We offer gait therapy on the Lokomat® system at all of our clinics. The Lokomat® is a driven gait orthosis that automates or assists walking movements on a treadmill, allowing greater efficiency of treadmill training and reducing physical demand on therapists. Locomotion therapy on the treadmill has been shown to improve over-ground walking function caused by neurological diseases and injuries in many cases.
The Lokomat® system consists of the robotic gait orthosis, the overhead body weight-supporting system, and the treadmill. The client is suspended in a harness over the treadmill, and the robotic frame is fitted to the client’s legs. The robotic frame then moves the client’s legs (with or without the client’s active participation) in a natural walking pattern. The computer-controlled guidance allows individual adjustments of different gait parameters such as stride length and amount of weight-bearing.
We utilize the Lokomat® to treat individuals with any neurological disease or injuries who will benefit from locomotion therapy and can tolerate the repetitive movement. This includes clients with stroke, spinal cord injury, brain injury, multiple sclerosis, and cerebral palsy. Other therapeutic activities are incorporated while the client is in the Lokomat® to promote upper body and arm function for gait and posture.
Many clients come to Neuromotion with the goal of regaining or improving their ability to walk. One method we use to help with this goal is training on the body weight-supported treadmill. The harness and treadmill system of the Lokomat can be used to provide a safe environment for stepping and gait without the fear of falling. The amount of deweighting can be adjusted so that the client takes anywhere from all of their weight to no weight at all.
This training method can be very useful for clients who have active movement but insufficient strength to carry their entire weight on their own. It allows for early activation, standing, and walking – which in turn can improve recovery by increasing strength, maintaining range of motion, and improving confidence.
MyndMove is a new and exciting modality developed by MyndTec Inc. right here in Canada! Using an 8-channelled functional electrical stimulation (FES) device, MyndMove’s aim is to improve purposeful movement of a client’s arm and hand. Different from a typical FES system, MyndMove is a dynamic therapy where a patient actively attempts a desired movement assisted by a therapist while being stimulated. It is the hope that with this therapy, an individual would regain purposeful movement patterns to achieve more independence and in turn, improve their quality of life. Currently, MyndMove is helping to treat paralysis in individuals that have suffered from a stroke or a spinal cord injury.
It stimulates the neural pathways engaged when practicing and executing functional movements. MyndMove delivers electrical stimulation to the muscles and then the muscles send a signal to the brain. When patients actively attempt a movement, this sends a signal down to the muscle. Based on the concept of neuroplasticity, a new pathway for the desired movement is established.
There have been numerous clinical studies looking at the effectiveness of MyndMove on recovery. The results have shown that people with high level spinal cord injuries (C1-C7) and anyone with a stroke (acute or chronic) has had some lasting recovery in their upper extremities after an intensive bout with MyndMove therapy.
FES cycling uses co-ordinated electrical stimulation to create a cycling pattern. This cycling pattern exercises the large muscles of the legs as running or cycling would do in a person who doesn’t have a spinal cord injury. The FES cycle at Neuromotion/Move is called the RT300. It is made by a company called Restorative Therapies. You can see more information about the cycle on the website: http://www.restorative-therapies.com/.
The FES in Vancouver and Surrey work on upper and lower extermities.
An electrical current is passed through paralysed muscle causing it to contract. The electrical current uses the peripheral nerves to pass the current to the muscle (the peripheral nerves must be intact for a contraction to occur).
Research has shown some positive benefits:
- Increase in bulk of stimulated muscles
- Increase in bone density in some leg bones
- Reduced body fat content
- Improved cardiovascular health (fitness training)
- Reduced risk of diabetes (improved glucose tolerance)
- Reduced spasticity in stimulated muscles
- Maintained flexibility
Feedback from people who use FES cycling:
- Feel happy seeing leg muscles contracting and exercising
- Feel healthy doing regular exercise
- For some people with very high injuries, FES cycling is the only way to exercise at an intensity that provides a fitness benefit
NUSTEP® is a recumbent cross trainer provides simultaneous upper and lower body conditioning for the muscles and cardiovascular system. The semi-recumbent stepping motion provides low impact on knee, hip and shoulder joints.
Leg stabilizers offer support for users with lower body weaknesses and provides better foot and leg alignment. Accessory handles ensure neutral wrist position during workout and can allow individuals with difficulties gripping to incorporate their arms into the wok out. Read More.
The standing tilt table aids individuals into an upright standing posture by being harnessed into the apparatus and being tilted slowly and safely from a lying position upright, placing load through the lower limbs. There are many benefits to standing alone, but often therapists include functional training such as upper extremity strengthening and goal-oriented balance tasks to get the most out of this posture.
The standing tilt table allows for weight bearing through the lower extremities in a position of imposed stretch on the hip, knee and ankle joints opposite to the seated position. Oftentimes, it is used as a tool for training balance and a precursor to gait training. Benefits to standing in the tilt table include improved bone density, cardiopulmonary function, gastrointestinal motility, reduced pain, and improved functional recovery. It has also been found to be helpful with the reduction of spasticity in those following stroke, spinal cord injury, and other neuromuscular disorders. Standing also offsets the spinal postural changes of sitting by engaging the deep core support muscles and maintaining length throughout.
Electromyography (EMG) is a type of biofeedback that provides information on muscle activity, it shows us if a muscle is contracting, or relaxing.
EMG biofeedback can be used to either increase activity in weak or paralyzed muscle, or it can be used to facilitate a reduction in muscle tension in overactive muscles.
The physiotherapist places external, or surface electrodes on the skin, to detect the electrical activity in a muscle. The information picked up from the biofeedback unit is displayed on a screen for both you and your physiotherapist to view. For example, for pelvic floor rehabilitation, external electrodes may be placed either side of the anus to gain information regarding the muscle tension in your pelvic floor muscles.
EMG biofeedback is a safe modality with very few contraindications.
A sensory swing is a form of graded sensory therapy used in the treatment of individuals with overactive or underactive vestibular systems. Our sensory swing is a ceiling mounted, platform swing which provides linear and rotational movement for children and some adults with vestibular or sensory integration difficulties. Children with autism sometimes have difficulties with sensory integration and the sensory swing can help calm and regulate their behaviour. It is also an excellent tool for balance training, improving righting reactions, core strengthening, motor planning and not to mention having fun!
The sensory swing works because it provides a challenge to the vestibular system.
The vestibular system plays an essential role in the connection between our body, gravity and the physical world. It provides us with the information about where our body is in space.
The therapist provides the child (or adult) with a variety of experiences on the swing, such as swinging in sitting, swinging in prone, throwing objects towards a target while sitting, looking at targets while swinging, changing directions and much more. By providing graded vestibular encounters, our therapists help the client integrate the vestibular, sensory and visual systems and in turn, our clients or their caregivers will notice functional improvements.
Video Frenzel Goggles are a set of goggles that record video of the eyes. This system allows the therapist to see how the eyes move in response to head and body movements in room light and in the dark. It helps with diagnosing and treating vestibular conditions. The goggles magnify the eyes on the screen to allow the therapist to easily see eye movements that are occurring. There is the ability to eliminate light going through the goggles so that eye movements can be analyzed in the dark. This prevents the patient from fixating on an object in room light and avoids the patient from being able to suppress the nystagmus. This system also allows the video of eye movements to be recorded and played back.
A hydraulic lift is a portable device that can be used along with a sling to support and transfer our clients safely from their wheelchair to the treatment area. One of our main goals at Neuromotion Physiotherapy is to keep our clients and therapists comfortable and safe during transfers.
Unlike many other physiotherapy clinics, Neuromotion has high-low tables that are extra wide to allow for a large range of functional mobility exercises. At times, the therapists will kneel behind a client to practice sitting balance and weight shifting and other times the client will need the extra space to practice rolling or hands and knee activities.
Many of our clients attend their sessions in power wheelchairs or manual wheelchairs and having adjustable treatment beds make for an easier transfer and being able to adjust the treatment beds, gives therapists the ability to gradually challenge clients during transfer training or sit-to-stand practice.