By: Dylan Horn


Photo Credit/Milos Popovic/Myndtect

Anybody with loved ones who have suffered from brain injuries such as stroke know the intense physical burdens that can hinder them for years afterwards. A stroke can have drastic effects on both the communications and movement centres of the brain, causing them to lose their ability to speak and use their arms and hands.Fortunately, thanks to groundbreaking work conducted at U of T, repairing and reversing these physical impairments has taken major steps forward. Professor Milos Popovic, working with the University Health Network’s Toronto Rehabilitation Institute, has put years of research into MyndMove, a piece of technology designed to bridge new connections between the brain and movement in limbs damaged by strokes, spinal cord injury, and other traumatic brain injuries. Professor Popovic initially started focusing on hand movements because of their key role in physiotherapy: “I spent almost 20 years working in the field on upper limbs because if people cannot use their hands, they essentially can’t do most things.” Popovic explains, “You often can’t even walk if you don’t have functional hands to hold a walker. Without hands you cannot care for yourself, [and] this is a huge burden for people and for their families.”Popovic works with patients who cannot move either one or both of their upper limbs. Even with one functioning limb, tasks we take for granted become impossibly difficult: “Put your right hand in your pocket and then try to open your wallet and pay something with your Visa card. Just try to put your jacket on, or [make] a sandwich. Doing all those bimanual tasks is very difficult if one arm is paralyzed.”Originally working in collaboration with the private company MyndTec, which formed in 2008, Popovic set out to develop a type of neuroprosthetic system specifically made for patients with spinal cord injuries that they could use to contract the paralyzed muscles of the arm and hand. By doing so, the system would enable a patient to reach and grasp objects. “When we started doing this we didn’t know the technology would evolve this way and that people would be able to recover voluntary function.”Instead of requiring a custom-made neuroprosthesis that patients would need to wear all the time to be able to move the arm and hand, “We discovered [MyndMove] helps [the patient] reprogram the brain, and that patients following this therapy can relearn how they use the arm and hand on their own.”Rather than spending large sums of money on custom limbs for every patient, physiotherapists can now use one MyndMove device to treat several paralyzed patients with varying needs. Popovic explained, “That’s what research is all about. You go on one trip or in one direction, and you discover I can do things in a different way and achieve even better outcomes, and that’s what happened to us.”The device itself uses a touch screen interface that allows physiotherapists to send very low-energy electrical pulses sufficient to activate muscle contraction. As Popovic explained, there are a total of eight stimulation channel receptors that can be used on the device at the same time: “If you want to get a complex reaching and grasping movement, you need to activate eight muscle groups.”The device therefore plays an essential role in reminding the brain how to perform such a task. Popovic says it is important to remember that the brain is a distributed system. Unlike a computer, not all the control elements of the brain are sitting in one place. If you damage parts of the brain responsible for movement, there are other parts that can be retrained to accomplish that same task.“Once the muscles start contracting, you get … feedback to the brain that the movement that she or he wanted to performed has been carried out.” Popovic noted that the repetition of this action allows the brain to slowly but surely develop a new connection: “When the patient has imagined the movement, and you perform the movement for the patient, you slowly reprogram the brain [on] how to do that task on its own.”MyndMove also has the practical advantage of being an out-patient procedure. Popovic recommends 40 hours of therapy or more in one-hour bouts, but notable improvements have even been seen at the 20-hour stage: “We did a pilot with 20+ individuals and the majority of them had clinically meaningful improvements after only 20 one-hour sessions.”MyndMove is currently being implemented in physiotherapy clinics across the country. Although it is currently not covered by OHIP, private insurance companies have begun to cover it as they start to understand the clear financial advantages of having clients who can regain their hand functions.MyndMove is manufactured by Canadian startup company MyndTec Inc., located in Mississauga, Ont. Professor Popovic is a co-founder and serves as the CTO of the company.

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