A New Pathway to Healing

Ghaith Androwis Ph.D. '14, a post-doctoral researcher at NJIT, amid his growing array of biomedical devices.

Ghaith Androwis has developed a novel method for improving muscle control in children with cerebral palsy (CP) by targeting a pathway that bypasses the problem in the brain, mechanically stimulating a nerve in the inner ear.

The nerve’s principal role is to maintain balance, and to do so, it sends messages to the motor system that controls muscle stiffness and movement.  By stimulating the nerve through an oscillating seat he devised, Androwis Ph.D. ’14 has reduced CP symptoms, including muscle rigidity and jerky movements.

“Cerebral palsy is caused by damage to the brain during or right after birth and it cannot be fixed, but we can approach the problem of muscle tone through another pathway – by stimulating the vestibular nerve. While it cannot cure the problem, we think it can increase the success of physical therapy, which does not always work well because these kids are often too stiff,” he says.

Androwis, who earned his Ph.D. in biomedical engineering in December and is now a post-doctoral researcher at NJIT, will present his work on vestibular stimulation later this summer at the 36th annual international conference of the IEEE Engineering in Medicine and Biology Society in Chicago. He worked closely on the project during graduate school with his advisor, Richard Foulds, an associate professor of biomedical engineering and a noted creator of machines that recognize and control human movement.

Allan Strongwater, M.D., chief of pediatric orthopaedic surgery for St. Joseph’s Children’s Hospital in Paterson, is the team’s clinical partner.

“Kids with CP may be motor-disabled, but many are cognitively normal. Being able to think normally inside a body that doesn’t work is about as tough as it gets, and so anything I can do to help these children, I will,” Strongwater notes, adding that he reached out to biomedical engineers at NJIT to both develop new approaches to therapy and to better understand them.

“I’ve been working with kids with CP for 10 years and most of my work has involved surgery,” he says. “There is a lack of understanding, however, of the basic science behind therapy – why some approaches work and others don’t.”

Animals that leap large distances and land without hurting themselves demonstrate the critical importance of the vestibular nerve.

“What we understand from squirrels, for example, is that they may not know the exact distance they’re covering – they estimate – but their vestibular systems, which detect gravity and the sensation of falling, respond by sending signals when jumping to lower muscle tone to better absorb shock.”

Children with CP have difficulty walking and performing other tasks in part because their muscles freeze up and jerk unexpectedly due to a lack of signaling or the transmission of incorrect signals. Androwis found that a single 15-minute session led to muscle improvements that lasted for 15 to 20 minutes. Following that pilot test, he will consider different regimens while also testing new ways to stimulate the vestibular nerve.

Working with a new population of patients – people who have had strokes – at JFK Medical Center in Edison, he and Peter Michael, a Ph.D. student at NJIT, will test both stimulation effects through his vestibular-stimulation chair and through another method that causes the whole body to vibrate in short bursts.

“With people who have had strokes, we would like to shrink the recovery time and magnify the chances of success with physical therapy,” he says, adding that he may add whole-body stimulation to the therapy regimens of children with CP after first testing it on adults.

Androwis, who is surrounded by an ever-changing array of devices in Foulds’s lab, has become something of a biomedical tinkerer himself. While he is pursuing research on vestibular stimulation, he is also devising high-tech braces he hopes will help disabled children to walk better.

“The idea is to create an inexpensive alternative to exoskeletons,” he says. “In research, seeing a smile on a child’s face after an intervention motivates me to continue working.”