Friday, July 13, 2012

Functional Locomotion Therapy

Locomotion therapy supported by an automated gait orthosis on a treadmill has shown to be an effective intervention for improving over-ground walking function caused by neurological diseases and injuries in many cases. 

The Lokomat system assists walking movements of gait-impaired patients and is used to improve mobility in individuals following stroke, spinal cord injury, cerebral palsy and multiple sclerosis as well as other neurological diseases and injuries. The LokomatPro has been on the market since 2001 and has been a crucial improvement in the art and science of locomotion therapy. 

LokomatPro features a new and more compact design and is equipped with the Augmented Performance Feedback and a touch screen as a standard.


Advantages of Lokomat®Pro based therapy:

  • longer and more intensive training sessions compared to manual treadmill training
  • real time feedback for a higher motivation and compliance
  • physiological gait pattern provided by individually adjustable orthoses, guidance force and body weight support
  • assessment and reporting functionality for an easy measurement of the patient’s progress
  • Pediatric Orthoses: an optional add-on module offering the first driven gait orthosis for functional and motivating locomotion therapy for small children
Information on this page is provided for interest only on a "best efforts" basis and does not 
constitute personal advice. Always discuss medical conditions and related matters with your doctor.

Source: www.hocoma.com

Thursday, July 12, 2012

Functional Electrical Stimulation System (FESS)


Functional Electrical Stimulation (FES) is a rehabilitation technique where electrical current is applied to an individual with a disability to enhance that person's ability to function and live independently.

FES is used to stimulate peripheral nerves, the "lower motor neurons" that connect the spinal cord to your muscles.

Stimulating these nerves evokes patterned movement of the legs or the arms.  This is how FES enables your muscles to perform work even though you may have has lost all or some voluntary control of the muscles.

The use of RT300-SLSA, FES system (FESS) is widely used in the international rehabilitation community.  The RT300-SLSA is compact and portable and thus suited for use in places where space is a constraints.  It also comes with a smart stimulation system (SAGE) which automatically saves each patient’s cycling parameters as well as performance measures at the end of each session.  SAGE automatically progresses the training parameters based on patient’s performance.  All the information saved by SAGE is sent via internet connection to an online portal where caregivers, therapists and patients are able to monitor the patient’s progress.     
Fig - FESS, RT300-SLSA from Restorative Therapies


 
The FESS is an an arm and leg cycling machine coupled with functional electrical stimulation.  This therapeutic device enables muscle strengthening in individuals with complete or partial loss of voluntary muscle control as a result of injury to the central nervous system, for example in spinal cord injury, multiple sclerosis and stroke.    

Electrical stimulation is provided through surface electrodes placed on the patient’s skin and over selected groups of muscles in the patient’s arms and/or legs and/or trunk.  Patterned electrical stimulation of the patient’s arm and/or leg muscles will enable the patient to actively propel the arm and/or foot pedals.  Patients remain seated in their wheelchairs while cycling.   

 
The use of this device will serve as an adjunct to facilitate:
  •  Recovery of voluntary muscle control
By stimulating paralysed or weakened muscle, therapists are facilitating adaptive changes in the central nervous system (CNS) i.e. brain and spinal cord.  This effect may be enhanced when the patient is performing a meaningful activity like cycling.  Adaptations in the CNS may then translate into improved motor recovery.
  •   Reduction of spasticity   
When poorly controlled, spasticity can be a major hindrance to function especially when combined with muscle weakness.  Optimal management of spasticity will improve patient’s mobility, function and maintenance of personal hygiene.    
  •  Increase in cardiovascular fitness
Extended periods of bed rest quickly result in reduction in the heart and lungs ability to support activity i.e. cardiovascular fitness.  On admission to the rehabilitation centre, patients often tire quickly during therapy due to poor cardiovascular fitness.  Increasing their cardiovascular fitness will allow patients to tolerate longer sessions of therapy.  

The FES Leg and Arm bike will add to a suite of cutting-edge therapeutic 
services, enabling a centre to provide enhanced, evidence-based care for the
patients.   

Information on this page is provided for interest only on a "best efforts" basis and does not 
constitute personal advice. Always discuss medical conditions and related matters with your doctor.

Source: Joy Teo & Doreen Yeo,  Rehab Therapy Services, TTSH; http://www.restorative-therapies.com/