#15: Brain Computer Interfaces and OT with Lauren Souders (CE Course)

CE Courses
, , , , , , , , ,
1

Take the Quiz to get 1 CEU

Listen: Apple | Spotify | Google
Full Course Details: Public course page
Learn more about our guest: Lauren Souders, MOT, OTR/L, CBIS, CSRS

Read the article and discussion upon which this podcast is based.

Course Description

Released August 23, 2021 from Aurora, NE

The ability to affordably track brainwave activity has opened up tremendous opportunities in occupational therapy. Regardless of where we work (or the patient populations we treat), our work has the potential to be significantly informed by this technology over the next few decades.

In this one-hour course, we will look at a research study on brain-computer interface (BCI). The study will serve as a jumping-off point to explore the concepts and developments that OTs should follow in this space.
After our article review, we’ll be joined by Lauren Souders, MOT, OTR/L, CBIS, CSRS. Lauren works as Director of Clinical Operations for a BCI startup.

We’ll talk with her about what is on the market for brain-computer interface, as well as what types of BCI we can expect to see coming to market in the future. And, most importantly, we’ll discuss how occupational therapy care may be improved over the next decade with the aid of these exciting new technologies.

Supplemental Materials

Primary Research Explored

Be sure to check out the OT Potential Club’s written breakdown of the following research article, then share your questions and thoughts with fellow practitioners.

Kim T, Kim S, Lee B. Effects of Action Observational Training Plus Brain-Computer Interface-Based Functional Electrical Stimulation on Paretic Arm Motor Recovery in Patient with Stroke: A Randomized Controlled Trial . Occup Ther Int. 2016 Mar;23(1):39-47. doi: 10.1002/oti.1403. Epub 2015 Aug 24. PMID: 26301519.

Secondary Research

Bundy DT, Souders L, Baranyai K, Leonard L, Schalk G, Coker R, Moran DW, Huskey T, Leuthardt EC. Contralesional Brain-Computer Interface Control of a Powered Exoskeleton for Motor Recovery in Chronic Stroke Survivors. Stroke. 2017 Jul;48(7):1908-1915. doi: 10.1161/STROKEAHA.116.016304. Epub 2017 May 26. PMID: 28550098; PMCID: PMC5482564.

Cervera, M. A., Soekadar, S. R., Ushiba, J., Millán, J., Liu, M., Birbaumer, N., & Garipelli, G. (2018). Brain-computer interfaces for post-stroke motor rehabilitation: a meta-analysis. Annals of clinical and translational neurology, 5(5), 651–663. https://doi.org/10.1002/acn3.544

Learning Objectives

  • You will be able to name the basic types of brain-computer interface approaches and clinical applications that are being developed.
  • You will be able to identify the concepts that drive BCI—including ones that you can start incorporating into your practice today.

Agenda

Intro (5 minutes)

Breakdown and analysis of journal article (10 minutes)

  • An introduction to the concepts to you need to know about
    • Mental practice
    • Mirror neurons/imitative learning
    • Action Observational Training (AOT)
    • AOT+ brain-computer interface (BCI) with functional electrical stimulation (FES)
    • Activity-dependent brain plasticity
  • Why was this paper written?
  • What methods did the authors use?
  • What were the results?
  • Authors’ conclusion and recommendations
  • Takeaways for OT practitioners

Discussion on practical implications for OTs (with guest Lauren Souders) (45 minutes)

  • What were your initial impressions of the article?
  • Which advancements in BCI do you think are most important for OTs to be following?
  • What are the different types of BCI that have the potential to be used in therapy?
  • In traditional OT settings, do you think we should be changing our practice, based on what we are learning in the BCI world?
  • In traditional OT settings, if a patient asked you about BCI, what would you tell them?
  • In 5-10 years, how do you see BCI technologies impacting occupational therapy?
  • How do you see OT needing to change to prepare for the new technologies?

Contact hours

1 hour (0.1 AOTA CEUs)

Target Audience/Educational Level

Our target audience is occupational therapy practitioners who are looking to learn about clinical applications of brain computer interface technology as it relates to evidence based rehabilitation. The educational level is introductory.

Instructional Methods/Registration/Special Needs Requests/Cancellation Policy

This course is an independent/self-study course delivered via podcast on iTunes, Spotify and Google Play. Explore your listening options on the OT Potential Podcast page.

If you need accommodations to take this course, please contact us and we will address your needs on an individual basis.

If this course were to be cancelled, please see our cancellation policy on our terms page.

Course Completion Requirements

In order to receive a certificate for this course, you must first listen to the podcast in its entirety. Then, you will need to take the test (found at the top of this page) and earn 75% or higher. If you pass, a certificate will be automatically generated and sent to your email.

Speakers

Lauren Souders, MOT, OTR/L, CBIS, CSRS

Lauren-Photo

Lauren Souders is the current Director of Clinical Operations for Neurolutions, Inc., and has been working with Neurolutions since 2012 assisting in the development and clinical evolution applying brain-computer interface technology in the stroke rehabilitation space. Lauren was an integral clinical lead at the infancy of Neurolutions first product, the IpsiHand. Lauren is also one of the first pioneering occupational therapists to assist in using brain-computer interface technology with stroke patients. Her work has yielded a breakthrough medical technology designation and first ever FDA clearance for a brain computer interface for motor rehabilitation.

Lauren has held other clinical roles as an occupational therapist with advanced certifications as a certified brain injury specialist (CBIS) and a certified stroke rehabilitation specialist (CSRS). Lauren has evaluated and treated patients across the lifespan in a variety of environments. Lauren also served as an adjunct faculty member at Saint Louis University and a clinical specialist for Washington University’s School of Medicine’s Department of Neurology. Lauren has presented at a number of conferences for the American Occupational Therapy Association and the American Congress of Rehabilitation Medicine. Lauren continues to serve as a guest lecturer at a number of universities including Saint Louis University and Maryville University. Lauren is the co-founder of NeuroVlog – a company providing evidence based information to assist clinicians in treating neurological patients across the lifespan. Overall, Lauren aspires to innovate creative medical technologies to provide solutions to improve the lives of those who need it the most.

Sarah Lyon, OTR/L:

Sarah Lyon, OTR/L headshot

Sarah’s passion is helping fellow OT practitioners translate evidence into daily practice. Sarah earned her BA in religion from St. Olaf College, then earned her master’s degree in occupational therapy from New York University in 2011. Since then, she’s worked in numerous facilities, including a critical access hospital, an acute trauma hospital, and a state inpatient psychiatric hospital.

In 2011, Sarah launched OT Potential because she realized we needed a reliable source of quality occupational therapy-related content and resources. She has also had the opportunity to create content for brands like WebPT, MedBridge, Saebo, and NeuroLutions.

She launched the OT Potential Club in 2019 to marry her love of simplifying complex topics with her desire to help therapists access the most important OT-related research released each year.

Sarah is a prairie girl at heart, which is why she returned to her hometown to raise her children in Aurora, Nebraska (home of the strobe light).

AOTA-Badge-Ep15

After earning your certificate, please consider taking a moment to answer the following three questions:

1.) On a scale of 1-5 please indicate the degree to which the learning objectives were met.

  • 1
  • 2
  • 3
  • 4
  • 5
0 voters

2.) Please rate our instructors on a scale of 1-5.

  • 1
  • 2
  • 3
  • 4
  • 5
0 voters

3.) On a scale of 1-5, please rate the learning environment of the Club.

  • 1
  • 2
  • 3
  • 4
  • 5
0 voters

Please share any other feedback below! Including, ideas for future programming, and most importantly, how you feel this podcast will impact your practice!

1 Like
4

Great podcast! I will definitely start increasing how much I have patients mentally practice. One thing I have been doing is having patients with bad shoulders not think about moving their arm rather have them imagine there is a string attached to their thumb and the string is pulling their thumb up. I can usually get at least 10 degree increase in their ROM.

2 Likes
5

Most exciting, promising and potentially helpful technology I’ve heard since learning neuroplasticity continues throughout life. I am eager to gobble up all I can and agree that it can ignite intrinsic motivation, feedback, hope, sense of control and can assist in more areas of health than we can imagine.
Thank you

3 Likes
6

I absolutely love this advancement and the self directed component to achievement. This is going to help a lot of people.

1 Like
7

Excellent topic! Clear examples of BCIs use. A pleasure to learn about!

1 Like
8

I was excited to hear Lauren mention that CMS would be reimbursing BCI breakthrough devices through a new policy called Medicare Coverage for Innovative Technology, but CMS later revoked the policy. It seems like the replacement policy is at a stalemate and there have not been many updates! If anyone knows more about recent policy updates, let me know. These devices should be accessible (of course only if they are safe and effective).

2 Likes
9

Oh I had not heard that! I’m curious to know an updated too. @clarice1 Do you know anything about this or who at AOTA might be tracking this policy?

1 Like
10

@SarahLyon Thanks for the tag! I hadn’t heard of this rule before but looks like it is at a stale mate for now.

Not sure if AOTA has been tracking it since it seems a bit beyond the typical scope of policies they get involved - but of course i don’t speak for them and they may have paid attention to it previously.

Here’s a great article from Health Affairs (one of my fav policy blogs) on the rule and any updates.

Seems like there was a lot of concern around safe guards for Medicare beneficiaries and they have yet to find a solution that satisfies everyone.

According to the final rule it looks like some LCDs and MACs could approve coverage for these devices on a case by case process - see the screen shot and the link below

image
image1295Ă—811 151 KB

Health Affairs blog with updates: https://www.healthaffairs.org/content/forefront/improving-medicare-coverage-innovative-technologies

CMS fact sheet: https://www.cms.gov/newsroom/fact-sheets/medicare-coverage-innovative-technology-cms-3372-f

CMS Final Rule: https://public-inspection.federalregister.gov/2021-24916.pdf

@olivia6

1 Like
11

Wow, the health affairs article is super interesting. This makes me want to connect with @lauren5 again to hear what they are thinking as their pathway forward.

It seems like both the FDA and Medicare have huge challenges ahead in processing all of the new technologies that are coming out. I’ll be curious to keep learning more about this.

1 Like
12

Hi Sarah! This might be my first comment! :grinning:

Yes, the MCIT ruling halted with new administration. AdvaMed is a strong voice for lobbying in this area. They stated that CMS did not want to cover breakthrough devices because the clinical data which awarded a breakthrough designation from the FDA may not have been clinical data that was applicable to the medicare population of those 65 and older. Therefore, CMS continues to request a large amount of clinical data and post market registry data before entertaining coverage.

Hope this makes sense!

In our experience, it is a catch 22. Our brain-computer interface device which was awarded breakthrough designation, is also cleared from the FDA in a De Novo pathway - meaning the first every device of its kind to be approved by the FDA. When you’re the “first” there are no existing “codes” to leverage.

1 Like
13

That does seem like a catch 22!

Are you going to AOTA conference, @lauren5? I want to hear all of the details about what moving forward looks like for you all.

It just feels like a tough time for health tech right now!

14

Lauren,

Thank you so much for such a detailed and helpful reply to my question! If I am understanding correctly, breakthrough designation can occur two ways. One, it can be applied on a case by case basis for individual clients by Medicare Administrative Coordinators. Or, it can be applied to a device for all Medicare clients through other pathways like if it’s a De Novo device? How long does a De Novo designation last…until another company comes on the market with an FDA-approved competitor? I work in drug development (yes, as an OT!) so that’s why I’m so curious about the differences between medical devices and drugs.

Sarah, it would be amazing to have Lauren back on the show to talk more about healthcare policy and medical devices! I am especially interested in protections against medical device abandonment, to make sure clients have the long-term ability to get their devices fixed or updated (see this article Abandoned: the human cost of neurotechnology failure).

Thanks again :slight_smile:

1 Like
15

Wow, that article is startling. And, it highlights a problem that is seems likely to continue to increase as more and more technologies are explored! Yes, @lauren5, we’ll have to connect about having you back!

And, @olivia6 , I’m excited to start following your work as well- it sounds super interesting!

16

Great podcast. I will def integrate mental imagery in treatment, increase the reps in treatment and for the HEP. It’s very exciting and I am looking forward to the future developments!!

1 Like