NextSteps offers an aggressive therapy program with innovative equipment in a positive treatment environment to enable the client maximum possible recovery. We offer a unique fusion of physical therapists, physical therapist assistants and personal trainers working together closely to provide activity based therapy (ABT) for people with paralysis. The premise of ABT is to activate the neuromuscular system above and below the level of injury in order to retrain the central nervous system to recover function of a specific motor task. ABT weight-bearing exercises and motor skills training decrease spasticity and ignite the neural patterns that stimulate mobility. It draws on the central nervous system’s ability to spontaneously regenerate (neural plasticity) after injury in response to high-intensity physical activities like cycling and treadmill training. Locomotor training (LT) is a form of ABT that re-teaches walking by using body weight support and a treadmill system in combination with manual assistance by specially trained staff. LT uses vigorous repetitive exercise to activate dormant nerve pathways by repeatedly stimulating the muscles and nerves below the injury site. It leads to enhanced neural communication and improvements in the ability to walk and stand while diminishing the detrimental consequences of physical inactivity such as cardiovascular disease, osteoporosis, incontinence, and poor muscle strength.
Reeve’s Paralysis Resource Guide
The Lokomat system assists walking-impaired individuals by automating gait orthosis on a treadmill and is used to improve mobility following stroke, spinal cord injury, cerebral palsy and multiple sclerosis as well as other neurological diseases and injuries. Using a body weight support system, the patient’s legs are guided on the treadmill according to a pre-programmed physiological gait pattern. The computer controlled guidance allows individual adjustments of different gait parameters. Hip and knee joint angles are controlled in real time by software to achieve a physiologically meaningful gait pattern. Force transducers at the joints accurately measure the interaction between the patient and the Lokomat. Each of the four joints is constantly monitored to ensure that they are precisely held to the predefined gait pattern. The drives are precisely synchronized with the speed of the treadmill to assure a precise match between the speed of the gait orthosis and the treadmill. The Lokomat improves the efficiency of treadmill training for over-ground walking while providing intensive, individualized training in a motivational environment of constant feedback.
The ReWalk is an exoskeleton suit with motorized legs powering knee and hip movement. Its patented technology controls movement using subtle changes in center of gravity to mimic natural gait and provide a functional walking speed. The system senses a forward tilt of the upper body to trigger the first step. Repeated body shifts produce a sequence of steps in a natural and efficient walking gait. With specialized training and practice, ReWalk users can also sit, stand, turn, ascend and descend stairs.
The ReWalk system provides a form of exercise that is beneficial for wheelchairs users with limited exercise options because it mimics a natural walking motion and requires users to control their body movements. The system is adjustable for different users, and can accommodate a range of heights (160 to 190 cm / ~63 to ~75 inches) or weights (up to 100 kg / ~220 pounds). The key prerequisites for use include:
- The ability to use hands and shoulders (walking with crutches)
- Healthy cardiovascular system
- Healthy bone density
Current clinical studies are examining the effects of ReWalk on improvements in cardiorespiratory function, bowel/bladder function and sitting posture as well as decreases in percent body fat, pain and spasticity.
A team of dedicated, innovative researchers, doctors, clinicians, and biomechanical design specialists designed the TheraStride Body Weight Support Trainer to provide injured patients with new levels of natural support and mobility. Its construction provides highly configurable comfort for accelerated rehabilitation of SCI patients across a wide spectrum of ages, weights, and levels of physical challenge. Its innovative biomechanical structure and integrated feedback system are revolutionizing the locomotion rehabilitation industry. Locomotor training, guided by the scientific principle of neuroplasticity, provides the sensory input normally associated with walking in combination with repetitive stepping to trigger neurons and axons to develop new pathways around a lesion or injury. Step training on a body weight support treadmill facilitates primary neural retraining activity by delivering manual-assist sensory cues and intense repetitive practice. Quality of life issues such as cardiovascular health, respiratory strength, weight bearing, balance, motor control, and gait can all be improved with activity based therapy on the TheraStride System.
The RT300 FES is an upper extremity/lower extremity cycle ergometer combined with functional electrical stimulation (FES) to stimulate the lower motor neurons connecting the spinal cord to core abdominal and back muscles important for activities such as transferring, reaching, balance, posture and coughing. With the use of surface electrodes on affected arm or leg muscles, neuromuscular electrical stimulation is adjusted on an individual basis to maximize muscle contractions within a comfortable range to improve the following:
- Relaxation of muscle spasms
- Prevention or retardation of disuse atrophy
- Increasing local blood circulation
- Maintaining or increasing range of motion
The computerized system built into the bike allows the bike to adjust to how much assistance is needed based on the program set by your therapist. The motor can provide both assistance and resistance depending upon the phase of your therapy session.
The Galileo® Advanced is a whole body vibration plate used in combination with conventional therapies to significantly increase the efficiency of therapy. By providing a high number of repetitions in a short time, the repetitive motion of Galileo results in motor and neural learning effects. The Galileo introduces a mechanical stimulus to trigger a reflex reaction in the body that is involuntarily controlled and can quickly and effectively improve existing residual functions within the central nervous system. The principle of Galileo is based on the natural movement of human gait. Galileo's side-alternating motion is similar to a seesaw movement with variable amplitude and frequency, and therefore stimulates a movement pattern similar to human gait. The rapid movement of the training platform causes a tilting movement of the pelvis, just like when walking, but much more frequently. The tilt of the pelvis stimulates the spine and allows back and abdominal muscles to be targeted. To compensate for the tilting of the pelvis, the body responds with rhythmic muscle contractions, alternating between the left and right side of the body. From a frequency of about 12 hertz onwards, these muscle contractions are not a conscious process but, rather, are a reflex. This stretch reflex activates the muscles in the legs, the stomach and the back right up into the trunk. Training platforms with a vertical movement compress the spine and significantly limit the extent to which those muscles can be engaged.
Galileo training can increase muscle power and force, improve flexibility and range of motion, and enhance balance and coordination. It helps increase blood circulation and metabolism while putting minimum stress on the cardiovascular system.