2
true
major difference
Rehabilitation
• Improves functional abilities• Differentiates between motor
improvement and true functionalrecovery
• Requires an ongoing process with reevaluation and long term therapy
• Involves neural plasticity, which is real and makes a major difference
recovery
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Neural Plasticity
• Improvement requires the performance of functional tasks
• Neural plasticity can take place for years after a brain injury
• Unmasking of other neural pathways and synapses (neural plasticity)
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Dynamic Orthosis
• Non-electrical/purely mechanical device
• Positions wrist and fingers in extension in preparation of functionalactivities
• Must have some shoulder and elbow movement and be able to flex fingers when wrist placed in extension
• Allows patient to perform “functional” tasks to promote neural plasticity
SaeboFlex®
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• Increase in synaptic efficacy in existing neural circuits or the formation of new synapses, indicating brain plasticity may underlie the improvements seen with FES
• Repeated movements induced by FES might reinforce network patterns
Possible Mechanisms FES
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Hand Rehabilitation
• Uses electrical stimulation to open and close grasp
• Can be used in the hospital or at home
• Electrical stimulation may retrain the brain
Ness H200®
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Lower Extremity Rehab
• Uses electrical stimulation to raise the foot during swing and control the knee
• Can be used in the hospital or at home
• Electrical stimulation may retrain the brain
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Dysphagia Treatment• Aspiration may be due to weak muscles• Electrical current stimulates motor nerves and throat muscles• Muscles are strengthened and re-educated• Improvement in diet and swallow function VitalStim®
Advantages of BWSTT
• Unloading lower extremity
• Fall free environment
• Maintain balance• Proprioceptive
input• Goal oriented and
specific
• Increase bone density
• Increase circulation
• Maintain range of motion
• Increase muscle strength
• Decreased spasticity
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Motion
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Gait Velocity
Average Geriatric Speed
0.8 m/sec
Community Ambulator
0.6 m/sec
Complications/Increased Falls<0.6 m/sec
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greaterRobot-Assisted Interactive Therapy
Robot-assisted technology that is based on the proven understanding that numerous repetitions of functionallyoriented movements can stimulate brain reorganization in stroke patients, and thus trigger greater functional recovery recovery
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What does it all mean?
• Scientific basis for equipment
• Continuing research for validity
• Rapidly advancing
rehabilitation
Technology:
BITS
• BITS-Bioness Integrated Therapy System• Upgraded from Dynavision from Bioness• Clinical pre-driving skills• Visual scanning• Visuospatial deficits• Cognitive/sequencing tasks
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Interactive Metronome
• Initially developed for athletes• Then, used with ADHD adolescents• Later, expanded for application with neuro population• Attention• Concentration• Coordination• Endurance• Dual-tasking• Motor planning17