January 04, 2021
TASK SPECIFIC REHAB is the key to STROKE REHAB – find out how we do it at BWT.
In October 2020 The Australian Physiotherapy Association published a review of treatment for Stroke patients highlighting the importance of task related rehabilitation (by this we mean functional rehab such as sitting balance, standing to sitting and walking practice)
BWT physios not only have the experience but also exclusive equipment such as the Bionic Leg to enhance recovery from stroke. Linda Whike Director at BWT has always said ‘ If you don’t practice standing and walking you never will’ and, along with her team of physios and personal trainers, can arrange a bespoke rehab package of in clinic treatment with our exclusive technologies and a programme of truly functional rehab to practice at home.
By using the Bionic Leg in clinic the patient, once fitted with what is essentially a computerised exoskeleton, then activates a foot plate when weight is placed through the leg. This triggers sensors so that the device straightens the knee. It allows someone with a paralysed leg to walk, sit to stand and even do stairs. Through repetitive task specific re- training of muscle groups by practicing activities such as sitting to standing and walking, optimum chances of regaining function are achieved.
Although not every patient is suited to use the Bionic Leg, the philosophy of task specific rehab is the key component to the BWT approach to recovery. A tailored rehab programme geared to regaining independence and improving quality of life is carefully planned for each patient. Relevant and meaningful therapy – not simply a series of exercises – is worked on in clinic, so that the components of the activities can then be practiced repeatedly at home. This is not only motivational but aids understanding and compliance to rehab in what is a life changing situation.
The following two quotes from the research validate the philosophy of the BWT approach to recovery:
- ‘There is now a large body of evidence to guide rehabilitation interventions following stroke. . . . Clinical guidelines for stroke rehabilitation now universally recommend intensive task-specific training.
’Ref: L. Jolliffe, N.A. Lannin, D.A. Cadilhac, T. Hoffmann Systematic review of clinical practice guidelines to identify recommendations for rehabilitation after stroke and other acquired brain injuries BMJ Open, 8 (2018), p. e018791
2. ‘The results of this review provide additional support for the use of task-specific interventions to improve lower limb activities, particularly walking. The outcomes for lower limb activities are greatest when task-specific training is performed at higher intensities.’
Ref: B. French, L.H. Thomas, J. Coupe, N.E. McMahon, L. Connell, J. Harrison, et al.Repetitive task training for improving functional ability after stroke Cochrane Database Syst Rev, 11 (2016), p. CD006073
But it isn’t just the lower limb rehab that has the benefit of the latest technology, BWT are able to offer Saeboglide, Saeboflex and Saeboglove which enables patients to perform functional activities with the affected arm and hand. Information from their website explains the principles behind the technology.
‘The SaeboMAS dynamic mobile arm support system is a zero gravity upper extremity device specifically designed to facilitate and challenge the weakened shoulder and elbow during functional tasks and exercise drills. Patients suffering from neurological and orthopedic conditions and who exhibit arm weakness can benefit from the much needed support and facilitation https://www.saebo.com/shop/saebomas/
- Gravity supported, weight supported, zero-gravity, and gravity compensated are synonymous. It counteracts the effects of gravity while facilitating and promoting functional movement.
- Unloading the arm not only improves independence during daily living tasks, but may increase motor recovery by relearning normal movement patterns. Performing exercises with minimal compensation, as well as self-care tasks such as eating or drinking, are just a few of the activities patients will be able to achieve with Saebo’s unweighting technology.
- Additionally, patients with proximal weakness can now participate in proven treatment techniques, like task-oriented activities, that would have otherwise been difficult or impossible’
By combining this with the Saeboglove at home, repetitive task training is further enhanced. The SaeboGlove helps patients suffering from neurological and orthopaedic injuries incorporate their hand functionally in therapy and at home. The proprietary tension system extends the fingers and thumb following grasping. The lightweight, low-profile functional design is just one of the many innovative features that are offered with the SaeboGlove. https://www.saebo.com/shop/saeboglove/
Please call 01202 749514 if anything in this article raises a question and one of the neuro team will be happy to speak with you.
For the full published review see: Bobath therapy is inferior to task-specific training and not superior to other interventions in improving lower limb activities after stroke: a systematic review – ScienceDirect