Designing properties of nanofiber yarns and textile structures in garments as a tool to modify neural pathways and treat weakness post stroke.

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This fellowship proposal builds on doctoral research designing nanofiber yarns and novel 'bead' structures within everyday, familiar garments to contribute to functional changes in upper limb (UL) recovery from neurological deficits; specifically post stroke UL weakness. It aims to develop world-leading research positioning garments as highly effective applications of neurological treatments, which are responsive to medical and social needs, improving the translation of treatments into routine everyday life. By employing a STEAM agenda it combines material science, stroke rehabilitation with technical fashion/ textiles expertise. Improving UL recovery post stroke represents a major clinical goal. Currently up to 75% of survivors have persisting weakness and are currently underserved by the system; with methods failing to achieve the minimum guidelines of training required by around 240%. Current treatments are often primitive and lack a principled understanding, with exercise programmes being difficult to maintain and failing to accommodate lifestyle choices and behaviours of the individual. Muscle spindle afferents (MSA) are a major sensory input to the motor system, sensing the length and rate-of-change of length of muscles. This signal is vital to our sense of proprioception, telling us where the limbs are located in space. MSA can be activated artificially with a sharp mechanical tap. Generating such precisely-timed activation of MSA injects a powerful signal into the brain and spinal cord. This can activate circuits which may be immediately helpful - for example, in facilitating a weak muscle, or suppressing one which is overactive and generating an unhelpful co-contraction. MSA activation can also be paired with other stimuli (e.g. sound); then, the interval between stimuli can be controlled to modulate the induction of long-term plastic changes outlasting the stimulus. At present, most methods use electrical stimulation to activate sensory nerves for these purposes, but this is non-selective activating both cutaneous (skin tactile) nerves, as well as muscle spindles. The goal is to develop novel familiar textile-based methods of treating post stroke weakness by enhancing the precision and control of MSA activation. Placed early enough in recovery this method may prevent/ reduce the effects of further deficits.The bead enables the modification of neural pathways through the manipulation of patent pending piezoelectric properties by targeting the MSA in ways which current vibrational devices cannot achieve. The ease of its integration within textile structures takes advantage of the regular, intimate contact that a garment holds with the human body; presenting an opportunity to re-consider the delivery and positioning of rehabilitation between public and private contexts. In order to do so, considerations for perceptions of 'normal' body behaviours and the familiarities of how a garment and our identity impacts our being in the world are to be considered. The fellowship takes a highly multidisciplinary approach. It develops samples, conducts wearer tests and pre-analysis using design probe kits in collaboration with survivors and stakeholders, maps participants' existing behaviour with clothing, rehabilitation and levels of weakness with electrophysiological and material characterisation data. Independent reviews will document the impact of combining garments and 'medical devices', whilst body scanning and motion capture will be used to simulate effectiveness of textile structures prior to sampling.17 million incidences of strokes are reported worldwide per annum. This number is expected to rise by 123% in the next 20 years. Delivering effective treatments which are easy to use and appropriate to lifestyles is a top priority. The fellowship will establish a world-leading research lab, placing a focus on delivering impactful non-invasive neurological treatments in everyday garments.