Virtual Reality in Neurorehabilitation

Virtual reality is a technological system that has gained ground in neurological rehabilitation in recent years although it has begun to develop in the 60s. Virtual Reality is used to artificially create sensory information of an interactive virtual environment being perceived as real And thus favoring exploration, commitment, curiosity and motivation.
In the neurological physiotherapy clinic of Sant Cugat del Valles, we integrate Virtual Reality systems in neurorehabilitation of patients with Ictus, medullary lesions, multiple sclerosis and other neurological diseases. The aim of its integration is to increase the effectiveness of treatment according to scientific evidence, increase the adherence of treatment by users and provide them with opportunities and sensations that are not achieved by conventional methods.
In the field of rehabilitation of diseases and especially of the deficits caused by nervous system injuries, an important development of different systems and tools is observed. Most of these tools are focused on the treatment of the cognitive system (example: alteration of the memory) motor system (example: leg movement) and sensitive system (example: neuropathic pain).
An example of the application of Virtual Reality systems in the rehabilitation of patients in this neurological center is in alteration of the balance. The alteration of the balance can lead to a reduction in the practice of physical and outpatient activity, limiting participation in daily life activities and deteriorating quality of life. With a virtual reality system the therapist can provide the patient with the right environment for balance work without exposing it to risks. In this case activating the visuo-vestibular system involved in the maintenance of balance, gait etc.
There are several published studies that conclude that interventions based on Virtual Reality are effective in treating the balance and deficits of the march after the Vascular Cerebral Accident or Ictus. However, intervention protocols can not be constructed since the therapist has the fundamental role of evaluating and developing the most appropriate therapeutic plan for each patient.

Virtual Reality in Neurorehabilitation

Virtual reality is a technological system that has gained ground in neurological rehabilitation in recent years, although it has begun to develop in the 60s. Virtual Reality is used to artificially create sensory information from an interactive virtual environment being perceived as real and thus favoring exploration, commitment, curiosity and motivation.

In the neurological clinic of physiotherapy in Sant Cugat del Valles, we integrate Virtual Reality systems in neurorehabilitation of patients with stroke, spinal cord injury, multiple sclerosis and other neurological diseases. The objective of their integration is to increase the effectiveness of the treatment according to the scientific evidence, to increase the adherence of the treatment by the users and to provide opportunities and sensations not achieved by conventional methods.

In the field of the rehabilitation of diseases and especially of the deficits caused by the injuries of the nervous system, an important development of different systems and tools is observed. Many of these tools are focused on the treatment of the cognitive system (example: alteration of memory), motor system (example: leg movement) and sensory system (example: neuropathic pain).

An example of the application of Virtual Reality systems in the rehabilitation of patients in this neurological center is in alteration of balance. The alteration of balance can lead to a reduction in the practice of physical and ambulatory activity, limiting participation in activities of daily life and deterioration of the quality of life. With a virtual reality system, the therapist can provide the patient with the right environment for the work of balance without exposing him to risks. In this case activating the visuo-vestibular system involved in the maintenance of balance, gait etc.

There are several published studies that conclude that interventions based on Virtual Reality are effective in the treatment of balance and gait deficit after the Cerebral Vascular Accident or Stroke. However, intervention protocols can not be constructed since the therapist has the fundamental role of assessing and developing the most appropriate therapeutic plan for each patient.

Dos ejercicios que debes realizar si tienes un pie equino

If you have an equine foot due to your neurological injury, here are some tips so you can prevent capsular retractions, joint stiffness and muscle shortening. In the case that you already have them, it will be a matter of spending more time, but following these recommendations you could improve the contact of your foot with the ground and get better mobility for your foot.

As you should know, due to your joint misalignment, when you support the foot while standing or walking, there is a large part of the weight of the body that falls on the tip and the lateral part of the foot. Therefore what you should work is the support of the heel and the internal part of it.

You must do the exercises barefoot to allow the foot contact with a flat surface and control the supports well.

  • First exercise: place the flat foot on the floor and bend the knees keeping the heel in contact with the ground. Direct the knees inward if you notice that you lack support on the inside of the foot.
  • Second exercise: get yourself a wedge with a slight inclination and stand on top. A good idea is to place it in a place in your house where you spend a few minutes a day, in the basin sink, for example. In this way you will ensure you perform the exercise daily.

If you have difficulties to perform these exercises do not hesitate to contact the physiotherapists of the Nerorehabilitación Clinic to make an assessment and we can help you in the realization of them.

Formación profesional

The Neurorehabilitation Clinic of Sant Cugat del Vallés, Barcelona, ​​apart from being specialized in the treatment of patients with neurological diseases, is also a Training Center for Healthcare Professionals.
As a training center for professionals in the area of ​​neurological rehabilitation (physiotherapy, occupational therapy, speech therapy and psychology), the Neurorehabilitation Clinic ensures quality training accredited and controlled by the Commission for Continuing Education of the Health System of the Ministry of Health.
Controlled and well-planned training favors scientific progress in the field of neurorehabilitation, providing not only scientific knowledge but also new technical skills to the professionals in question, be they physiotherapists, occupational therapists, speech therapists or psychologists.
With the training service, courses, seminars and workshops for therapists, the Neurorehabilitation Clinic aims to provide conditions to update the knowledge of professionals, improve the qualifications of the staff of health institutions that receive patients with neurological diseases or pathologies (Stroke, Sclerosis Multiple, Parkinson’s disease, etc.). Apart from taking into account the theoretical knowledge and application of techniques and treatment approaches, the organization of the Neurorehabilitation Clinic seeks to provide professionals with skills for the correct recognition and assessment of patients and the development of clinical reasoning.

The Neurorehabilitation Clinic looks for specialized training and for that it organizes courses of special interest to the rehabilitation professions such as:

  • Training courses in the Bobath Concept for physiotherapists and occupational therapists
  • Scapular motor control course for physiotherapists and occupational therapists
  • Upper limb rehabilitation training course in neurological patients
  • Neuropsychology workshop for physiotherapists, occupational therapists and speech therapists
  • Mirror therapy workshop in the neurological patient
  • Course of postural control and balance in the neurological patient
  • Course of manual therapy for neurological patients addressed to physiotherapists
  • Workshop on the use of accessible technology in neurorehabilitation
  • Among others

If you are active in neurological rehabilitation or have special interest in this area, consult our training programs or contact us.

Rehabilitación de la marcha sobre tapiz rodante

It consists in the accomplishment of the march on a treadmill with the possibility of diminishing the corporal weight with a harness. The march can be assisted manually or robotic. The intense repetition of the cycle of the march is the main sensational impulse to promote motor activity. For someone who has difficulty maintaining the equalizer and therefore performing a steady pace, the tape allows you to maintain a rhythm and speed and thanks to the holders or the suspension system do not worry about the balance. The therapist, while the patient walks, can: Maintain trunk stability and pelvic alignment. Guide the displacement of weight. Control the foot in the support phase and in the oscillation phase. Control the knee during the loading phase. It is very important to practice an activity to improve the execution of the activity. That is why it is important that the march is carried out daily and at different times of the day. In the neurorehabilitation clinic we focus on improving the functional capacity of the walk, working the necessary skills to be able to walk safely and with the best possible quality. And from there practice the march as much as we can and in different situations (interior by land, by treadmill, by outside in different types of terrain …) The treadmill allows us to do a more complete practice of the cycle of the march. We have the opportunity to increase the speed and the resistance and optimize the aerobic capacity. Thanks to the maintenance of a constant activity, the nervous system activates the postural musculature that will help us improve stability, increases the tone of the weakened muscles and reduces that of the muscular spasticity. At the neurophysiological level it is proven that repeating a constant activity on the tape allows the activation of a neuronal group that we have innately in the spinal cord (lumbar region) responsible for activating autonomously the muscles needed to make the movements of the step during the march. These are named Central Power Generators (Central Power Generators) The treadmill can be made with body weight supported or without:

If we analyze the pros and cons of its use we can say that the harness facilitates the load on the affected bed, the straight and aligned position of the trunk, allows us to do an early training of the march, increases the person’s safety at the time. It’s time to start walking, discharge body weight to the legs and allow more time to walk as it reduces fatigue.

On the contrary, the harness can cause a diminution of the work of balance of trunk, and the situation of disastrous suspension that moves away of the march in the daily life.

To conclude, we can say that we believe that it is very important to have a treadmill in neurorehabilitation centers in order to increase the practice of walking, perform aerobic work difficult to achieve in daily life and improve the functional capacity of patients.

 

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Tratamiento Individualizado

The Neurorehabilitation clinic from its origins in the year 1994 as a neurological physiotherapy clinic, has as a priority the conduct of individual treatment sessions, relationship 1:1 between the therapist and the patient. This applies in all disciplines that we offer, both physiotherapy, occupational therapy, neuropsychology, psychology and speech.

This aspect is one of our fundamental pillars since the fact of working only with a patient can help us to be very analytical in our evaluations and to be able to mark some really personalized therapeutic objectives. It is also important for the personalization of the treatments, that is, to adapt the therapeutic exercises to the needs of the patient, for example, a patient after a stroke with equine foot, in the sessions of physiotherapy reduces the spasticity causing Of the deviation and we promote the opposite movement so you can walk more easily.

Within the physiotherapy sessions we can focus part of the session on performing a manual therapy necessary to correct possible joint limitations, alterations of muscle tone (spasticity) or sensitivity alterations. A second part in which we devise exercises and functional activities, guided and facilitated continuously by the therapist. According to how each user responds we can adapt the difficulty or propose variations to be able to work the therapeutic objectives and maintain the motivation and active participation of the patient in the Neurorehabilitation sessions.

By having the help of the therapist we can perform an intensive and well oriented practice looking for the maximum potential of each patient after suffering a brain damage, medullary, or other damage of the nervous system.

After a brain damage is very normal to have variacines at the level of control over movements and balance. So it is very important to be able to adapt the therapy to the state of the person.

Terapia Acuática

Aquatic therapy is based on the realization of physical therapy in an aquatic environment, in such a way that the mechanical properties of water associated with the forms of intervention of physiotherapy are used in order to improve the function, activity and participation of the patients. One of the main fields in which we can apply this form of treatment is neurorehabilitation, directed, among others, to adult patients suffering from neurological processes, such as stroke, multiple sclerosis, Parkinson’s disease, brain damage, tumors cerebral, muscular dystrophy, spinal cord injuries, etc. or children with motor disorders for brain damage from birth or acquired.

Thus, we can intervene in a rehabilitative way, in a preventive way, of treatment, as a physical or sport activity or, simply, with the aim of providing a moment of well-being to the patient. Water provides us with a medium where the body acquires a large amount of freedom of movement and where it can carry out exercises and activities that are difficult to perform on firm ground, being able to act on balance, coordination, dexterity, walking, postural control, physical conditioning, lung function, etc.

Within many and diverse types of aquatic therapy, one of the most known and used is the Halliwick Concept. Its main objective is to give everyone freedom and independence to perform in the water. The idea is, then, to teach anyone, regardless of their pathology, to swim, providing the physical and mental foundations for that purpose. One of the characteristics that best define this concept is that one works with respect to the abilities that the person possesses in the water and not taking into account the disability that presents in “land”.

Even if one of the priorities is that the patient can swim independently, it is not the only thing that stands out within this concept. In Halliwick great importance is given to the relational aspect of the pool. For this reason, we work frequently in groups, mainly in the case of children, to encourage group stimulation, the demand for concentration of the participants and cooperation among them, also creating links between the members. Despite this, sessions can also be developed individually, often in the case of adults.

In the Clínica de Neurorehabilitación we have therapists trained in this Concept. Thus, the sessions will be adapted to the personal needs of each patient, either individually or in groups, counting with the help of family or friends who will also participate in the session in the water. Our objective will always be that the person becomes independent in the water as quickly as possible, so that he can even go to the pool as a physical activity or sport independently. Although we will always be willing to take a dip!

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http://www.halliwick.com.br/es_ES/a-filosofia
http://www.halliwick.com.br/es_ES/a-filosofia

Author: Jesús Márquez Neila