CAN I WALK AGAIN? WEBINAR, APRIL 10, 2014 KIM ANDERSON-ERISMAN PHD DIRECTOR OF EDUCATION UNIVERSITY OF MIAMI MIAMI PROJECT TO CURE PARALYSIS
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1 CAN I WALK AGAIN? WEBINAR, APRIL 10, 2014 KIM ANDERSON-ERISMAN PHD DIRECTOR OF EDUCATION UNIVERSITY OF MIAMI MIAMI PROJECT TO CURE PARALYSIS JENNIFER FRENCH, MBA EXECUTIVE DIRECTOR NEUROTECH NETWORK
2 HAVE A QUESTION?
3 The Miami Project is dedicated to finding more effective treatments and, ultimately, a cure for paralysis resulting from spinal cord injury. Helping people regain life thru neurotechnology Focusing on education of and advocacy to access neurotechnology devices, therapies and treatments for people living with impairments, their care-givers and medical professionals.
4 DISCLAIMER PAGE The information presented in this session is not meant to replace the advice from a medical professional. You should consult a health care professional familiar with your specific case, concerns and condition. We highly suggest for you to take information to a trained medical professional familiar with your case to discuss options that are best for you.
5 AGENDA Will it be like before? Therapeutic vs. Prosthetic Application Benefits & Risks Consideration Technology Description and Supporting Research How to Access & Programs
6 WHY LOCOMOTOR TRAINING? Main principle provide the injured spinal cord with input to stimulate the remaining spinal cord network even after the connections with the brain are damaged Roy et al., 2012
7 WILL IT BE LIKE BEFORE? Probably not exactly like before Circuitry of the spinal cord is incredibly complex Reorganization is possible Schwab et al., 2010
8 WILL IT BE LIKE BEFORE? Regaining walking function may not solve all issues Sensation and pain Bladder, bowel, sexual function Temperature and blood pressure regulation Efficiency of movement
9 THERAPEUTIC VERSUS PROSTHETIC Therapeutic Application: Rehabilitative approach designed to facilitate the process of recovery from injury, illness, or disease to as normal a condition as possible. Focus is Restoration/recovery Voluntary control and Community Orientation Prosthetic Application: Tool used to compensate or replace lost function. Focus is Improve health condition Compensatory measures and Prevention/performance
10 BENEFITS OF WALKING Reduced Spasticity Cardiovascular/Pulmonary Health Improvements Circulatory Bladder/Bowel Management Pressure Sore Prevention Mental Health Musculoskeletal Health Muscle, bone, etc.
11 RISKS Increase potential for falls and bone fractures Sit to Stand low BP May be limited by contractures Unrealistic expectations can lead to lower QOL Increase of chronic pain Shoulder pain
12 TECHNOLOGY DESCRIPTIONS Body-weight Support Systems combined with Repetitive Motion Therapy Exoskeletons Electrical Stimulation
13 Body weight supported (BWS), repetitive motion, locomotor training Treadmill training & manual assist
14 Body weight supported (BWS), repetitive motion, locomotor training Treadmill training & stimulation assist
15 Body weight supported (BWS), repetitive motion, locomotor training Robotic assist (Lokomat)
16 BODY WEIGHT SUPPORTED (BWS), OVERGROUND, LOCOMOTOR TRAINING Over ground training
17 Changes in Walking Speed
18 Changes in Walking Distance
19 Whole Body Vibration & Locomotor Training Significant reduction in quadriceps spasticity Improvement in walking parameters
20 EXOSKELETONS l Cyberdyne l Ekso Bionics l ReWalk l Indego l REX Bionics
21 ELECTRICAL STIMULATION DROP FOOT STIMULATION Bioness: L300, L300T Innovative Neuronetics: WalkAide Odstock OFDS Brindley-Finetech - StimuStep
22 ELECTRICAL STIMULATION ALTERATIVE SYSTEM Commercial Devices Sigmetics/ParaStep Research Devices Implanted Neural Prosthetic Axibionics/Wearable Therapies Epidural Stimulation
23 HOW TO ACCESS? Purchase Personally Clinical or Post-Rehab Programs Clinical Trials
24 HOW TO ACCESS? HOSPITAL AFFILIATED Beyond Therapy - Atlanta, GA: Brooks Rehab Neuro-Recovery Center - Jacksonville, FL: NeuroRecovery Network Several Locations: PEAK Center Englewood, CO: Precision Rehabilitation Long Beach, CA: SHARE Program Minneapolis, MN:
25 HOW TO ACCESS? STAND ALONE PROGRAMS Buckeye Wellness Center: C.O.R.E.-Northridge, CA: Journey Forward Canton, MA: NeuroXcel North Palm Beach, FL: Next Step Fitness Lawndale, CA: Project Walk Several Locations: SCI-FIT - Sacramento, CA: The Recovery Project - Two Locations in MI: Walk The Line Southfield, MI:
26 HOW TO ACCESS? CLINICAL TRIALS Na1onal Library of Medicine & Na1onal Ins1tutes of Health Possible Clinical Trial Search Terms Walking AND condition Locomotor training Exoskeleton Robotic Therapy AND walking Electrical Stimulation AND walking Epidural Stimulation
27 What to ask before taking part in a clinical trial or human study?
28 What to ask before taking part in a clinical trial or human study?
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