Powerful combination: Technology and traditional therapy approaches

“This relationship between technology and traditional physiotherapy principles works very well,” says Dave Swinburne, co-founder of Complete Neuro Rehab on the approach that underpins the company.

Its community, intensive rehab centre in Stourbridge, West Midlands, provides technology-assisted physiotherapy and neuro-rehab for people with all neurological conditions. The practice was founded by Husband and Wife team Dave and Linsey in 2012 with the mission of providing first class, intensive community rehabilitation to the people of the West Midlands living with a neurological condition.

Since then, they have continually sought to invest in the latest rehab tech with the potential to enhance the impact of its interventions.

“Technology can be used to help patients practice movement, but that is reinforced with traditional physiotherapy treatment,” says Dave.

Linsey adds: “The technology complements traditional therapy and strengthening approaches to allow patients to perform thousands of repetitions in a very short amount of time.

“This leads to improved outcomes and improved functional outcomes, which is well researched.”

Today, Complete Neuro Rehab is home to a range of robotic, computer assisted and anti-gravity technologies from manufacturers such as Alter G, Tyromotion, Litegait, Medimotion and Hansomed.

They are utilised by its team of neurological physiotherapists in their work across the full spectrum of neurological conditions including brain and spinal injuries.

The latest additions at the centre come from EGZOTech, in partnership with Thor Assistive Technologies.

Last year the facility became the first in the UK to install EGZOTech’s Luna EMG device, as well as its FES product, the Stella Bio.

The Luna EMG enables EMG-assisted movement – with the slightest muscle activity triggering robotic assistance during the movement. It supports improvement of muscle strength, limb range of motion and muscle coordination. It is designed for use among low and non-low mobility impairment patients (0-5 on the Lovett Scale).

Stella Bio is the world’s most sensitive EMG with implemented electrostimulation. Its portability makes it suitable for clinical and home use, with predefined programmes for different patient groups, including those relevant to neurological conditions.

“We were looking for a device that helps to train neurologically weak muscles,” says Linsey.

“There isn’t anything else on the market in this country that can do this kind of work with clients. With the Lunar and Stella, we have been able to treat neurologically weak muscles in a way that we couldn't before.

"We can use the technology to assess if the muscle has any activity at all. We can then use the device to train those weak muscles, do lots of reps with it, or use neuro gaming, and we can progress that into functional movement.”

A key benefit of the new technology has been its role in enabling the physiotherapist to maximise the impact of their time with the client, as Linsey explains.

“With the Lunar, and the data it generates, our therapists can look back at, and analyse, their sessions. Whereas previously we could be spending a lot of time manually repeating a movement again and again with the client, the robot will do that for us. This means we can use our analysis skills to a higher degree.”

Another advantage of the Lunar, says Dave, is its flexibility in terms of the muscle groups it can target.

“You can change attachments on the Lunar so that you can move most joints in the body, whether you are working on ankle range of movement, knee flexion and extension or movement in the hip, elbow, shoulder or forearm.

“You can use it passively, with the robot doing the movement for you, or with the EMG measuring muscle activity to trigger the robot to perform that particular movement.

“The data it gives us allows the therapist to carry it into their treatment sessions for the physical work they would do with the patient afterwards.”

Also proving highly useful in client sessions is the Stella’s ability to support movement patterns that span different muscle groups.

“A movement pattern we like to practice is hand to mouth,” says Linsey.

“We can set up stimulation to the deltoid and bicep, and then the forearm to grasp. We can choose which muscle group we want to be the trigger. If we had a weakness in the deltoid, for example, that could be the trigger. As soon as that reaches enough of a threshold it will kick the stimulation in to allow the patient to take hand to mouth, and then release. It’s good to be able to hook different muscle groups up and do some really targeted functional movements.”  

Complete Neuro Rehab’s client, anonymously named ‘AG’, is among those to have benefitted from the new technology.

Prior to accessing the Lunar, the stroke survivor had been progressing with traditional rehab, with “lots of walking, standing and trying to engage muscle groups”, says Linsey.

He then had some sessions with the Lunar designed to train his quad muscles, through repetition of knee extension work.

“He went from walking with a cricket splint with his knee held fully in extension to then walking and maintaining his knee extension when he was fully weight-bearing on that side. He previously needed three therapists to walk at assessment, and is now independently mobile with a stick. That really specific joint training meant that his leg was safe for him to progress his walking. He can now go to his caravan, using the steps up and down to access it, so it has been quite important in improving his quality of life.”

Another client positively impacted by sessions involving the technology is a lady living with central cord syndrome.
Linsey says: “She struggles to move her arms away from her body so we use continual passive movement for that, training her deltoids.

“She has really benefited from it and can now lift her arm out to the side, to apply deodorant, for example.”

Overall, Dave says that the new devices have allowed Complete Neuro Rehab to “create a more wide-ranging treatment programme by freeing up joints to help the patient achieve more”.

Crucial to the successful outcomes supported by the tech, however, is the continual focus on grounding physiotherapy and neuro-rehab principles.

“It’s not just that you can use the technology on its own and you are instantly going to get better,” says Dave.

“You have to use the technology and integrate it into the patient’s life and a particularly important movement for them, to make it meaningful.”

To enquire about the EGZOTech products mentioned in this article contact stephen@thorsafety.co.uk or find out more from Thor Assistive Technologies here.