An informal poll of rehab professionals and experts in the field reveals what they see as the future of rehab technology and engineering.

Megan Harper, a physical therapist and outpatient rehab manager at Life Care Center of Littleton, Colo., for the past seven years, says she favors the use of the Nintendo Wii and Bioness’ Hand and Foot stimulators for patients with neurological injuries.
The company’s NESS H200 Hand Rehabilitation System is “a state-of-the-art functional electrical stimulation system that sends low-level stimulation to the paralyzed muscles in your arm and hand, enabling your hand to open and close,” according to the company’s website. NESS H200 offers people with paralyzed hand and wrist muscles better function for greater independence.
The device slides onto the user’s arm, and once it’s plugged in, it automatically opens and closes the user’s hand.
Bioness’ other product, the NESS L300 Foot Drop System is a non-invasive, “advanced neuroprosthesis” indicated for treatment of foot drop in patients with stroke, traumatic brain injury, multiple sclerosis, cerebral palsy, and incomplete spinal cord injury.
The device also has a gait sensor that adjusts to accommodate uneven surfaces and changes in elevation to help patients walk safely and confidently, regardless of terrain, the company says.The device uses a light-weight leg cuff designed to be comfortable to wear and easy for patients to put on without assistance. The electrodes are located within the custom-fitted device; a clinician positions them prior to initial use, and once they are in place, patients don’t have to reposition them.

Passive Exercise Gains Ground

Having served as chief medical officer for Brookdale Senior Living, Brentwood, Tenn., since 2006, geriatrician Kevin O’Neil, MD, has had the opportunity to see and test a number of rehab engineering and technological marvels. Recently, he has heard a lot about technologies that incorporate whole-body periodic acceleration (WBPA).
In a recent study of WBPA, also referred to as passive exercise, researchers testing it on mice found that WBPA “may serve as a powerful noninvasive intervention to facilitate therapeutic angiogenesis.” The goal of therapeutic angiogenesis is to stimulate the creation of new blood vessels in ischemic (blood-restricted) organs, tissues, or parts in hope of increasing the level of oxygen-rich blood reaching these areas.
Non-Invasive Medical Solutions (NIMS) is a Miami-based company that provides “drug-free, wellness solutions coupled with accredited peer-reviewed clinical research,” in the form of a patented technology called Acceleration Therapeutics (AT). AT is designed for individuals who are physically fit, sedentary, or incapable of an active lifestyle. NIMS has launched an FDA-listed medical device called Exer-Rest, which incorporates WBPA therapy. NIMS claims that utilization of WBPA is “an efficient way for the body to naturally activate the release of nitric oxide and other beneficial mediators throughout the vasculature.”
According to NIMS, independent clinical research has demonstrated significant health benefits and great promise for individuals using the devices for prevention and complementary/adjunctive therapy. The AT models are equipped with a wireless touch-screen remote control, a memory foam mattress, and pillow and knee riser, as well as a small and large set of shoes.
The repetitive head-to-foot motion of WBPA adds a pulse to the circulation with each acceleration and deceleration of the body. These additional smaller pulses, which are superimposed on the natural pulse, promote release of beneficial substances (mediators) from the inner lining of blood vessels (endothelium), a process called pulsatile shear stress, according to NIMS.

Robotics And More

Research continues to illustrate the efficacy of robotic devices, and they  have proliferated rapidly in the past decade or so. One device, known as the Myomo e100 System, was developed by Massachusetts Institute of Technology researchers in collaboration with clinical researchers and is claimed by the company to be the first “portable, robotic, exoskeletal orthosis controllable by a patient’s biological signals.”
Intended for use by stroke survivors, the device enables patient-initiated and -controlled movement of the affected limb without requiring electrical stimulation or surgical procedures of any kind. When used under the supervision of an occupational therapist or physical therapist, the system can help patients progress from basic motor training to more complex, multi-plane movement patterns, according to the company’s website.
Steve Kelly, Myomo’s chief executive officer, describes the device on the company’s website as a personal robotics product with a sensor that acts like a microphone and “listens to muscle signals and hears it,” he says.
The device’s robotic arm brace senses muscle signals that indicate a deliberate intention to move and provides electronically assisted movement. According to Myomo, the process engages both neurological and motor pathways, reinforcing brain-to-body feedback in such a way that motor function “can be re-learned and restored.”
Kelly explains, “Our brains have the capacity to heal. Myomo’s neurorobotic technology is a platform for enabling that healing process.”
Software linked to the device helps the robot give the appropriate amount of resistance. “It’s a neurotrainer,” says Kelly of the device. “There are a few experimental models in teaching hospitals that are somewhat similar. What we do with this is try to bring a more personal, portable modular approach so that is can be done just about anywhere.”