Betram  Ezenwa, Ph.D. 

Associate Professor, Senior Research Scientist 

Interests and Expertise
Dr. Ezenwa's research focuses on blending traditional engineering techniques with health and clinical sciences to improve the quality of human life. They include:

Falls Research: Predicting unintentional falls in the elderly population so that proactive steps may be instituted to prevent first or repeat falls is the compelling reason for my interest in Falls Research because the aftermaths can be summarized with three words: Fear; Fracture and Death. The objective of my falls research is continued development of a network of quantitative evidence for preventing unintentional falls in the elderly based on individual intrinsic, extrinsic and confounding risk factors in specifically defined home, work and leisure setting activities. Emerging technology such as frictionless sliding and rotating staging systems have made it possible for Dr. Ezenwa to develop the environment that mimics unpredictable condition preceding unintentional falls so that individual neural and muscular responses to unintentional balance destabilization can be quantified, but this is only a start. Pilot test funded by the Extendicare Foundation show prospects of using the technology to differentiate fallers from non-fallers. I am pleased with the positive reception of the pilot study outcomes by Medical Doctors and Therapists at Medical College of Wisconsin Milwaukee and University of Wisconsin Medical School Madison Departments of Geriatrics and Gerontology. Apart from the impact of individual; neural and muscular state as contributors to unintentional falls from our research we are aware that vestibular, vision, medication and individual lifestyle also play important roles. Our current goal is to pull this quantitative evidence into a decision engine to develop robust prediction of who may be susceptible to fall. UWM faculties, Milwaukee VA Hospital and Medical College of Wisconsin faculties collaborate in the studies.

CMAP Research: The objective of CMAP research is to eliminate potential inadvertent negative impact on measured outcome resulting from pressure on measurement electrode during nerve conduction evaluation. Due to conditions of bony prominence and unusual body surface conditions pressure is sometimes exerted on measurement electrodes to facilitate measurable signal. Use CMAP measure have been limited to conduction velocity information excluding amplitude information because the amplitude component of the measured signal varies a lot and is thought to unreliable. I developed a system that identified why the amplitude information is unreliable (US Patent 7179231, 2007) and a method to correct it. Bench tests suggest that pressure on measure electrode affects both the signal magnitude and conduction velocity information as well. Pre-clinical trials are planned to determine efficacy.

Osteoporosis Research: Age and musculoskeletal degeneration are precursor to osteopenia a lesser degree of muscle and bone thinning that, left untreated, can progress to osteoporosis. This condition that manifests more in women has associated orthopedic complications at the hip and spine. My immediate interest is to determine bone stress characteristics that safely cause increase in bone density and muscle mass for rapid improvement in bone lattice structures and muscle strength. A core mechanical vibration technology called NOMAMS has been developed (patent pending) that allows measurable and controlled stress input to body segment or whole body bone structure and musculature. The system is capable of applying intermittent variable intensities of nodes of vibration at multiple frequencies and hence avoids the dominance of any single frequency. Bench tests funded by University of Wisconsin System Applied Research are underway to finalize a prototype and pilot studies to determine impact on people diagnosed with osteoporosis. UWM faculties, Milwaukee VA Hospital and Medical College of Wisconsin faculties collaborate in the studies.

Research to Aid Persons with Disabilities: Dr Ezenwa believes in developing relevant new Assistive Technology to suite persons with unique disabilities. To achieve high standards, he developed technology courses tailored for non-engineering students. That move helped to facilitate the formation of design teams comprising senior engineering students and Health Science professionals that resulted in optimal outcome invited for presentation at 2005 RESNA conference in Florida. See Dr. Ezenwa's Assistive Technology Design projects (14 years) archived by the National Science Foundation on UCONN Website: http://nsf-pad.bme.uconn.edu), starting with edition 1994. If you have problems with earlier editions inquire from the editor.

Preventing Fighter Pilot Blackout: Early or late peeling from approaching missile is deadly for pilots during engagement. Our interest was to simulate survivability of pilot during high performance of L1/M1 maneuver for tests using high-speed High-G centrifuge.

Functional Electrical Rehabilitation for Spinal Cord Injured: Veterans who suffered spinal cord injury were the focus for evaluating existing and developing new functional electrical rehabilitation systems for the rehabilitating and maintaining neuromuscular and skeletal integrity for better quality of life of veterans. The Design News featured Dr. Ezenwa's unique design at Wright State University, Dayton Ohio.

Dynamic Control of Prosthetic Socket Excess Pressure: Advances in technology has made it possible to design and develop prosthetic socket with perfect fit. Companies now use advanced technologies to produce prosthetic legs that offer prosthetic socket relief, absorb pressure during landing and aid push off. These steps in the right direction occur as reaction to problems. However many amputees who cannot tolerate waiting for reactions, stop using prosthetic devices and resign to becoming wheelchair bound. My interest is to eliminate excess pressure and return prosthetic device use as was fitted by prosthetics. A combination of smart sensors, real-time process, steps ahead predictors, in multiple issues-based logic show promise (patent pending). A part of UWM CHS MOVE project funded by the US Department of Defense.

Control Systems: Effective control of the ailing parts of human performance requires strategies beyond traditional control system theories because the human machine is complex, and time varying in characteristics and performance, and quite frankly not yet well defined, and no two human machines are alike. Dr. Ezenwa blends traditional engineering with high-precision real-time characteristic feedback to provide relevant control strategies where practical. Success such as use of electrical stimulation to propel a wheel chair and to engage in prolonged lower extremity and combined upper and lower extremity exercise for the spinal cord injured are outstanding, Journal of Rehab R&D and US Design News refers. Current interests in this area include use of multiple issues based logic for decision-making in neuromuscular control, dynamic imaging and control of human joint

Patents Received:
Multi-frequency bio-impedance system for body composition determination and evaluation US Patent 5063937, 1991

Transfer Transport system for the disabled US Patent 5193633, 1993

Apparatus and method for analyzing nerve conduction US Patent 7179231, 2007

Patents Pending:

Multi-Mode Vibration Platform to Treatment of Bone Loss (Filed UW System WySis)

Prosthetic Socket with Dynamic Control of Pressure Points (Filed UW System WySis)

Positions:

Post Doctoral Fellow, Biomedical Engineering Department, Wright State University, Dayton Ohio

Research Assistant Professor, Biomedical Engineering Department, Wright State University, Dayton Ohio.

Director, Engineering Development National Center for Rehabilitation Engineering, Wright State University, Dayton Ohio

Adjunct Clinical Faculty School of Graduate Studies Wright State University, Dayton Ohio

Director and Manager, Rehabilitation Engineering Department, Rehabilitation Institute of Michigan, Detroit Medical Center, Detroit Michigan

Assistant Professor, Department of Physical Medicine and Rehabilitation Wayne State University School of Medicine, Wayne State University, Detroit Michigan

Adjunct Assistant Professor, Department of Mechanical Engineering, Wayne State University College of Engineering, Wayne State University, Detroit Michigan

Associate Professor, College of Health Sciences, College of Engineering and Applied Sciences, University of Wisconsin-Milwaukee, Milwaukee Wisconsin

Senior Research Scientist, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee Wisconsin

Professional Memberships
Institute of Electrical & Electronics Engineers (IEEE)
IEEE Engineering in Medicine and Biology Society
IEEE Neural and Rehabilitation Engineering Society

Professional Service
Assistant Editor, IEEE Transactions on Rehabilitation Engineering
Associate Editor, IEEE Transactions on Rehabilitation Engineering
Theme Chair, Clinical Engineering Symposium IEEE EMBS Conference
Session Chair, Clinical Engineering / Education IEEE EMBS Conference
Technical Review, Medical Physics and Biomedical Engineering Congress

Recent Publications
Selected from peer-reviewed publications and conferencesEzenwa, BN, Reynolds, D, Rowley B, Danset, P. Characterization of The Lower Limb of Quadriplegics for The Design of a Controller for Functional Electrical Stimulation", AUTOMEDICA. 11: 43-52, 1989.

Hooker, S, Figoni, S, Glaser, R, Ezenwa, BN, Faghri, P. Physiologic responses to prolonged electrically-induced leg cycle exercise in the spinal cord injured. Arch Phys Med Rehabil 71:863-869, 1990.

Ezenwa, BN, Glaser, R, Couch, W, Figoni, S, Rodgers, M Adaptive Control of Functioning Neuromuscular Stimulation-Induced Knee Extension Exercise J Rehabil Res Dev,. 28: 1-8, 1991.

Rodgers, M, Glaser, G, Figoni, F, Hooker, S, Ezenwa, BN, Collins, S, Mathews, T, Suryaprasad, P, Gupta, S. Musculoskeletal responses of spinal cord injured individuals to functional neuromuscular stimulation-induced knee extension exercise training J Rehabil Res Dev, 28: 19-26, 1991.

Figoni, S, Glaser, R, Rodgers, M, Hooker, H, Ezenwa, BN, Collins, C, Mathews, T, Suryaprasad, A, Gupta, S. Acute Hemodynamic Responses of Spinal Cord Injured Individuals to Functional Neuromuscular Stimulation-Induced Knee Extension Exercise J Rehabil Res Dev, 28:. 9-18, 1991.

Ezenwa, BN, McGuire J, "Minimizing the impact of electrode pressure during CMAP evaluation" in Proc. 26th Int. Conf. IEEE Engineering in Medicine and Biology Soc., 2004, vol. 26, San Francisco. pp. 4733-4736.

Ezenwa, BN, "Frictionless sliding and rotating system for neuromuscular reserve determination" in Proc. 25th Int. Conf. IEEE Engineering in Medicine and Biology Soc., 2003, vol. 25, Cancun. pp. 878-1880.

Ezenwa, BN, "Integrated clinical engineering information systems" in Proc. 19th Int. Conf. IEEE Engineering in Medicine and Biology Soc., 1997, vol. 19, Chicago. pp. 2672-2675.

Zander, JE, King, PM, Ezenwa, BN. Influence of flooring conditions on lower leg volume following prolonged standing. International Journal of Industrial Ergonomics. 34:279-288, 2004

Ezenwa, BN, McGuire, JR. "Technology and method to evaluate neural and muscular responses to unintentional balance destabilization in the elderly" ICADI St. Petersburg FL, USA pp:203-204, 2006.

Kim J, Ezenwa, BN. "The effect of neck stiffness on balance control in the elderly" ICADI St. Petersburg FL, USA pp:205-206, 2006.

Ahmad AS, Ezenwa, BN. "Evaluation of neuromuscular responses in the elderly during task performance to determine falls susceptibility" ICADI St. Petersburg FL, USA pp: 179-180, 2006.

Invited Presentations
Continued Medical Education lecture: Medical College of Wisconsin, Division of Geriatrics and Gerontology, January 6, 2006.

Continued Medical Education lecture: University of Wisconsin Madison Wisconsin, section on Geriatrics and Gerontology, March, 15 2006

Completed Research Support
National Science Foundation: Undergraduate Design Projects Wayne State University Michigan and University of Wisconsin-Milwaukee Wisconsin. The objective of this research is expose undergraduate mechanical engineering seniors to problems facing persons with physical limitation

College Park Industries: Comparative Evaluation of Eversion and Inversion of Artificial Ankle. The objective of this research was to quantify eversion and inversion characteristics of artificial foot.

Amfit Incorporated, California:Evaluation of Custom Made Insoles. The objective of this research was to determine the differences between custom-made insoles and off the shelf.

NIDRR: Use of Robot arm in OT Upper Extremity Coordination Therapy. The objective of this research was to develop and evaluate the use of robot in OT upper extremity rehabilitation developed.

Veterans Affairs: Evaluation of a Bio-Impedance System For Real-time Bladder Volume Monitoring. The objective of this research was to evaluate the efficacy of using the multiple frequency bio-impedance system developed by B. Ezenwa in non-invasive monitoring of bladder fluid volume in SCI patients.

ROSS Laboratories Columbus Ohio: Determination of Fluid Compartments With Multiple Frequency Bioelectric Impedance (Reliability Analysis). The objective of this research was to evaluate the efficacy of using the multiple frequency bio-impedance system developed by B. Ezenwa in blood flow in humans.

Veterans Affairs: Improving Exercise Performance of Quadriplegics The objective of this research was to evaluate and quantify the use of FES-induced device to improve the health of quadriplegics.

Veterans Affairs: Evaluation of FES Techniques for Exercise. The objective of this research was to evaluate and quantify existing FES-induced exercise to improve the health of quadriplegics to determine efficacy and relevance.

Michigan Rehabilitation Services (DoEd): Community Assistive Technology Council For Wayne and Oakland Counties. The objective of this project was to initiate and develop pathways for long-term maintenance of community-based assistive technology awareness for efficient service delivery by facilitating cooperation and communication between service providers and all stakeholders (population served and payers).

US Department of Education Rehabilitation Engineering and Technology Training. The objective of this project was student education training program to produce MS graduates competent to provide assistive technology services to persons with disabilities.

Speaker Topics 
Biomedical Instrumentation
Rehabilitation Robotics
Predicting Falls Among the Elderly
Osteoporosis Prevention
Biomedical Engineering and Assistive Technology Design