ZeroG Leads to Better Outcomes

Source: PRWeb

New Clinical Research Demonstrates Therapy with ZeroG Leads to Better Patient Outcomes

Aretech, LLC, a world leader in robotic body-weight support systems, announced today that multiple recently published research studies demonstrate that patients who use the ZeroG Gait and Balance System during inpatient rehabilitation achieve significantly higher clinical outcomes when compared to traditional standard of care (SOC) therapy. (1,2,3)

These studies, which were conducted in patients with acute stroke and acute traumatic brain injury, highlight ZeroG’s unique ability to provide dynamic body-weight support, controlled perturbations, and fall protection, which help patients achieve better outcomes.

One peer reviewed study performed at Gaylord Specialty Healthcare (Wallingford, CT), provides the first published evidence for the effectiveness of incorporating overground TRiP perturbations into gait rehabilitation in patients following stroke. TRiP (Training Responses in Postural Rehabilitation) is used to apply controlled perturbations of various strengths and directions to the patient while using the ZeroG robot. The Gaylord study found that patients treated with ZeroG and TRiP achieved significantly higher gains in Berg Balance scores when compared to Standard of Care. These findings suggest physical therapy that includes ZeroG with TRiP may help lower fall risk!

“We were impressed with the degree of balance improvement in the group that used ZeroG with TRiP during their inpatient rehabilitation.” says Pete Grevelding, PT, MSPT, NCS, Vice President of Clinical Operations at Gaylord Specialty Healthcare and Executive Director of the Milne Institute for Healthcare Innovation. “ZeroG with TRiP provides unanticipated perturbations while a patient is walking or practicing postural activities. These balance disruptions allow the patient to develop more effective recovery strategies, without the risk nor interference of manual intervention by the therapist. These relearned strategies potentially help avoid a harmful fall once back in the community. This study is the first to demonstrate that perturbations delivered during overground therapy activities can have a significant effect on improving patient outcomes.”

Joe Hidler, PhD, Aretech CEO, states “TRiP is one of the many ZeroG features that therapists are excited to use with their patients. What the Gaylord study shows is that challenging a patient’s balance control using ZeroG with TRiP may ultimately lower fall risk and improve functional independence.”

Two other studies evaluated the clinical effects of using ZeroG during inpatient rehabilitation following acute traumatic brain injury (TBI) and stroke. Each found that patients using ZeroG achieved significantly higher gains in total Functional Impairment Measure (FIM) scores then patients who receive SOC therapy. Specifically, the patients with acute stroke who used ZeroG during their daily therapy program improved their overall FIM score by 40 points while the SOC group improved by 30.5 points. Patients with acute TBI who used ZeroG during acute rehabilitation improved their overall FIM score by 59.7 points. This was nearly triple the gains in the SOC group, which were 21.1 total FIM.

“We are very excited by the results of these studies,” said Joe Hidler. “We have always believed that ZeroG’s unique ability to help deliver high-intensity physical therapy early after neurological injuries would lead to best outcomes. These studies now support this. And to see patients who use ZeroG with TRiP experience the largest gains in balance scores emphasizes the impact ZeroG can have on patient outcomes that cannot be replicated by other systems.”

References
1. Anggelis E, et al. “Impact of motor therapy with dynamic body-weight support on Functional Independence Measures in traumatic brain injury:” NeuroRehabilitation. 2019 Dec 18;45(4):519-524
2. Elwert N, Powell ES, Anggelis E, Sawaki L, “Effect of dynamic body-weight support on function independence measure in acute ischemic stroke.” 14th ISPRM World Congress and 53rd AAP Annual Meeting. 2020
3. Meyer et al. “A Novel Body Weight-Supported Postural Perturbation Module for Gait and Balance Rehabilitation After Stroke: Preliminary Evaluation Study” JMIR Rehabil Assist Technol. 2022;9 (1)

About ZeroG TRiP
TRiP (Training Responses in Postural Rehabilitation) is a patent pending software algorithm for the ZeroG Gait and Balance System. TRiP allows therapists to apply controlled and measurable perturbations to patients while ambulating or during stationary activities using the ZeroG robot.

About the ZeroG Gait and Balance System
The ZeroG Gait and Balance System has been used by patients since 2008 and is intended for patients in rehabilitation who need dynamic body-weight support and are at a risk of falling. ZeroG gives therapists the opportunity to safely treat a broad range of patient populations with dynamic body-weight support in functional activities, apply TRiP perturbations while providing fall protection.

About Aretech
Aretech, LLC, headquartered in Ashburn, Virginia, is a world leader in developing advanced rehabilitation technologies for improving function and independence. The company has a strong commitment to quality, innovation, and developing technology based on evidence-based research.

Patients Achieve Higher Functional Outcomes with ZeroG

Source: PRWeb

Two recent studies have demonstrated that patients with acute cerebrovascular accident (CVA) and traumatic brain injury (TBI) who use Aretech’s ZeroG Gait and Balance System during their acute inpatient therapy program achieved higher gains in overall score on the Functional Independence Measure (FIM) as well as sub-categories of the FIM when compared to standard of care (SOC).  Both studies were led by Dr. Lumy Sawaki, MD, PhD, Department of Physical Medicine & Rehabilitation at the University of Kentucky.

The first study compared 29 patients with CVA whose acute physical therapy included regular use of the ZeroG Gait and Balance System to 29 patients whose physical therapy did not utilize any form of overground dynamic body-weight support devices (SOC).  The primary outcome measure was change in overall FIM scores from admission to discharge, while secondary outcome measures included motor FIM score and cognitive FIM score.  The group that utilized ZeroG demonstrated statistically higher gains in overall FIM scores (p = 0.01) and Motor FIM scores (p = 0.016) than SOC therapy.  The ZeroG trained group also demonstrated significantly higher gains in Locomotion (p = 0.023) and Sphincter Control (p = 0.012), which are subscales of the Motor FIM score.

The second study followed the same protocol except each group included a cohort of 6 patients with TBI.  The results of this study were even more pronounced.  The average change in overall FIM scores in the group of patients who utilized ZeroG during their acute rehabilitation more than doubled the changes in the SOC group (ZeroG: 59.7, SOC: 21.1; p = 0.007).  In addition, the group that utilized ZeroG demonstrated statistically significant gains in Motor FIM (p = 0.008) and Cognitive FIM (p = 0.021), as well as Self-Care, Mobility, Locomotion, and Social Cognition subscales when compared to SOC.­

Aretech’s CEO and inventor of ZeroG, Dr. Joe Hidler, said these studies confirm the ideology he and his team had when the idea for ZeroG was first conceived back in the early 2000’s.  “When I first started working on ZeroG, I felt that the system could help patients achieve much higher outcomes than standard of care because ZeroG’s dynamic body-weight support would allow them to begin high-intensity physical therapy earlier in their rehabilitation program, and ZeroG’s advanced fall protection takes away the fear of falling and getting injured.”

Dr. Sawaki agrees and says the staff and patients loved using ZeroG.  “We found that patients immediately took to ZeroG and felt comfortable pushing themselves during activities they normally would be afraid to do.  For our staff, they didn’t have to worry about the safety of the patient because ZeroG took care of that.  Instead, they could focus on the quality of the therapy, and have patients practice the types of activities they would do at home and in the community.”

Dr. Hidler added. “ZeroG is so much more than a simple fall-protection system.   The dynamic body-weight support helps compensate for impairments such as weakness and abnormal synergy patterns.  This allows patients to begin their therapy as soon as they are medically stable and as their abilities improve, the therapist can reduce the amount of body-weight support and make the therapy more challenging.  This progressive therapy approach can be done with a single therapist, which helps to reduce healthcare costs.”

About the ZeroG Gait and Balance System

The ZeroG Gait and Balance System has been used by patients since 2008 and is intended for patients in rehabilitation. ZeroG safely allows walking overground, functional activities, balance and fall prevention training in a ‘reduced gravity’ environment.  The system consists of dynamic body-weight support, fall protection, robotic trolley tracking which anticipates and reacts to patient movements, and TRiP for applying perturbations.  The patient has full freedom to practice a wide variety of activities including steps, getting up from a chair, picking up objects, and using assistive devices such as walkers or canes.

About Aretech

Aretech (http://www.aretechllc.com), headquartered in Ashburn, Virginia, is a world leader in developing advanced rehabilitation technologies for improving function and independence. The company has a strong commitment to quality, innovation, and developing technology based on evidence-based research.

References:

Elwert N, Powell ES, Anggelis E, Sawaki L, “Effect of dynamic body-weight support on function independence measure in acute ischemic stroke.” 14th ISPRM World Congress and 53rd AAP Annual Meeting. 2020.

Anggelis E, Powell ES, Westgate PM, Glueck AC, Sawaki L, “Impact of motor therapy with dynamic body-weight support on Functional Independence Measures in traumatic brain injury: An exploratory study.” NeuroRehabilitation. 2019 Dec 18;45(4):519-524.

 

 

 

 

 

 

Webinar: “Turning Control: A Dynamic Balance Functional Activity”

Source: APDM

Join OHSU’s Dr. Fay Horak and Dr. Martina Mancini for a webinar entitled “Turning Control: A Dynamic Balance Functional Activity.”

April 21st, 2016:  12:00-1:00pm Pacific Standard Time

1 CEU Credit

This webinar covers the significance and challenge of controlling turning, or locomotion on a curved trajectory, for rehabilitation of dynamic balance.

We discuss the physiology and biomechanics of turning and what goes wrong with turning ability in the elderly and patients with Parkinson’s disease.  We show how measurement of turning with body-worn sensors has provided insight into the frequency and quality of turning in everyday life and how it relates to fall risk and neurological impairments. A better understanding of turning as a complex motor skill will help physical therapists develop more effective, innovative approaches to rehabilitation of mobility and reduce risk of falls.

Limited space available!  Register now to attend – $39 

Recording will be provided to those unable to attend live webinar.

REGISTER

Aretech Partners with APDM Wearable Technologies

Source:  PRWeb

Aretech announced today that the ZeroG Gait and Balance Training System will now feature APDM’s Mobility Lab for comprehensive gait and balance assessment. APDM technology includes wearable sensors that provide sensitive, validated and reliable outcome measures of rehabilitation interventions. When combined with ZeroG, therapists now have the opportunity to treat their patients with the highest level of safety and treatment options, and then accurately quantify improvements in gait, balance and postural control.

ZeroG Gait and Balance Mobility Lab

“We’ve always known ZeroG is the most advanced rehabilitation system in the world; however the one piece we were missing was the ability to accurately assess improvements in walking, postural stability, turning, sit to stand and other ADL tasks with validated measures. By integrating ADPM’s Mobility Lab into the ZeroG framework, therapists can now track outcomes with a variety of clinical scales and store this information in ZeroG’s secure patient database,” said Joe Hidler, CEO of Aretech. “We are looking forward to this new partnership with APDM and continuing to advance rehabilitation options for so many patients, therapists and researchers who use our technology.”

ZeroG Mobility Lab

 

 

 

 

 

 

“Through comprehensive validation against motion analysis and clinical measures, Mobility Lab is the most trusted wearable sensor technology on the market for quantifying gait and balance,” said Matthew Johnson, General Manager of APDM. “Pairing our technology with Aretech’s ZeroG is a perfect match to help make it easy for therapists to collect, analyze and store valid outcome measures to justify treatment.”

Advantages of ZeroG

  •     Safely treat a wide range of patient sizes and clinical diagnoses across a wide range of therapeutic activities
  •     Therapy intensity can be modulated through high-level dynamic body-weight support
  •     Real-time biofeedback and games motivates patients
  •     Lowers the risk of injury to patients and therapists
  •     Easy to use, with short setup times

Advantages of Mobility Lab

  •     Justify treatment with evidence-based practice
  •     Analyze outcome measures with functional tests such as timed up and go, 2 minute walk and sit to stand
  •     Accurately measure minimally-detectable changes in gait and balance
  •     Record natural movement, activity levels, gait, balance, turning, tremor and intervention response

About Aretech, LLC
Aretech, LLC, based in Ashburn, Virginia, is the world leader in robotic overground body-weight support systems. The company has a strong commitment to quality, innovation, and developing technology based on evidence-based research. Additional information about Aretech can be found at http://www.aretechllc.com.

About APDM, Inc.
APDM Inc., based in Portland, OR, produces the highest quality wearable sensors on the market; used by hundreds of universities, hospitals, and professional sports teams worldwide. APDM’s mission is to develop and commercialize best-in-class solutions for quantifying human movement with wearable technologies. Additional information about APDM can be found athttp://www.apdm.com.

Aretech’s ZeroG used in research to help restore the ability to walk following spinal cord injury

Source: Neuroscience News

The ability to walk has been restored following a spinal cord injury, using one’s own brain power, according to research published in the open access Journal of NeuroEngineering and Rehabilitation.

This is the first time that a person with complete paralysis in both legs (paraplegia) due to spinal cord injury was able to walk without relying on manually controlled robotic limbs, as with previous walking aid devices.

The participant, who had been paralyzed for five years, walked along a 3.66m long course using an electroencephalogram (EEG) based system. The system takes electrical signals from the participant’s brain, which then travel down to electrodes placed around his knees to create movement.

Dr. An Do, one of the lead researchers involved in the study, from University of California, Irvine, USA, says: “Even after years of paralysis the brain can still generate robust brain waves that can be harnessed to enable basic walking. We showed that you can restore intuitive, brain-controlled walking after a complete spinal cord injury. This noninvasive system for leg muscle stimulation is a promising method and is an advance of our current brain-controlled systems that use virtual reality or a robotic exoskeleton.”

Mental training was initially needed to reactivate the brain’s walking ability. Seated and wearing an EEG cap to read his brainwaves, the participant trained to control an avatar in a virtual reality environment. He also required physical training to recondition and strengthen his leg muscles.

The participant later practiced walking while suspended 5cm above ground, so he could freely move his legs without having to support himself. On his 20th visit, he translated these skills to walk on the ground and wore the ZeroG Gait and Balance Training System for aid and to prevent falls. Over the 19 week testing period, he gained more control and performed more tests per visit.

ZeroG UC Irvine

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Experimental setup.    Left: The suspended walking test. In response to “Idle” or “Walk” cues displayed on a computer screen (not shown) the participant modulates his EEG by idling or attempting to walk. EEG is sent wirelessly (via Bluetooth communication protocol) to the computer, which processes the data and wirelessly sends a decision to either “Idle” or “Walk” to a microcontroller. The microcontroller (placed in the belt-pack) drives the FES of the femoral and deep peroneal nerves to perform either FES-mediated standing or walking (in place). Right: The overground walking test. In response to verbal cues, the participant performs BCI-FES mediated walking and standing to walk along a linear course and stop at three cones positioned 1.8 m apart. The basic components are: the BCI-FES system, motion sensor system (two gyroscopes and a laser distance meter), and the ZeroG body weight support system to prevent falls. The information flow from EEG to FES is identical to that of the suspended walking test. Note that the participant’s face was scrambled due to privacy concerns Credit: King et al. Journal of NeuroEngineering and Rehabilitation 2015.

Video of Walk

Kessler Foundation uses the Aretech ZeroG Gait and Balance System to advance research

Source: Globenewswire

The Kessler Foundation acquired the ZeroG Gait and Balance Training System to advance their rehabilitation research for people with disabilities. ZeroG will be used in research by Kessler to help explore new ways to help individuals function more independently at home, the community and in the workplace. ZeroG, a robotic body-weight support system mounted in an overhead track, allows individuals to engage in rehabilitative activities safely and independently.

 

ZeroG compliments the other technological resources scientists at Kessler are using and will provide real-time data for mobility research. People of various ages, weight and diagnoses can use the ZeroG for many types of functional activities. Participants can safely sit, stand, squat, climb stairs, use an exercise ball and run up to six miles per hour. In ZeroG, they can walk over ground, on a treadmill or in an exoskeleton, without the fear of falling. Via a wireless interface, the device provides real-time data for mobility research, including distance, speed and duration of walking, levels of body-weight support and falls prevented. Activity can be monitored via ZeroG’s touchscreen or a mobile phone or tablet.

 

Kessler Foundation is using ZeroG Version 2, which is more compact and has a higher weight capacity—a maximum of 400 pounds. Version 2 also provides biofeedback to challenge individuals physically and cognitively. A high-resolution display screen features interactive games and target matching activities such as breaking blocks and bobbing and weaving to avoid objects, which increase motivation and encourage participation.

 

The Kessler Foundation is a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org.

Motor learning strategies applied to neurorehabilitation

Source:  Kessler Foundation

Dr. Joe Hidler, CEO of Aretech and inventor of the ZeroG Gait and Balance Training System discusses the research he and colleagues have done which has served as the catalyst as to why ZeroG was developed. This podcast was hosted by the Northern New Jersey Spinal Injury System with support from the National Institute on disability and Rehabilitation Research. US Department of Education grant H133N110020.

Dr. Hidler explains that one of his favorite quotes in relation to motor learning comes from John Krakauer, M.A., M.D., “Rehabilitation needs to emphasis techniques that promote the formation of an appropriate internal model and not just the repetition of movements.”  Dr. Hidler describes how movements occur using internal model formations which start at birth and continue into adulthood. How does this work in stroke patients who have been using their internal models their entire life which now no longer are appropriate? Everything changes so now there is inefficient motor control.

Error signals are very important in the learning process. The variability of tasks and the task variability in the acquisition phase is very important and improves performance in subsequent sessions in the generalizing of learning new tasks. The ZeroG Gait and Balance Training System differs from other robotic rehabilitation systems which move the limbs for the patient. ZeroG builds on the basics of motor learning and motor control strategies to help progress patients while learning variability of tasks.