NEW BIONIC LEG AT MARLTON REHAB HELPS STROKE PATIENTS & OTHERS WALK THEIR WAY TO GAIT RECOVERY

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1 NEW BIONIC LEG AT MARLTON REHAB HELPS STROKE PATIENTS & OTHERS WALK THEIR WAY TO GAIT RECOVERY Device offers hope of improved mobility to people disabled weeks or years ago Recovery results from Bionic Leg enabling exercises proven to help the brain rewire Marlton, NJ Stroke patients and others rehabilitating at Marlton Rehabilitation Hospital are the first in New Jersey to walk their way to recovery with the aid of a new Bionic Leg. Marlton Rehab has just put into service its new Tibion Bionic Leg, a wearable robotic device that provides the assistance and resistance required by stroke survivors, MS patients and others wishing to re-learn how to stand up, walk and climb stairs without the use of a walker, cane or even a stair railing. The Tibion Bionic Leg isn t a bionic replacement like those provided to TV s Six Million Dollar Man and Bionic Woman it s strictly a rehabilitation device developed in Silicon Valley that will help Marlton Rehab patients regain pre-stroke, pre-injury or pre-surgery capabilities. It looks a bit like that of the protagonist in the movie Robocop. Inside its black carbon-fiber exterior are a sophisticated computer, the same lithium-ion batteries that power America s all-electric sports car, and powerful small motors capable of helping a patient weighing more than 200 lbs to regain lost ability to walk with increased independence. The Bionic Leg works by enabling patients to initiate and repeat the many sit-to-stand, stepping and stair climbing exercises necessary to enable the brain to rewire new pathways around areas lost to stroke and other neurological conditions. It also has shown benefit in patients who ve developed poor gait following incomplete recovery following knee and hip replacement, hip fracture and other orthopedic injuries. Patients using Marlton Rehabilitation Hospital s new Bionic Leg won t simply come along for the ride it works by requiring patients to put as much weight on their affected leg as they can the Bionic Leg just provides the difference. Medicare Part B and many private insurers cover outpatient therapy with the Bionic Leg. Wide range of Marlton Rehab patients will benefit One of the objectives of early stroke rehabilitation is to get patients up, walking as best they can, and ready for home or outpatient therapy, explains Ken Turley, MPT, NCS, Outpatient Therapy Department Manager at Marlton Rehabilitation Hospital. Patients with an impaired mobility typically develop compensation techniques unable to rise from a chair with both legs, for example, they instinctively compensate by trying to stand up using their unaffected leg and arm, and shuffle hesitantly with a walker or cane. The Bionic Leg provides a stroke patient s weak leg with the extra support it needs to increase early mobility and help their brain relearn how to stand up and step without compensation techniques. We ll use the Bionic Leg to make acute neurologically-impaired patients more mobile earlier, Mr.Turley predicts, and hopefully, to help them avoid the compensation techniques they tend develop with early conventional rehab. The objective of Bionic Leg therapy is to help patients get back to the lifestyle they enjoyed prior to their impairment. In some cases, that s a private home or apartment, but in others it may be an independent or assisted living facility. Marlton Rehabilitation Hospital will work with the wide range of New Jersey retirement communities to provide their residents with the care needed to maximize their independence and safety to continue in familiar surroundings. -more-

2 Page 2 of 2: NEW BIONIC LEG AT MARLTON REHAB Why Bionic Leg is essential to efficient stroke rehabilitation Until relatively recently, doctors and scientists generally accepted that brain damage by stroke was largely irreversible. These experts believed that whatever function was likely to come back would largely do so within three to six months, and that disability a year post-stroke was permanent. As a result, stroke therapy was and continues at many centers focused on helping patients to ambulate largely dependent on their unaffected leg. That kind of distinctive stroke gait is exhausting, and puts stroke survivors at greatly increased risk of falls. Poor gait following stroke contributes to a doubling of fall risk, as illustrated by a study reported in the May 2009 issue of Stroke: Journal of the American Heart Association. In a study of 1,104 stroke survivors, 37% reported at least one fall during the six months after their stroke. Of the 407 participants who fell, more than a third required medical treatment and 8% sustained a fracture. However, research over the past 20 years has shown that prolonged stepping helps stroke patients to rewire their brain to establish new neural pathways to their legs in a process known as neuroplasticity. The Tibion Bionic Leg harnesses neuroplasticity because it s an intention-based device it provides just enough support to a patient s stroke-affected leg to enable the patient to use it synchronously with the unaffected one. From that point on, the patient not the therapist, and not the Bionic Leg do most of the rehabilitation work. The patient must take steps with, and put prescribed weight on the affected leg. Patients typically begin to show improvement in just a month when receiving two-three treatments per week.leg therapy. Inpatients can benefit from daily therapy, which some Bionic Leg facilities believe can reduce development of hard-to-break bad habits, like trying to stand and sit just with their unaffected leg and arm. A few patients have demonstrated improved stepping for minutes or hours as soon as the Bionic Leg is removed on the first therapy session. Bionic Leg therapy can continue as long as the patient continues to make gains or improves to the point where they can improve their gait speed and endurance the same way others do by walking! Stroke patients interested in being evaluated for Bionic Leg therapy should ask their physicians to refer them to Marlton Rehabilitation Hospital Outpatient Therapy Department at Not all stroke patients are suitable for Bionic Leg therapy. Marlton Rehab clinicians must evaluate all candidates, and receive authorization from primary care physicians or medical specialists. Additional information on the Tibion Bionic Leg is available at Marlton Rehabilitation Hospital was the first acute care hospital in New Jersey to receive CARF accreditation as an Inpatient Stroke Specialty Program. It provides rehabilitation through its 49-bed inpatient unit and state of the art outpatient services. It serves patients with a broad range of rehabilitation needs, including those recovering from stroke, multiple trauma, orthopedic surgery, amputation, hip fracture, brain injury, severe advanced osteoarthritis, polyarticular and rheumatoid arthritis, and many other conditions. It is owned and operated by Vibra Healthcare. For additional information, visit

3 The Tibion Bionic Leg Exclusively in New Jersey at Marlton Rehabilitation Hospital Background Information at-a-glance What the Tibion Bionic Leg is and isn t The Tibion Bionic Leg is an advanced biomechanical device. It contains pressure-sensors in a shoe insert to detect and amplify users movements, as well as an on-board computer to interpret those movements, and motors to assist the user in walking, sitting or standing. It is not a prosthetic, and is not intended for long-term use. For therapy, it is simply strapped to the patient s leg over his or her clothes. At the end of a therapy session, it is removed. How the Tibion Bionic Leg helps patients regain functions like walking The human brain has a characteristic known as neuroplasticity an incredible ability to repair and re-wire itself after injury caused by stroke or trauma. It can re-learn lost skills, such as walking, by simply repeating the necessary movements over and over. The Tibion Bionic Leg helps patients regain function by letting them practice the repetitive movements associated with walking, sitting, standing and climbing stairs. Patients who benefit from therapy with the Bionic Leg The Tibion Bionic Leg can help: Stroke survivors Patients who need rehab therapy after orthopedic injury, hip or knee replacements Patients with neuromuscular disorders Patients with traumatic brain injury Important note: the Tibion Bionic Leg is biomechanical. There is no electrical muscle stimulation, so it can be safely used by patients with pacemakers or implanted defibrillators. Functions patients can re-learn with Tibion Bionic Leg therapy The Tibion Bionic Leg enables patients to relearn how to: Stand up and sit down independently Walk on normal surfaces with improved balance and gait Climb stairs

4 The significance of the availability of Bionic Leg therapy The Tibion Bionic Leg is designed for rehabilitation with stroke survivors, patients with orthopedic injuries, hip or knee replacements and patients with certain neuromuscular disorders or brain trauma. According to IRF-PAI Statistics & Trends, by erehabdata.com (presented at AMPRA conference October 2011): Of the Medicare patients nationwide admitted into an In-Patient Rehabilitation Facility (IRF): 20% are stroke patients (23.6% in the South Atlantic region) 13.68% are for fracture of a lower extremity 11.79% are for replacement of a lower extremity joint This data is significant in terms of potential candidates for therapy using the Tibion Bionic Leg, given that more than 45% of patients nationwide who are admitted to an IRF have conditions that may be treated effectively with the device. Additional patients may also qualify (those with neuromuscular disorders or brain trauma). Note: the above statistics only refer to Medicare patients, and is therefore actually higher with the addition of non-medicare patients. Components of the Tibion Bionic Leg A pressure-sensing shoe insert that detects and measures the amount of weight a patient is applying to the affected leg A computer that adjusts the amount of support and resistance provided to the patient s affected leg during different tasks and predicts what the patient will do next Two motors to provide support and assist motion An angle sensor in the knee to inform the computer what the patient is doing Preparing for a rehab session with the Tibion Bionic Leg The therapist: Puts a thin sensor pad into the patient s shoe on the affected leg. This detects how much weight the patient is applying to the heel and front of the foot Straps on the Bionic Leg and plugs in a signal cable from the foot sensor pad Dials in the patient s weight, and how much weight the patient must apply to the affected leg before the Bionic Leg begins to provide assistance Dials in how much assistance the Bionic Leg should provide when the patient stands, sits, and climbs or descends stairs

5 Time needed to achieve results with Tibion Bionic Leg therapy Patients typically begin to show improvement in just a month of twice-weekly Bionic Leg therapy. Some patients achieve significant improvement after just one session of therapy Where Tibion Bionic Leg therapy is available in New Jersey: Marlton Rehabilitation Hospital is currently the only organization in New Jersey offering rehab therapy with the Tibion Bionic Leg. Marlton Rehabilitation Hospital was chosen by Tibion to introduce the Bionic Leg to New Jersey because of Marlton Rehab s commitment to innovative rehabilitation technology and its commitment to patient health and wellness. Marlton Rehab is the first rehabilitation hospital in New Jersey to receive CARF (The Commission on Accreditation of rehabilitation Facilities) and full accreditation of The Joint Commission. Marlton Rehabilitation Hospital 92 Brick Road Marlton, New Jersey Toll Free / In-Patient / Out-Patient / Media contact: For more information, please contact: Donna Sobel, Director of Business Development, at

6 Introducing The Tibion Bionic Leg at Marlton Rehabilitation Hospital The Tibion Bionic Leg builds on the increasing appreciation of the components of conventional and body weight support treadmill therapy (BWSTT) that could contribute most to neuroplasticity and functional recovery of gait specifically: Patient intention/initiation of functional activity the patient, and not a therapist or robot, must initiate effort by applying weight to the affected foot. Sensors within a Bionic Leg shoe insert detect when the patient has applied a PT-specified minimum force, after which motors within the Bionic Leg provide a PT-specified percentage of body weight support solely to the affected leg. Intensity of functional therapy enabling the patient to work hard and productively at ambulation. Once the Bionic Leg matches affected leg strength with the unaffected leg, the patient can safely be encouraged by the PT to work intensely without compensatory techniques, aids or therapist intervention at conventional sit-to-stand, over ground walking, and reciprocal stair-climbing exercises. Repetition of functional tasks a critical component of neuroplasticity. Patient weakness, fear of falling and avoidance of therapist risk, all combine to limit the number of steps and repetitions possible with conventional stroke therapy. The Bionic Leg enables hundreds even thousands of repetitions in a typical two-session therapy week. Practice functional tasks, in a natural environment sit-to-stands and walking over ground without aids or compensatory techniques, from the first inpatient post-stroke days. The Bionic Leg avoids the artificial limitation of the treadmill, and the unrealistic centering support of single-point suspension. Bionic Leg-equipped clinics take their patients on walks to the cafeteria for a cup of coffee, out in the sunshine, and up and down stairs reprogramming their expectations as well as their neuronal pathways. PT modulation of Bionic Leg support as the patient regains confidence in therapy sessions, Bionic Leg assistance is dialed back. The therapist reprograms the Bionic Leg to demand more patient-applied force on the affected foot to initiate Bionic Leg support, less support provided in standing up and climbing stairs, less resistance in descending stairs and sitting down. Exploitation of post-bionic Leg carry-over for home exercise in post-therapy periods, patients display carry-over of Bionic Leg training effects when the robotic leg is removed. Patients can extend and exploit those carry-over periods to reinforce apparent neuroplastic effect by repeating clinic exercises at home. the tibion leg works