Neuro Rehabilitation

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Neuro Rehabilitation

Any neurological condition, such as a stroke or a traumatic brain injury, may result in paralysis of various brain functions. If this occurs, comprehensive rehabilitation is essential for recovery. Neuro Rehabilitation is a process, where multiple specialities are involved, helps you to recover from paralysed brain functions. It is cumulative efforts of various specialists to achieve a single goal to bring an unfortunate victim of brain stroke patient to a functioning platform.

At Purva Medical trust, our rehabilitation work focusses chiefly on paediatric strokes, improving functional abilities of your child and helping them adapt to their injury. This, we achieve through an array of therapies tailored towards your goals. Some of them are physiotherapy, neuro psychology and occupational therapy. Each of these therapies are complemented by specialist support in spheres such as language and diet, while drug therapy is used to manage few symptoms.

We have experienced neuro rehabilitation consultants and therapists who are experts in treating long term neurological conditions. You will receive their support as you learn to safely manage day to day activities with your disability and enjoy a wonderful quality of life.

Vast Experience Of all Injury Types

Our scope of expertise is comprehensive enough to provide consistency of treatment – beginning from diagnosis to your return home. We have a vast resource of experience and skills, to cope with common and rare types of brain injury, ranging from strokes and dementia to multiple sclerosis.

Providing Greater Independance To Patients

In the end, providing you the highest level of independence possible is central to the team’s ethos. It is our belief that when you plateau in your rehabilitation, your recovery should be continued in a home environment where exposure to familiar surroundings and resuming regular activities will help you further adapt to your condition.

We will create a care plan according to your requirements by conducting multidisciplinary meetings with surgeons, physicians and nursing staff and this will be reviewed and amended accordingly in line with your progress. You will have a consultant working closely with you to form realistic goals towards which you will work with our entire team’s support and commitment.

Our Neurorehabilitation Services

With a team of integrated consultants and therapists, 24 hour care is provided by our specialist neurological rehabilitation service.

Those affected by the following conditions are offered specialized programs:

We offer a comprehensive spectrum of services that includes:

Neuro psychology for cognitive support.
Physiotherapy, to provide you with an everyday exercise routine.
Occupational therapy, to offer support on everyday functions like washing, dressing and leisure activities.
Speech & language therapy to strengthen written & verbal communication.

A Customised Treatment Plan For You

A suitable therapy programme that focuses on your unique recovery requirements will be created by our therapy team. You will receive advice on how to adapt to your disability and carry out daily tasks with safety, to help you lead an independent life.

Newer Techniques

The face of neurorehabilitation has progressively changed in recent years. Traditional neurorehabilitation procedures may have limited efficacy in most patients with common neurological diseases. New technologies have been reported to enhance the effectiveness of rehabilitation strategies in these conditions.

Transcranial Magnetic Stimulation (TMS)

Perhaps the most cutting edge stroke recovery treatment on this list is transcranial magnetic stimulation. During this therapy, an electromagnetic coil is placed against your scalp and the electromagnet delivers a magnetic pulse that stimulates the brain. This modality has historically been used to treat psychological symptoms, but recent studies have explored its impact on stroke recovery.

Neural Prosthatics

This type of research has seen rapid progress, two examples of which are the development of brain-machine interfaces (BMIs) that enable patients to control assistive devices-such as robotic limbs-by using neural signals recorded directly from the brain, and the use of functional electrical stimulation (FES) to reanimate paralyzed limbs. Brain-machine interfaces (BMIs) that record and decode signals from the brain in real-time enable volitional control of assistive devices, and modify patterns of cortical activity through the process of neurofeedback. First, neurofeedback will shape patterns of volitional brain activity as users learn how to exploit the prosthesis more efficiently. Feedback could involve residual sensory modalities such as vision, or perhaps include artificial sensory pathways provided by electrical stimulation. Second, repetitive stimulation might induce long-term changes that increase the excitability of spinal circuitry and enhance the efficacy with which movements can be evoked. Third, coactivation of the brain and spinal cord may strengthen surviving connections between the two sites through Hebbian mechanisms. The latter can be summarized in the statement: cells that fire together wire together. Importantly, these three changes are complementary in acting to potentiate precisely the same sensorimotor loop that is augmented by the prosthesis. The concept is highly based on repetitive training again and Hebbian plasticity for CNS. Thus, co-activation of the brain and spinal cord may strengthen surviving connections between the two sites. Remodeling of such surviving pathways and their spinal targets may help to support some functional recovery [67]. Key–points to manipulate plasticity by neural prosthetics: brain-machine interfaces (BMIs) functional electrical stimulation (FES) neuromodulatory stimulation

Motion-Sensing, Gamified Neurorehabilitation Devices

In recent years, there has been development in motion-sensing, gamified neurorehabilitation devices that help with motor recovery after stroke. These motion-sensing neurorehab devices work by motivating individuals to accomplish high repetition of rehab exercise, which helps rewire the brain through neuroplasticity. The devices make an excellent at-home therapy program to use between visits with your therapist.

The first is MusicGlove, which is a music-based, sensorized glove that helps survivors exercise their affected hand. A randomized controlled trial found that MusicGlove helps improve hand function within 2 weeks when used for a total of 6 hours per week.

The second neurorehabilitation device is FitMi, which involves two motion-sensing “pucks” that track movement as individuals follow along to prescribed rehabilitation exercises on the screen.

While randomized controlled trials are still underway, FitMi is already used in some of America’s top clinics. In FitMi’s reviews, survivors have reported improvement in motor recovery, including individuals with no existing movement.

Virtual Reality

Virtual reality and interactive video gaming have emerged as exciting, new stroke rehabilitation techniques on the block; and excitement could be its strongest feature.

While, a recent study did not find virtual reality to be more effective than conventional therapy, some evidence showed that motor improvements increased when virtual reality was used in conjunction with conventional therapy to increase overall therapy hours.

In other words, virtual reality is not a superior rehabilitation technique, but it can help with motor recovery if it helps you increase the total amount of time spent doing therapy.

Robotic Technology

An increasing number of studies indicate that improvements in function following CNS injuries are largely mediated by compensatory strategies rather than true recovery, particularly after the first few weeks following injury.Thus, rather than demonstrating improvements in impairment, patients are learning to use their impaired systems more effectively.

Robot-assisted devices are an important tool in neurorehabilitation. They bring great benefits to therapists and patients. Robots are used where they can perform repetitive human activities reliably and with at least the same precision, but often faster and without getting tired.

To date, rehabilitation therapy can be aided by the technological support of robotic-based therapy, non-invasive brain stimulation, and neural interfaces.

by combining traditional rehabilitation techniques with neuromodulation, biofeedback recordings and/or novel robotic and wearable assistive devices, several studies have proven it is possible to sensibly improve the amount of recovery with respect to traditional treatments.

Most trials of robot-assisted motor rehabilitation concern the upper extremity (UE), with robotics for the lower extremity (LE) still in its infancy.

LOKOMAT for lower limbs

ARMEO for upper limbs

Cognitive Stroke Recovery Treatments

Sensory re-education
Sensory re-education is a form of cognitive-behavioral therapy that helps patients improve their senses. This is helpful for overcoming sensory issues like post-stroke numbness, tingling sensations, or difficulty feeling hot and cold.

During this therapy, individuals practice sensory re-education exercises to help stimulate and rewire the brain. For example, a therapist may bury different-textured objects in a bag of beans and ask the survivor to retrieve the objects. The stimulation of the different textures helps with sensory re-education.

2. Speech-language pathology
Speech-language pathology is a field that addresses communication disorders, cognitive-communication disorders, voice disorders, and swallowing disorders. A speech-language pathologist (SLP), more commonly known as a speech therapist, can help diagnose and treat these issues.

An SLP helps diagnose individuals that struggle with cognitive functions like memory and language and guide them through various rehabilitation exercises that address their concerns. Some examples of these exercises include speech therapy exercises and cognitive exercises.

Just like physical therapy exercises help improve movement, these cognitive-communication exercises help improve cognitive-communication skills. It’s all about massed practice and repetition to stimulate the brain and keep neuroplasticity engaged

Rehabilitation Exercise

Stroke exercises are the basics of rehabilitation. During inpatient rehabilitation, survivors work alongside their therapists to accomplish massed practice of various physical and occupational therapy exercises.

After discharge from inpatient rehabilitation, survivors often see their therapists once a week during outpatient rehabilitation. They are often provided with a written sheet of exercises to practice at home between sessions.

However, studies show that these sheets of exercises have poor compliance rates, however, which suggests that other engaging stroke recovery treatments can help increase adherence to an at-home rehab program.

Passive Rehabilitation Exercise: For individuals with hemiplegia, passive exercise is a great stroke recovery treatment. It involves movement that is not initiated by your muscles. Instead, a therapist or trained caregiver moves your limbs through a movement for you; or you can use your non-affected side to assist your affected side. These exercises are a must to prevent frozen joints.

This rehabilitation technique is particularly helpful for hemiplegia because it helps get the affected limbs moving and discourages learned-nonuse, a condition that occurs when mobility continues to worsen due to neglect. Best of all, although you aren’t initiating the movement yourself, passive exercise still stimulates the parts of the brain involved in muscle movement.

In other words, even if you aren’t initiating the movement yourself, passive movement still helps rewire the brain and encourage motor recovery.

Mental Practice/Meditation

Mental practice is another stroke recovery treatment that’s a great fit for individuals with severely limited mobility or paralysis. It involves mentally visualizing yourself moving. You can visualize yourself doing your rehab exercises, or you can visualize other types of movement, such as walking across a lawn or along a sandy beach.

Studies have shown that mental practice sparks changes in the same areas of the brain that control movements, such as the motor and premotor areas. Evidence also shows that combining mental practice with physical practice improves mobility more than just physical practice alone.

Mental practice is simple, non-invasive, free, and accessible. It’s the perfect addition to any stroke rehabilitation regimen, especially individuals recovering from paralysis.

Neurologic Music Therapy

Music helps enrich the environment, which engages multiple regions of the brain. It has an established track record helping with motor, speech, and cognitive recovery after stroke.

Particularly with motor recovery, neurologic music therapy works by encouraging individuals to sync their movements with rhythm and beat. For example, in gait rehabilitation, music therapy aims to sync leg movements with a musical beat. In hand rehabilitation, it aims to sync finger movement with a musical beat, just like MusicGlove.

Of all its applications, neurologic music therapy has the most evidence supporting its use in motor recovery after stroke, which is good news for survivors that want an entertaining way to improve movement.

Mirror Therapy

Mirror therapy is a promising modality for stroke survivors that struggle with severely limited mobility in their affected hand, or even hand paralysis. It works by placing a tabletop mirror over the affected hand and practicing hand therapy exercises with the non-affected hand. The reflection “tricks or fools” the brain into thinking that you’re moving both hands, which helps rewire the brain.

Constraint-Induced Movement Therapy

Constraint-Induced Movement Therapy (CIMT) is a stroke rehabilitation technique that is arguably aggressive in its approach. It involves restricting your unaffected side while forcing the use of your affected side.

What makes this modality aggressive is that it can be quite frustrating to the individual if the affected side has severely limited mobility and then the individual is asked to complete exercises with that side for multiple hours per day.

Although it can be frustrating and aggressive, CIMT has an established track record of helping improve movement after stroke.

Electrical Stimulation

Electrical stimulation is a rehabilitation technique that is particularly useful for helping with severe mobility limitations and even post-stroke paralysis. It works by placing electrodes over the skin and sending electrical impulses directly to the affected muscles. Not only does this help stimulate the brain, but it initiates movement in the affected muscles, which is helpful for individuals with paralysis.

It is best to combine these techniques for better motor recovery than just electrical stimulation alone.