What is neurological rehabilitation?
Neurological rehabilitation or neurorehabilitation is that branch of rehabilitation medicine that deals with the recovery of deficits and disabilities caused by neurological diseases.
The most common neurological diseases include brain injury, stroke, multiple sclerosis, epilepsy, brain or spinal cord injuries, as well as Parkinson’s and Alzheimer’s disease.
In these cases the rehabilitation process takes on a fundamental importance as it aims to help patients find their physical, mental and psychological autonomy.
Which is the best technique to use to address neurological rehabilitation?
Over the years, various methods have been developed to restore autonomy to neurological patients and to guarantee functional recovery of the injured party.
One of the most common techniques in the field of neurological rehabilitation is biofeedback, but what does it mean exactly?
The term “biofeedback” literally translates into biological feedback and consists in reporting to the patient, with the aid of specific equipment, information relating to the physiological / motor functions of the patient himself, increasing the awareness of his own functional efficiency.
We at Corehab have developed an innovative medical biofeedback device called Riablo that, thanks to wearable inertial sensors, collects data while the patient performs the exercises and provides real-time visual-auditory feedback in the form of a video game, which guides him in the execution of every single movement.
The biofeedback technique acts on cortical plasticity, allowing the reconstruction of damaged neural networks and the correct restoration of motor patterns.
Precisely for this reason it finds wide applications in the field of neurological rehabilitation, for patients who have suffered a stroke or who are conditioned by diseases such as Parkinson’s, multiple sclerosis, ataxia just to name a few.
Who is using and how the biofeedback method?
The first realities to explore the potential of Riablo’s biofeedback in the neurological field were the Villa Beretta hospital (in Costa Masnaga, in the province of Lecco), masterfully guided by Dr. Franco Molteni, and the neuro-rehabilitation department of the Fondazione Santa Lucia in Rome headed by Dr. Paolucci and Dr. Morone.
In these facilities, patients of all ages and different clinical conditions are “subjected” to rehabilitation treatment with Riablo from the start of admission, then continuing for weeks under the careful guidance of physiotherapists.
The database of exercises for neurological patients that rehabilitation professionals can draw on covers all body districts and ranges from single-piece exercises to multi-joint exercises, from functional exercises to reinforcement and mobility exercises.
Our statistics indicate that the most frequently performed exercises with neurological patients are:
- Stand and Sit: a movement that is fundamental for everyday life, that is, getting up from a repeating chair. Riablo controls the movement of the load on the platform in synergy with the movements of the trunk on the frontal and sagittal planes and on the movements of the knee
- Start walking: the gait start movement with a push on the platform and back; the system controls the displacement of the load, the alignment between the trunk, hip and tibia at the moment of arrival on the platform and provides immediate feedback to the patient to make him understand if he is swinging excessively with the trunk
- Boost walking: or the phase gait boosting, in which one “goes down” from the platform and go back on it. Riablo also in this case provides feedback on the oscillations of the trunk and allows the patient to understand in real time if he is actually extending the leg that remains behind and shifting the weight on the contralateral limb, preparing for a new step.
“Biofeedback is a rehabilitative technique that acts on the reorganization of neural networks favoring the restoration of motor patterns”
Balance training in neurorehabilitation
A further area of proven effectiveness of the use of biofeedback technology in neurorehabilitation is represented by the training of balance.
For this purpose the Riablo database proposes exercises such as Weight Transfer, an exercise for the transfer of load in a medium-lateral or anterior-posterior direction, in which the patient is trained to control the distribution of his body weight on the frontal plane or on the sagittal plane.
From the point of view of evaluations, Riablo also offers the possibility of carrying out an equilibrium test (Romberg test) on a pressure platform to which instability can be added on the frontal or sagittal plane. Following the test, a pdf report is automatically generated that shows in a clear and detailed way the most relevant information (route, length / speed of crossing of the COP, sway, rms, …).
At the Fondazione Santa Lucia in Rome, a team of experts is conducting an important clinical study to demonstrate the improvements made by a “video-game based balance training” in the post-stroke rehabilitation program, compared to a traditional rehabilitation program. (Lupo, A & Martino Cinnera, et al. ,2018, “Effects on balance skills and patient compliance of biofeedback training with inertial measurement units and exergaming in subacute stroke: a pilot randomized controlled trial”. Functional neurology. 33. 131-136).