Title:?

Development of a pipeline for EEG-based diagnostics in disorders of consciousness

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Background:

A major challenge in the routine clinical care of patients with disorders of consciousness is the adequate diagnosis of consciousness with the aim of differentiating between patients in unresponsive wakefulness state and those in a minimally conscious state. Misdiagnosis has a major impact on prognosis and further treatment. Electroencephalography (EEG) is used to support the clinical assessment of patients with disorders of consciousness. Today, there are a variety of features from the EEG that are associated with the state of consciousness. Methods to extract these features from an EEG are often published in dedicated toolboxes in different programming languages (e.g. MOHAWK in Matlab, NICE in Python). The methods include various approaches to signal processing and machine learning, but differ considerably between the centers involved.

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Aim:

The aim of this project is to implement a standardized and user-friendly toolbox in Python that bundles existing methods. Furthermore, the toolbox is to be expanded to include our own methods.

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Areas of learning and competence:

• Basics and application of EEG
• Specialization in the area of severe disorders of consciousness and their diagnosis/prognosis
• Insight into the rehabilitation of patients with severe disorders of consciousness
• Overview of existing methods for EEG evaluation in research on severe disorders of consciousness
• Use of widely used programming languages (especially Python)
• Insight into innovative methods of signal processing
• Insight into machine learning methods
• Development of own processing methods
• Evaluation eigener Methoden anhand vorhandener Patientendaten
• Evaluation of own methods using existing patient data
• Application of the pipeline to a large database of existing EEGs from patients with severe disorders of consciousness

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Contact:

If you are interested, please contact Vincent Fleischhauer

Title:?

Sensor-based recording of spontaneous movement behavior using motion tracking in patients with severe disorders of consciousness

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Background:

There is already evidence that certain behaviors such as crossing the legs or covert motor behaviors are indicators of recovery from disorders of consciousness. Behaviors that allow the diagnosis of disorders of consciousness sometimes prove to be highly variable. The observation of spontaneous behavioral patterns is already a component of diagnostics using clinical scales. However, such testing is only a selective assessment of a person's state and only covers a short period of time. Any behavioral patterns outside this observation period remain undetected.

Aim:

As part of this project, the spontaneous movement behavior of patients with severe disorders of consciousness is to be recorded using sensors attached to the patient's body that record all movements over a period of up to 16 hours. The movement data will then be used to draw conclusions about the patient's current state of consciousness and derive a prognosis.

Areas of learning and competence:

• Insight into the rehabilitation of patients with severe disorders of consciousness
• Monitoring of individual patients over the two-month study period
• Learning the basics of bedside diagnosis of severe disorders of consciousness using the Coma Recovery Scale-Revised (CRS-R)
• Insight into motion tracking technology from the industry
• Organization and implementation of study investigations with CRS-R and motion tracking
• Insight into the evaluation of sensor data

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If you are interested, please contact Martin Rosenfelder

The number of steps a paralyzed person takes with the affected leg per day is decisive for the recovery of walking ability after a stroke. The aim is to retrospectively analyze how the treatment of patients with a gait robot has affected the outcome of rehabilitation. In addition, the effects of the number of steps per rehabilitation day on the outcome of patients with paresis will be prospectively investigated using a pedometer.

More information will follow shortly.

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If you are interested, please contact Martin Rosenfelder

Title:

Development of a model for predicting rehabilitation success using big data

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Background:
As part of this project, 5,000 to 10,000 retrospectively collected patient data sets from Therapiezentrum Burgau will be analyzed in order to identify correlations between a few early patient characteristics and later rehabilitation success. The focus is on the use of modern machine learning methods, e.g. large language models (LLMs), in order to extract usable information from unstructured data such as free text on admission. The combination of structured and unstructured data opens up new possibilities for data-driven modeling of individual rehabilitation processes.

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Aim:
The aim is to develop predictive models that enable reliable statements to be made about the expected success of rehabilitation at the beginning of a rehabilitation stay and thus support personalized, evidence-based therapy planning.

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Areas of learning and competence:

• Preparation of unstructured data
• Creating databases
• Familiarization with modern machine learning models

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Contact:

If you are interested, please contact Vincent Fleischhauer

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Title:?

Individualized Non-invasive BRAIN Stimulation (tDCS) in subacute Aphasia: A multicentre randomized controlled trial (RCT) - INBRAIN-A

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Background:

There is increasing evidence that transcranial direct current stimulation (tDCS) has a positive effect on improving speech and communication performance in the subacute and chronic phases of aphasia after stroke. Since there are promising smaller studies for the subacute phase that support this success, it is necessary to investigate this success in a multicenter randomized controlled trial (RCT). Such a study is already underway for the chronic phase. The primary aim is to investigate the influence of tDCS on functional communication skills in people with subacute aphasia (from 2 weeks up to and including 4 months after stroke) and simultaneous speech therapy/logopaedics (SLT). In addition, secondary research will be conducted on the influence of tDCS on all language modalities, the external assessment of communicative performance by relatives or caregivers, the quality of aphasia-related care and the applicability of tDCS for therapists in a neurological rehabilitation clinic. In summary, the focus is on patient participation and the feasibility of the intervention as well as on linguistic aspects. In addition, the intervention is considered from the perspective of those affected.

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Aim:?

Investigation of the influence of tDCS on the success of speech therapy in the subacute phase after stroke.

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Hypothesis:?

The combination of speech therapy/logotherapy (SLT) and transcranial direct current stimulation (tDCS) results in a significantly greater improvement in communicative skills in people with aphasia (PwA) than SLT in combination with placebo stimulation (sham tDCS).

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Areas of learning and competence:

• Insight/deepening in the field of diagnostics and therapy of neurogenic speech disorders (aphasia)
• Basics and application of transcranial direct current stimulation (tDCS)
• Insight into the BAR phase model (in particular rehabilitation phase C) and interdisciplinary care in neurorehabilitation
• Holistic study design taking into account methodological, evaluative and economic aspects, preparation of an ethics application (MDR/MPDG), preparation of study documents (study protocol, CRFs), implementation and evaluation of a pilot study
• Insight into informed consent discussions and consent processes for study participants
• Acquisition of the basics of descriptive and inferential statistical analysis
• Use of common statistical programs (e.g. SPSS, R)
• Knowledge of research ethics, data protection and GCP (Good Clinical Practice)

If you are interested, please contact Bernadette Einh?upl

Title:?

Proactive Early Decannulation in Neurological Early Rehabilitation (Phase B): A Multicenter Randomized Controlled Trial with Parallel-Group Design – ProDec

Background:?

In neurological rehabilitation, a step-by-step approach to decannulation has become established over the past decades, which involves controlled unblocking in combination with dysphagia therapy. This process often extends over several weeks and leads to a long-term tracheostomy, which is associated with an increased risk of complications such as bleeding, pneumonia, tracheal stenosis, dehiscence and granuloma formation. In addition, prolonged cannulation impairs the rehabilitation of voice, speech and swallowing functions, prolongs hospitalization and increases healthcare costs. Initial studies indicate that early, proactive decannulation in neurological (severe acquired brain injury (SABI)) patients does not negatively affect survival, morbidity or the rate of recanalization within 12 months of discharge. On the contrary, there is a trend towards shorter lengths of stay, reduced readmissions and a lower use of antibiotics. Adequate consciousness, moderate expiratory pressure, presence of spontaneous cough and cough strength and stable oxygenation seem to be fundamental for successful decannulation.

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Aim:?

The multicenter randomized study will investigate the influence of proactive early decannulation on long-term recovery and survival in neurological rehabilitation patients.

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Hypothesis:

Proactive early decannulation in early neurological rehabilitation has a positive effect on the incidence of complications and infections as well as the rehabilitation of speech and swallowing and increases the survival rate.

Areas of learning and competence:

• Insight/deepening in the field of diagnostics and therapy of dysphagia and various weaning procedures
• Basics and application of Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
• Theory and practice in handling blocked tracheostomy tubes
• Insight into the BAR phase model (in particular rehabilitation phase C) and interdisciplinary care in neurorehabilitation
• Holistic study design taking into account methodological, evaluative and economic aspects, preparation of an ethics application, preparation of study documents (study protocol, CRFs), implementation and evaluation of a sub-study
• Insight into informed consent discussions and consent processes for study participants
• Acquisition of the basics of descriptive and inferential statistical analysis
• Use of common statistical programs (e.g. SPSS, R)
• Knowledge of research ethics, data protection and GCP (Good Clinical Practice)

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If you are interested, please contact Bernadette Einh?upl

Therapiezentrum Burgau is developing a prospective randomized controlled Affolter study for patients with apraxia (action planning disorder).

More information will follow shortly.

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If you are interested, please contact Martin Rosenfelder