triggering system for the prescribed rehabilitation task;   determining if the subject is engaged in performing the prescribed rehabilitation task using the monitoring and triggering system;   applying a first electrical stimulus to the vagus nerve when the subject is engaged in performing the prescribed rehabilitation task;   determining if the subject is successfully in performing the prescribed rehabilitation task; and,   applying a second electrical stimulus to the vagus nerve upon determining that the subject is successfully performing the prescribed rehabilitation task.   
     
     
         2 . The method of  claim 1 , further comprising:
 evaluating whether a rehabilitation of the subject is complete based on a signal from the monitoring and triggering system; and,   ending a rehabilitation session if the rehabilitation is complete.   
     
     
         3 . The method of  claim 1 , wherein the step of applying the first electrical stimulus further comprises applying the first electrical stimulus for a predetermined period of time. 
     
     
         4 . The method of  claim 1 , wherein the step of applying the first electrical stimulus further comprises applying the second electrical stimulus for a predetermined period of time. 
     
     
         5 . The method of  claim 1 , wherein the step of providing the monitoring and triggering system further comprises:
 providing a vagus nerve stimulator;   providing a container;   providing a set of objects, movably disposed in the container;   providing a camera, with a view of the set of objects; and,   providing a processor, having a memory, operatively connected to the camera and the vagus nerve stimulator, controlling the vagus nerve stimulator.   
     
     
         6 . The method of  claim 5 , wherein the step of applying the first electrical stimulus further comprises:
 sending a first control signal from the processor to the vagus nerve stimulator; and,   wherein the step of applying the second electrical stimulus further comprises sending a second control signal from the processor to the vagus nerve stimulator.   
     
     
         7 . The method of  claim 6 , further comprising:
 providing a display, operatively connected to the processor; and,   providing a set of program instructions with instructions that when executed cause the method to:
 display at least one object, of the set of objects, on the display. 
   
     
     
         8 . The method of  claim 7 , further comprising:
 providing a user device, operatively connected to the processor; and,   providing the set of program instructions with further instructions that cause the processor to perform the step of:
 sending one of a group of the first control signal and the second control signal, based on a time domain stream of data, related to the set of objects, to the user device. 
   
     
     
         9 . The method of  claim 7 , further comprising:
 providing the set of program instructions with further instructions that cause the processor to perform the steps of:
 monitoring the container for an ingress and an egress; and, 
 sending one of a group of the first control signal and the second control signal based on at least one of a group of the ingress and the egress. 
   
     
     
         10 . The method of  claim 5 , further comprising:
 providing a downward facing mirror, adjacent the camera, directed toward the set of objects.   
     
     
         11 . The method of  claim 5 , further comprising providing a subset of objects, of the set of objects, for stimulating at least one of a group of:
 mechanoreceptors;   nociceptors; and,   thermoreceptors of the subject.   
     
     
         12 . A method of automatically triggering a vagus nerve stimulation to treat sensory disfunction resulting from peripheral nerve damage in a subject comprising:
 providing a vagus nerve stimulator;   providing a container;   providing a set of objects, movably disposed in the container;   providing a camera, with a view of the set of objects;   providing a processor, having a memory, operatively connected to the camera and the vagus nerve stimulator;   providing the memory with a set of program instructions that, when executed by the processor, cause the processor to perform the steps of:
 monitoring the set of objects for a time domain stream of data; and, 
 making a first determination as to whether the subject is engaged in a sensory stimulation task from the time domain stream of data; 
 sending a first signal to the vagus nerve stimulator to apply the vagus nerve stimulation based on the first determination; 
 making a second determination as to whether the subject is successful in perform the sensory stimulation task from the time domain stream of data; and, 
 sending second a signal to the vagus nerve stimulator to apply the vagus nerve stimulation based on the second determination. 
   
     
     
         13 . The method of  claim 12 , further comprising:
 evaluating whether or not a rehabilitation of the subject is complete based on the time domain stream of data; and,   ending a rehabilitation session if the rehabilitation of the subject is complete.   
     
     
         14 . The method of  claim 12 , wherein the vagus nerve stimulation is applied for a predetermined time while the subject is engaged in the sensory stimulation task. 
     
     
         15 . The method of  claim 12 , further comprising:
 providing a display, operatively connected to the processor; and,   providing the set of program instructions with instructions that when executed cause the processor to:
 display at least one object, of the set of objects, on the display. 
   
     
     
         16 . The method of  claim 12 , further comprising:
 providing a downward facing mirror, adjacent the camera, directed toward the set of objects.   
     
     
         17 . The method of  claim 12 , further comprising providing a subset of objects of the set of objects for stimulating at least one of a group of:
 mechanoreceptors;   nociceptors; and,   thermoreceptors, of the subject.   
     
     
         18 . The method of  claim 12 , further comprising:
 providing a network interface, connected to the processor;   providing a network, in communication with the network interface;   providing a user device, connected to the network; and,   providing the set of program instructions with further instructions that cause the method to perform the step of:
 sending the first signal, based on one of a group of the first determination and the second determination to the user device. 
   
     
     
         19 . The method of  claim 12 , further comprising:
 providing the set of program instructions with further instructions that cause the processor to perform the steps of:
 monitoring a portal in the container for an ingress into the portal and an egress from the portal; and, 
 sending the first signal based on at least one of a group of the ingress and the egress.