Proving the effectiveness of Home and Community based Rehabilitation post CVA

Writing in Archives of Physical Medicine and Rehabilitation, 03/12/2013 Dr. Altman IM et al and his team from Rehab Without Walls USA look at the effectiveness of Home and Community based Rehabilitation (HCBR). The team looked at 738 individuals with CVA who completed the prescribed course of rehabilitation (CCT) compared to 150 who were discharged prior to program completion.

The group looked at the outcome measure of the Mayo-Portland Adaptability Inventory. The Mayo-Portland Adaptability Inventory (MPAI) was designed to assist in the clinical evaluation of patients during the postacute (posthospital) period following acquired brain injury (ABI). It is also designed to assist in the evaluation of rehabilitation programs for these patients. The MPAI-4 represents a range of physical, cognitive, emotional, behavioral, and social problems that patients post ABI may encounter.

The group that completed the course of HCBR therapy – CCT group showed greater improvement on all MPAI-4 indices than the group that were discharged prior to completing the prescribed exercise therapy program.

 

Tutor system – LegTutor effective tool with intensive robotic and manual gait training in sub-acute stroke

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In the February edition of Journal of NeuroEngineering and Rehabilitation Dr. Conesa and his group from Functional Rehabilitation Department and the Brain Injury Unit, Neurorehabilitation Hospital Institut Guttmann Barcelona, Spain and the Harvard Medical School, Boston, MA,  USA report that 8 weeks of intensive physical rehabilitation including robotic and manual gait training was well tolerated by early stroke patients. The group saw significant gains in function with outcome measures including improved walking speed and balance scales. In particular, robotic training on the mid-level gait dysfunction group showed the best improvement. The gait training was split up into robotic gait training from 0-4 weeks and manual gait training weeks 4-8.

The LegTutor is a Leg brace that measures hip and knee movement. it is used to customize isolated and intensive manual gait exercise practice and give the patients augmented feedback on their performance. The 3DTutor can be used to give intensive ankle exercise practice and assist in treating drop foot.