Evidence Based Practice
Improving Gait in Chronic TBI with Motor Learning Strategies
Long-term disability is a frequent sequel of traumatic brain injury (TBI) and takes the form of persisting motor impairments that impact walking and autonomous movement. So to improve environmental negotiation and basic care skills, independent gait is an essential therapy goal for TBI patients.
Literature shows that the best time for independent gait recovery occurs within the first few...
Creative Mobility Technology for Improved Outcomes
I recently attended the APTA Next Conference in Boston. A new component to this conference is the experience zone—an education space in the exhibit hall allowing presenters to draw on resources from the show floor as part of their presentations. A great idea. I attended a course called “Creative Mobility Technology for Improved Outcomes” in the zone.
Here we learned to get the most...
Evidence Update: Supported Standing Protocols
For decades already we’ve seen standing programs used as a therapeutic intervention for adults with neurological conditions. We’ve known that without such intervention, patients with spinal cord injuries, strokes, traumatic brain injuries or multiple sclerosis spend hours and hours each day in sedentary postures—with devastating results. Sitting for upwards of eight hours a day leads to...
Great Strides with the Rifton TRAM
A few years ago we welcomed a non-traditional student—we’ll call him Jay—at Lincoln Developmental Center (LDC) where we work. Most of our students have had a development disorder since birth; most are undersized and fit well into traditional equipment, but Jay sustained a traumatic brain injury at the age of 14 and arrived at LDC at the age of 17, fully grown, with limited positioning...
The Rifton TRAM vs the Standard Four-Wheeled Walker
For those of us concerned with rehab following central nervous system lesions, the last ten years have been exciting. There has been extensive research focused on the brain and its neuroplastic properties, and it’s changing the way we think about treatment.
Specifically, recent research has encouraged gait rehabilitation—task-specific and repetitive. We all recognize now that ambulation...
New Mobility Magazine Discusses Rifton TRAM
Word is spreading about the unique functionality of the Rifton TRAM for gait training, standing, and transfers. New Mobility has just published a great piece pointing those suffering from paralysis to the benefits available from this new device. (New Mobility is the publication of United Spinal Association.) Take a moment to read it and then share it with others who are looking for better gait training and...
Safe Patient Handling and Movement: Effectively Using Gait Training Equipment
It is an exciting time in the field of rehabilitation. For people who have sustained a neurological injury such as a stroke, incomplete spinal cord injury or traumatic brain injury there is now hope for regaining the ability to ambulate and sometimes even achieving a full recovery. In the past, a neurological injury was viewed as irreversible, and rehabilitation was focused on helping patients adapt and...
Compensation and Recovery
Should PTs train for compensation or recovery? Clinicians today are debating whether interventions should focus on teaching whatever is required to accomplish a task (compensation) or promote the neuroplasticity needed to allow the task to be accomplished “normally” (recovery).There is a great dialogue on this topic posted on the Journal of Neurologic PT (JNPT) discussions page which I highly...
Brain Injury Recovery: one couple’s story
I was privileged to interview David the other day. We conversed by email since his speech is affected. David and his wife Ashley are survivors: their six-week-old son Jayvas died suddenly in 2009; one year later, at a 2010 New Year’s Eve celebration, David had a choking accident resulting in an anoxic brain injury. He was in a coma for a month and a half. Coming out of the coma at a rehab hospital...
Beyond the walker
Minnesota Clinic gets Better Outcomes from Smarter Gait Training than from Traditional Quad Walkers
Contributed by Nicole Grant, PT Courage Center, Golden Valley, MN
As a physical therapist here at Courage Center in Golden Valley, Minnesota, I see many adult patients with significant motor deficits. For gait training, traditional four-wheeled walkers and rolling platform walkers provide stability, but not...