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CERENEO PREVENTION

We put research
into practice

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Innovation is more than a buzzword for us. Equipped with our own clinical research team and thanks to our strong research collaborations, we do not only implement innovative technologies into our practices as fast as possible, but we also test their efficiency in treatment.

Research goals

The goal of our research partnerships is to develop a novel form of neurorehabilitation that is seamlessly integrated into the daily routine of our patients. The goal is that you train yourself by being as active as possible. The necessary corrective feedback, assistance and safety measures are provided by intelligent technology and by the interaction with your therapist.

We are continuously taking part in innovative research collaborations and projects working in conjunction with renowned educational bodies around the world and always aiming for the highest quality in neurorehabilitation, based on the latest scientific developments.

Motivation

Patients need to be self-motivated to be active in their daily lives. Our motivational research focuses on innovative therapy approaches to incentivise and foster active training and activity in everyday life.

Taking ownership

We are continuously taking part in innovative research collaborations and projects working in conjunction with renowned educational bodies around the world and always aiming for the highest quality of neurorehabilitation, based on the latest scientific developments.

Research collaborations

Close collaboration with various departments, such as D-HEST or RESC. Among other projects, the focus is on developing sensor technologies to be able to monitor stroke patients during their daily life.
Together with Johns Hopkins University, cereneo performs randomised, clinical studies in the area of arm rehabilitation using new robot training approaches.
Cooperation with Geert Verheyden, who steers a research line for sensorimotor deficits and assessment, recovery and rehabilitation in the upper limb after stroke.
The Lake Lucerne Institute (LLUI) is a private research & training center for neurorehabilitation. It works closely with the cereneo clinics as a platform to put research and education into practice.
Together with The LOOP Zurich Medical Research Center, cereneo is conducting a study to significantly improve precision rehabilitation through personalized stimulation loops.
We cooperate with the Schulthess Clinic, the leading clinic for orthopaedics, for acute orthopaedic questions and examinations.
We cooperate with the USZ in many ways and projects. Especially in the treatment of stroke patients with the Zurich Stroke Center or by providing high quality care for gold standard Parkinson treatments at USZ combined with long-term rehabilitation programmes at the cereneo clinics.
In cooperation with CERENEO PREVENTION, we focus on evidence-based prevention concepts for long-term brain health. The emphasis is on targeted neuroprevention, aiming to maintain cognitive performance, mental clarity, and quality of life well into old age. Through this close collaboration, we combine medical expertise with innovative prevention strategies – for a strong brain at every stage of life.

The latest technology in stroke recovery

Our neurorehabilitation clinics are equipped with state-of-the-art movement analysis, robotic systems and other innovative devices to complement the hands-on training with the therapist.

Armeo® Power by Hocoma

This arm exoskeleton helps impaired patients to train their arm movement by assisting with force.

ZeroG® by Aretech

This innovative over-ground gait training tool helps to train mobility and balance. Dynamic partial body weight support (DBWS) reduces the risk of falling whilst offering the patient a real-life experience.

Split-belt treadmill

Training on a split-belt treadmill with different velocities for each limb can trigger brain adaptations that render the gait more symmetrical. After a stroke this can be used to make the gait faster and less exhausting.

Current stroke research projects

Together with the cereneo Institute for Interdisciplinary Research (cefir), the University Hospital of Zurich and the ETH (Technical University), we perform basic and clinical research including randomised controlled trials testing new training and diagnostic methods.

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Precision training

Training relies heavily on the feedback of the therapists, again based on observation and experience.

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Diagnostic sensors

The continuous evaluation of neurological impairments and disability are the backbone of targeted and successful rehabilitation therapy

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Reward-augmented training

Based on evidence that we developed in our basic science program, we hypothesise that training can be improved by adding rewards.

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Current Publications

A translational roadmap for the use of precision non-invasive brain stimulation (NIBS) in stroke rehabilitation

Dr Meret Branscheidt, Medical Director at the cereneo Rehabilitation Center Hertenstein has been part of the NIBS roundtable expert team to establish a translational roadmap for the use of precision non-invasive brain stimulation in stroke rehabilitation. The outcome of this expert roundtable is the establishment of 5 key recommendations for the use of NIBS with the goal to tailor NIBS to the specific patient needs by using the same set of measurements to better track results to compare different studies.
At cereneo, Dr Meret Branscheidt is successfully using the different NIBS techniques at the cereneo rehabilitation clinic in Switzerland to support the recovery of stroke patients.

Automated and Quantitative Assessment of Tactile Mislocalization After Stroke

This is a case report by Mike D. Rinderknecht, Julio A. Dueñas, Jeremia P. Held, Olivier Lambercy, Fabio M. Conti, Leopold Zizlsperger, Andreas R. Luft, Marie-ClaudeHepp-Reymond and RogerGassert. The report describes a novel automated assessment tool for tactile mislocalization in neurological patients with somatosensory deficits after stroke. The automated assessment tool allows to identify, locate, precisely quantify, and depict the patients’ deficits in topesthesia, which can be severely affected by neurological injuries, such as stroke.

Rethinking interhemispheric imbalance as a target for stroke neurorehabilitation

This longitudinal study by Jing Xu, Meret Branscheidt, Heidi Schambra, Levke Steiner, Mario Widmer, Jörn Diederichsen, Jeff Goldsmith, Martin Lindquist, Tomoko Kitago, Andreas R. Luft, John W. Krakauer and Pablo A. Celnik aims to investigate inter hemispheric interactions of stroke patients by tracking their pre-movement inter hemispheric inhibition (IHI) for one year following their stroke. An inhibitory imbalance found in patients with chronic stroke seems to correlate with poor motor performance and is a target for therapeutic interventions.

Differential Poststroke Motor Recovery in an Arm Versus Hand Muscle in the Absence of Motor Evoked Potentials

This study by Heidi M. Schambra, Jing Xu, Meret Branscheidt, Martin Lindquist, Jasim Uddin, Levke Steiner, Benjamin Hertler, Nathan Kim, Jessica Berard, Michelle D. Harran, Juan C. Cortes, Tomoko Kitago, Andreas Luft, John W. Krakauer and Pablo A. Celnik aims to determine if presence or absence of motor evoked potentials (MEPs) differentially influences recovery of volitional contraction and strength in an arm muscle versus an intrinsic hand muscle. Recovery of movement in proximal and distal upper extremity (UE) muscles after stroke appears to follow different time courses which suggests differences in their neutral substrates.

Characterization of stroke-related upper limb motor impairments across various upper limb activities by use of kinematic core set measures

This prospective cross-sectional observational study by Anne Schwarz, Miguel M. C. Bhagubai, Saskia H. G. Nies, Jeremia P. O. Held, Peter H. Veltink, Jaap H. Buurke and Andreas R. Luft aims to comprehensively characterize spatiotemporal kinematics of stroke subjects during upper limb daily living activities. Therefore, kinematic expressions were investigated with respect to different movement types and impairment levels for the entire task as well as for motion subphases.

Evolution and prediction of mismatch between observed and perceived upper limb function after stroke: a prospective, longitudinal, observational cohort study

A prospective, longitudinal, observational cohort study by Bea Essers, Annick Van Gils, Christophe Lafosse, Marc Michielsen, Hilde Beyens, Fabienne Schillebeeckx, Janne M. Veerbeek, Andreas R. Luft, Daphne Kos and Geert Verheyden: The aim is to investigate the evolution of a group of stroke patients from six to 12 months, to determine factors on admission to inpatient rehabilitation. A shown ‘mismatch’ group of patients with good observed upper limb (UL) motor function but low perceived UL activity at six months post stroke tends to use the affected UL less in daily life than would be expected based on clinical tests. The importance of tailoring to the individual needs of patients is to be confirmed.

Augmented Reality–Based Rehabilitation of Gait Impairments: Case Report

This study by Jeremia Philipp Oskar Held, Kevin Yu, Connor Pyles, Janne Marieke Verbeek, Felix Bork, Sandro-Michael Heining, Nassir Navab, Andreas R. Luft aims (1) to investigate manipulation of the gait pattern of persons who have had a stroke based on virtual augmentation during overground walking compared to walking without augmented reality (AR) performance feedback and (2) to investigate the usability of the AR system. Improving balance and gait are among the main goals of rehabilitation after stroke.

Technology-aided assessment of functionally relevant sensorimotor impairments in arm and hand of post-stroke individuals

This study by Christoph M. Kanzler, Anne Schwarz, Jeremia P. O. Held, Andreas R. Luft, Roger Gassert and Olivier Lambercy evaluates the ability of the Virtual Peg Insertion Test (VPIT) to characterize arm and hand sensorimotor impairments that are relevant for performing functional tasks after stroke. To optimise the impact of neurorehabilitation interventions, it is essential to assess arm and hand sensorimotor impairments that are functionally relevant. The VPIT addresses limitations and quantifies movements during a goal-directed manipulation task.

Consensus-Based Core Set of Outcome Measures for Clinical Motor Rehabilitation After Stroke – A Delphi Study

This Delphi study by Johannes Pohl, Jeremia Philipp Oskar Held, Geert Verheyden, Margit Alt Murphy, Stefan Engelter, Agnes Flöel, Thierry Keller, Gert Kwakkel, Tobias Nef, Nick Ward, Andreas R. Luft, Janne Marieke Veerbeek aims to develop an internationally agreed on core set of motor outcome measures for clinical application to serve as a quality standard in clinical motor rehabilitation post stroke.

Reward During Arm Training Improves Impairment and Activity After Stroke

A randomized controlled trial by Mario Widmer, Jeremia P. O. Held, Frieder Wittmann, Belen Valladares, Olivier Lambercy, Christian Sturzenegger, Antonella Palla, Kai Lutz, Andreas R. Luft: Learning and learning-related neuroplasticity in motor cortex are potential mechanisms mediating recovery of movement abilities after stroke. These mechanisms depend on dopaminergic projections from midbrain that may encode reward information. Likewise, therapist experience confirms the role of feedback/reward for training efficacy after stroke.
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