Information for Clinicians about the NeuroNode

“There is no greater feeling in the world than watching a patient, connected to their NeuroNode for the first time, realize that the world has opened back up for them. It’s real communication, functional communication.

Caitlin Smith, MA CCP-SLP

EMG (“electromyography”) is the measurement of electrical activity associated with the activation of a muscle group as detected by non-invasive electrodes on the surface of the skin. The NeuroNode’s use of EMG in an assistive device is a technological breakthrough, but EMG has been used in clinical and research settings since the 1980s for the diagnosis of neuromuscular diseases, rehabilitation, and controlling prosthetic devices. It’s a proven, reliable technology.

The NeuroNode uses a patient’s EMG signal as a switch, allowing even someone with what appears to be complete paralysis to operate a computer. This assistive communication device is highly effective for patients with ALS/MND, SCI, and cerebral palsy. Importantly, the NeuroNode allows communication to continue uninterrupted if a patient is put on a ventilator. This means your patient will not have to choose between communicating with their loved ones and breathing.

Questions about whether the NeuroNode is right for your patient? Contact us.

The NeuroNode in the Classroom

Since the NeuroNode’s launch at the Assistive Technology Industry Associate (ATIA) Control Bionics has been working to implement this new device into classrooms across the country. One of our first clients, Maeve, is a student in the New York area diagnosed with Spinal Muscular Atrophy (SMA). Maeve’s teachers, clincians, and AT team had struggled for years to find the a reliable access method to maintain her educational goals – then came NeuroNode! Learn more about Maeve’s story below. If you are interested in assessing one of your students for the NeuroNode, we’re here to help, contact us today.

An introduction to the NeuroNode for SLPs

Speech language pathologists can use the NeuroNode as the next step beyond an eye gaze board, even for patients with the most severe disabilities. It’s that simple to use. In some cases, the NeuroNode might even be your first tactic in restoring communication to someone who you believe is reachable but seems unresponsive.

Control Bionics has over seven years of experience working with patients with ALS/MND and SCI. We have helped many SLPs learn to work with our devices. The process takes only about 30 minutes, and you will see immediate results with your patients.

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An SLP’s account of using the NeuroNode

“Since starting to work with this EMG technology, I have been able to connect technology with people who have some of the greatest communication challenges I had ever seen in my twenty five year career. I have been able to help people who could not speak, move, eat, or breathe on their own communicate to loved ones even when they were placed into ICU units or in palliative care.

One of the most powerful experiences I had with this technology was with a patient in the ICU due to a serious injury. He was not able to move, breathe, speak, or eat on his own. This patient had a loving wife and two small children. His final arrangements were being planned because he was not responding to his caretakers. Most people thought he had given up.

After I connected him with EMG for communication, he immediately was able to turn on his lamp beside his bed. This changed everything. He turned a corner that day and now he is living independently. The best news of all is that he doesn’t need the device any longer.”

Caitlin Smith, MA CCP-SLP

Assessing a patient for the NeuroNode

Every SLP knows that many factors must be considered when assessing a patient for a speech generating/assistive device: their wants and needs, degree of voluntary movement, energy level, and cognitive abilities are key. A lot of trial and error is involved in finding the right fit. Good candidates for the NeuroNode often fit one of these profiles:

  • A person with a degenerative disease, such as ALS/MND. This person might start using the NeuroNode in the early stages of their illness. As the disease progresses, they will not have to learn to use a new switch when their cognition might be more impaired. (Please note that people in the later stages of ALS/MND can also learn to use the NeuroNode. Starting early is not a requirement!)
  • A person with a spinal cord injury, cerebral palsy, or partial paralysis. Whether or not this person needs the help of the NeuroNode to speak, they will find the NeuroNode an extremely simple, effective way to use a computer and operate environmental controls.
  • A person who has severe or profound communication needs or is on a ventilator, regardless of whether they are paralyzed. Using the NeuroNode becomes second nature – patients tell us that they feel like they actually become the switch, making it an extremely fast, efficient way to speak using a computer. For those suffering from extreme fatigue, the NeuroNode is much less tiring than an eye, press, or puff switch.

View more information on the assessment process and the available options here.

How it works

  1. The NeuroNode’s sensors sit on the surface of the skin, located on the muscle chosen to be the switch. When the patient tenses that muscle, the NeuroNode detects the EMG signal, even if you can’t see the muscle move.
  2. The NeuroNode amplifies and interprets the EMG signal, then sends it to the users chosen computer, tablet or mobile device.
  3. On the chosen device, the signal reaches Switch Control’s virtual keyboard and mouse controls. This allows the patient to operate a keyboard appropriate to their needs – from something very simple, like a list of a few words, to a full alphanumeric keyboard with predictive text for speaking and writing in fluent, complete thoughts. The mouse controls provide full access to all of the computer’s features for web browsing, sending email, etc.

Equipment included with the NeuroNode

  • The NeuroNode wireless and wearable EMG communication device
  • NeuroNode Controller software application
  • 12-Month supply of clinical-grade adhesive EMG sensors. Different types of sensors are available, depending on your patient’s needs.
  • 12-Month 24/7 telepresence technical support
  • 24-Month product warrant period, coving the cost and replacement of the NeuroNode device.

Attaching the sensors: finding a working nerve signal in someone who is paralyzed

Finding the best site for the NeuroNode is a process of trial and error. The clinician typically works with an expert from Control Bionics, along with the patient and caregiver, to identify which muscles, if any, the patient can move voluntarily. If there seem to be no voluntary muscle movements, we try big muscles in the legs, arms, and facial muscles.

The setup time in therapy is very brief, once a muscle has been identified for use as the switch. When sensors need to be replaced, don’t worry: either a clinician or a caregiver can replace them. Although the sensors need to be sited on the same muscle, they do not need to be at precisely the same spot on the skin each time. Control Bionics provides 24/7/365 support via web cam, in case a problem arises.

Introducing the patient and caregivers to the NeuroNode

A representative of Control Bionics works with the clinician – often an SLP – to introduce the NeuroNode to the patient. We understand that each person learning to use a new assistive communication device will have unique needs.

Maintenance of the NeuroNode

The NeuroNode requires very little maintenance and can be maintained by either a clinician or a caregiver. Make sure of the following:
  • Both the device (if it is not plugged into a power source) and the NeuroNode battery are charged.
  • The patient has an ample supply of replacement sensors.
  • The phone number and email address of Control Bionics are nearby, in case you need support.

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