Brain Injury, Spinal Cord Injury
Spinal Cord Injury
Using an exoskeleton for walking after weakness or paralysis has generated a lot of attention and I have had a number of patient ask me about it. ReWalk is a battery-powered robotic exoskeleton that attaches to the legs and lower back. It contains motors at the knee and hip joints and sensors to help it adjust with each footfall. While wearing the device and holding two forearm crutches, someone with complete lower-limb paralysis can walk.
Exoskeletons have sparked hope for those with paralysis. Using an exoskeleton for walking seems like a dream come true, but, sadly for most the technology is still out of reach. The cost is prohibitive and health insurers generally don’t cover the expensive equipment. The ReWalk System costs, on average, $81,000. Ottobock’s C-Brace is priced at $75,000. And the Indego Personal is $98,000.
Not only is cost an issue, but the device is not practical in all environments. One user of the Ottobock C-Brace exoskeleton finds the device very helpful in her home, but when she hiked the Appalachian Trail. She had difficulty keeping the battery charged for long periods and found rain to be problematic because it isn’t waterproof.
For some, no price is too high for the hope of walking again. In our area, Spain Rehab Center – UAB in Birmingham, AL and Shepherd Center in Atlanta, GA are the two closest training centers that can evaluate the benefit of an exoskeleton for walking for people interested in this system.
Have you had experience with an exoskeleton? If so, please share what it was like for you.
Spinal Cord Injury, Stroke
Thanks to all the volunteers who helped make the Ambucs Therapy Bike Build a huge success! A record number of bikes were assembled and distributed to disabled children and adults. These bikes give people who are unable to operate a traditional bike the fun and freedom of riding their own bike. As therapists, we know how important mobility is to staying healthy both physically and emotionally and Therapy Achievements is proud to assist this terrific organization.
Ambucs Therapy Bikes is one of the core charities of the Huntsville Semper Fi Riders organization. Semper Fi Riders is a group of Marines who love motorcycles and who’s mission is to support worthwhile causes involving America’s veterans and their families by giving of their time and sponsoring charitable events. They not only purchase the bikes but assembly and distribute them as well. Ooh Rah!
Spinal Cord Injury
physical therapy, wheelchair fitting
Cathy Craver, physical therapist, teaches wheelchair fitting to other therapists with a goal of optimizing function for patients. Cathy works at Spain Rehabilitation Center and recently presented “Seating and Wheeled Mobility: Where Science and Art Meet” to therapists in North Alabama. Cathy has a passion for helping others and has been a physical therapist at Spain Rehabilitation Center for more than 11 years. “I decided I wanted to work with people who have regular problems and who want to live a regular life. I wanted to find a way to help people make the most of their life situation given their disability. Since then it’s been a creative challenge. How do you help people make the most of what they have so they can live the life they have left to live? That drives me every day.” Wheelchair evaluation and fittings are one of the ways she does that.
People who use wheelchairs know the correct wheelchair fit is essential for optimal function. Wheelchairs come in all shapes and sizes and people who have issues with limits in mobility often cannot shift, move or maintain upright sitting without the supports provided by their chairs. “Your wheelchair is an important part of your life, so you want to make sure you end up with the right wheelchair that fits your body, preferences, activities and lifestyle” says The Model Systems Knowledge Translation Center (MSKTC), an advocacy group for individuals with traumatic brain injury (TBI), spinal cord injury (SCI), and burn injury. “With new types of wheelchairs and components coming on the market all the time, the days of “one size fits all” are long gone.” Some of MSKTC recommends you consider include:
The Clinic: Selecting the right clinic is a critical first step. The clinic you select should have a process and the key players in place to assist you with making the right choice.
The Team: Your team should include experienced rehabilitation professionals including:
• A medical doctor who understands your overall health situation. The doctor is the one who writes the prescription needed for your insurance to pay for the wheelchair and has ultimate responsibility for determination of medical necessity.
• An Occupational or physical therapist who is experienced in wheelchair evaluation and training.
• A Qualified wheelchair supplier who works with the therapy and medical team to trial, order and maintain equipment.
Certification: Many occupational and physical therapists and wheelchair suppliers will have Assistive Technology Practitioner (ATP) certification from RESNA (Rehabilitation Engineering and Assistive Technology Society of North America) indicating they have passed a national examination and credentials check in their specialty. If Medicare is the payer, they require the wheelchair vendor to have at least one ATP-credentialed specialist.
Karen Allen Hislop is the therapist who does wheelchair evaluations and fittings at Therapy Achievements. She is ATP Seating Specialist certified with RESNA and has been doing wheelchair evaluations and fittings for over 20 years. She works with a number of doctors and wheelchair suppliers to ensure patients get the correct wheelchair fit for optimal function.
Therapy Achievements is a Rehabilitation Center that provides Physical, Occupational and Speech Therapy for Balance and Movement, Speech and Swallowing, Swelling from Lymphedema and Edema, Driving Rehabilitation and Functional Living Skills for visual and cognitive re-training. We help people with Brain Injury, Stroke, Multiple Sclerosis, Parkinson’s Disease, Lymphedema, Head and Neck Cancer, Vertigo and Dizziness, and other disorders that interfere with mobility and function. We offer VitalStim Technology, Saebo Technology, LSVT LOUD Treatment, LSVT BIG Treatment, and Neuro-Developmental Treatment.
Spinal Cord Injury, Stroke
Members of the local Semper Fi Riding Club were some of the volunteers who assembled adaptive bikes for people with limited mobility at the Ambucs bike build. Being mobile is vital to the health and welfare of people with movement disorders such as stroke, spinal cord injury or cerebral palsy. It is very rewarding to be a part of helping 12 more people to increase their independence.
AMBUCS – American Business Clubs –is dedicated to creating mobility and independence for people with disabilities and fulfills this mission by:
Performing various forms of community service including building ramps and accessible playgrounds
Providing AmTryke therapeutic tricycles to individuals unable to operate a traditional bike
Awarding scholarships to therapists
AMBUCS – was formed in 1919 by Auburn graduate William White. His dream was to begin a national service organization for young business and professional men. Today there are more than 130 chapters in over 30 states – and they’re still growing! To learn more about AMBUCS and how to participate in adaptive bike build or their programs log on to: www.ambucs.org.
We are Cycling is a group that promotes all forms of cycling and classifies adaptive bikes for people with limited mobility:
Tricycles have three wheels, which means that the rider does not need to be able to balance. This is particularly useful for people with learning disabilities, such as Dyspraxia, and those recovering from illnesses (strokes, for example). Tricycles can be fitted with foot plates to make it easier for riders to rotate the pedals and they come in upright or recumbent (horizontal sitting position). For adults and children with balance issues, stabilizers can also be fitted to standard bikes, which makes them more like tricycles.
Tandems can have two, three or four wheels and are made for two people to ride together. Cycle configurations may have one rider in front of the other, or side by side in the case of three and four-wheeled machines. Tandems are particularly helpful when there’s a need to take over the pedaling or steering. Two-wheeled tandems are particularly good for people with visual impairments too. Another possibility for partnered riding is a ‘tag-along’ which consists of half a bike that bolts on to a standard 2-wheel bike. These are more commonly used for children, but there are adult versions on the market.
Hand powered cycles work along the same principle as standard cycles. The pedals are replaced with handles that also steer, and riders use their arms to push the
handles around to drive the chain and wheels. Most hand cycles have three wheels, although some have four wheels. Four-wheel cycles may have power assistance instead of the rider turning handles, or they may be built for going down hill, in which case gravity powers the bike. As with tricycles, hand cycles can have upright seats or low down recumbent seats. Specialist ‘clip on’ cycles are also available that can be attached directly to a persons wheelchair. Hand cycles are used by people with limited or no lower body mobility, e.g. because of paraplegia, leg amputations and those with joint problems such as arthritis. Hand cycles are also useful for rebuilding upper body strength – e.g. by those recovering from stroke.
Do you have a spinal cord injury? Therapy Achievements Can Help!
Physical Therapy to Improve Balance, Flexibility and Strength
Reduce Pain and Improve Mobility
Occupational Therapy to Improve functional ability
Recommend assistive devices
Speech Therapy to Improve Voice Volume and Control