CleveMed Blogs

It all began when it was time for the needed photoshoot for SleepView, (our new baby among CleveMed’s family of sleep diagnostic devices). I went to Sarah (my boss) and said, “Who should be the model?” She paused a moment, then rattled off 2 names from the engineering department. “Maybe they would like to help?” she smiled sweetly.

I emailed them both; a pleading, cajoling couple of sentences, and waited. Surprisingly, they seemed quite happy to switch gears for a bit, and the first affirmative came 48 minutes sooner than the other. So the choice was easy: Dominic.

The day before the photo/video-shoot was quite a buzz of activity.

Dominic was kind enough to not back out of the whole thing while he had the chance.

Tony (our photographer) was just amazing. Just being in Tony’s studio, seemed to make the creative juices flow. We were spouting all kinds of ideas for future ad campaigns: one part of me marveled, yet another part of me cringed. But we needed this rambling I think… Dominic needed to take his mind off the discomfort he must have surely endured, from holding his hands out over a white board, and obeying 5-syllable instructions from Tony: “An-inch-to-the-left.” “Turn-device-clock-wise. No, your clock-wise.” “Curve your index finger a little toward you?” (No kidding, Dominic left for vacation the next day).

Finally, Tony dropped off our DVD and I must say that Dominic’s hands look good holding the SleepView and the SleepView looks just great: small, compact, and oh-so-easy to handle! But Tony was not the only one who took pictures that day. I just had to sneak a couple of cell phone pics that I have posted on our Facebook page. Hope you enjoy them as much as I did.

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The Movement Disorders Division of CleveMed has primarily focused on monitoring motor symptoms associated with Parkinson’s disease (PD). A more common movement disorder is essential tremor (ET), which affects approximately 4% of the population over age 40 in the United States. In Parkinson’s disease, tremor (involuntary shaking) occurs primarily at rest, but essential tremor is mainly characterized by tremor of a moving limb.

Measuring Tremor

Subjective Rating: Tremor associated with essential tremor is traditionally rated by various subjective tremor rating scales. These scales all provide a discrete, subjective symptom rating at a discrete point in time. They require a clinician to visually assess the patient, and cannot capture complex fluctuations that occur throughout the day in response to interventions.

Objective Rating: Objectively capturing essential tremor symptoms continuously during daily activities, and using adaptive algorithms to both classify tremor types and severity, could help clinicians better adjust therapy to minimize symptom fluctuations, and expand care to rural and underserved populations. Therefore, CleveMed has recently begun development on a system to objectively monitor essential tremor.

CleveMed previously developed a compact wireless system, Kinesia™, to quantify Parkinson’s disease symptoms. In a clinical study, this system successfully demonstrated objective quantification of Parkinson’s disease motor symptoms. These promising results for Parkinson’s disease suggest the system may be adapted for quantifying tremor in essential tremor patients by developing specific ET algorithms. More continuous portable monitoring can capture the tremor fluctuations that can occur throughout the day. Using a combination of accelerometers and gyroscopes will provide a system with much greater sensitivity for tremor type discrimination and severity rating. (Existing systems contain only a single-axis accelerometer). Continuous ratings throughout the day can aid clinicians and researchers in therapy development and optimizing symptom management for patients with essential tremor.

I remember the story of a biomedical engineer I know. As an undergrad, he planned to graduate, leave school and enter the industry. In the last weeks of class, a professor brought in a patient with a high level spinal cord injury. He demonstrated how FES (functional electrical stimulation) could be used to control weak or paralyzed muscles. When he saw this paralyzed patient move his arms, he was hooked. He went on to graduate with a PhD in biomedical engineering with a focus on rehab engineering.

Biomedical Instrumentation 101: students learn circuit design, how to build an amplifier, data acquisition, signal processing, etc. The concepts are taught; but is there enough emphasis on how this information can be used in applications outside of the classroom? Education in these areas of engineering and physiology is important, but how it can be used in real world applications is just as critical.

CleveLabs is a lab course system that uses wireless data acquisition hardware and interactive software to teach engineering, data acquisition, digital signal processing and basic and advanced physiology. In addition to these customary topics, we also include a section of clinical applications: labs that demonstrate to students where they can apply all that they’ve learned. How about using electro-oculography (movement of the eye) to control the position of a dot on the screen, and control the color of the dot just by blinking? This shows how EOG can be used for computer cursor control, where blinking represents a click, for persons with high level spinal cord injuries. Or what about using electromyography (electrical muscle activity) from the biceps and wrist extensor muscles to control the elbow angle and hand grasp of a virtual robotic arm? This explains how the use of existing muscles can control a prosthetic limb. In addition, heart rate detectors are created, gait and stride time are measured, EEG is used to detect different states of alertness. CleveLabs goes beyond the traditional topics using clinical examples of biomedical engineering applications.

Where can real world examples, such as the story of my friend, take your students?

CleveMed’s SleepScout is a compact, portable sleep monitor used to aid in assessment of sleep disordered breathing outside the traditional sleep lab: in a hospital setting (with iPSG™), or typically perfect for self-administered home sleep testing (even remotely attended with DreamPort™) right in the patient’s home. But here is another way to use the SleepScout: Dentists with an interest in sleep, snoring (sleep disordered breathing), and remedies for snoring through oral appliances and surgeries can use SleepScout to perform take-home sleep tests for their patients.

Here’s why the SleepScout is a great option when considering a sleep recorder for the dental office:
• SleepScout uses AASM recommended Type 3 channel set
• SleepScout’s accessories are very cost-effective
• SleepScout can monitor effectiveness of treatment with CPAP and oral appliances
• SleepScout gives an easy-to-read report with auto-scoring of respiratory events
• SleepScout records EMG to monitor Bruxism
• With SleepScout you have next day results

These are just a few reasons to consider the SleepScout, and you can read more details here. Also, see a sample report from the SleepScout portable sleep monitor at www.CleveMed.com/DentalSleep. And if you haven’t seen the SleepScout overview video, check it out!