Stroke Cerebral Palsy Traumatic Brain Injury Spinal Cord Injury CASE STUDY - STROKE DIAGNOSIS AND INITIAL FUNCTIONAL ABILITIES Linda is a 51-year old female who had a stroke that resulted in paralyzing the left side of her body. Upon admission to the Neuro Therapeutics Program (4 ½ years post injury) Linda's gait and balance were impaired and experienced decreased ability to shift weight to her left foot. Due to muscle weakness, her knee hyper-extended backwards when she stopped. Her unstable ankle rolled uncontrollably side-to-side. While walking, her head leaned down to the left side and her trunk twisted from the left-side forward. She could not stand and maintain balance when faced with minimal challenges, such as crowded groups. Additionally, she was unable to raise her arm to shoulder level or past 90-degree flexion. GOALS Linda was referred to CORA Rehabilitation Clinic for EMG biofeedback and physical therapy for the purpose of establishing alternate neuro pathways to improve her gait and upper extremity function. Linda wanted to make these physical improvements so she would feel more independent and comfortable in public settings. PROGRAM After completing a thorough evaluation Linda was determined to be a good candidate for the Neuro Therapeutics program and began an individualized treatment plan consisting of: EMG Biofeedback, to establish alternate neuro-pathways to her left knee, hip, ankle and upper back/scapular area. Physical therapy including electrical stimulation to learn to use the newly established neuro pathways and gain control in gait, balance, and upper extremity functioning. OUTCOMES After completion of integrated treatments consisting of 15 EMG biofeedback and 15 physical therapy sessions, Linda has begun to walk with a functionally straight trunk and neck. Her ankle is more stable and balance has significantly improved. Linda walks faster and safer in crowds without fear of falling. She now is able to walk up and down stairs without the use of a railing or holding onto her husband's hand. Walking endurance has increased as it now takes less effort and energy. She is able to climb up onto a high stool and sit and eat a meal without falling off. Regarding her upper extremity function, Linda has progressed to having the ability to open and close her fist and grasp and release a three-inch ball. She also can actively elevate her upper extremity to approximately 110° and utilize a functional grasp at this level.   Request more information for the Neuro Therapeutics Program - Stroke   Back to the top CASE STUDY - CEREBRAL PALSY   DIAGNOSIS AND INITIAL FUNCTIONAL ABILITIES Jarrod is an 8-year old boy born with cerebral palsy. He had minimal strength, range of motion, and gross motor control in both legs, back, and left arm. He wears ankle braces on each leg. Upon his first visit to CORA he walked with a hyperextension of the upper and lower back to help maintain balance. His knees knocked together when he walked and extended past a normal range. While walking, he had difficulty in lifting his legs forward and to shift weight from side to side. Jarrod's gait was slow and running was impossible. He required the use of a walker to participate in gym class. The patient's standing balance was non-functional. GOALS Jarrod was referred to CORA's Neuro-Therapeutics Program with a goal to improve standing balance, to reduce gait dysfunction, and to improve use of his upper extremities. PROGRAM After completing a thorough evaluation, the treatment team established Jarrod as a good candidate for the program. During his evaluation, he showed an excellent response to the surface EMG monitoring. Subsequently, an individualized treatment plan was developed and included: EMG biofeedback to help Jarrod establish more functional neuro pathways to the muscles in his legs and back. Physical Therapy to help Jarrod learn to use these new neuro pathways for improved muscle strength and function. OUTCOME Jarrod has made significant progress with this integrated treatment approach. After 16 treatment sessions of EMG Biofeedback and physical therapy, he now walks with a straighter neck and back, has decreased scissoring (knees coming together in gait), improved weight shift and improved speed. With improved balance Jarrod began to walk backwards for the first time in his life (completed by 4th treatment session) and to run for the first time, without failing (completed after the 6th treatment session). Jarrod is now independent on outdoor, uneven surfaces and participates in gym without his walker. Fatigue and muscle weakness remain an issue, (his ability to run with his classmates and his brother has excited him) and his balance, walking and running are not yet perfect, but much more functional and safe.   Request more information for the Neuro Therapeutics Program - Cerebral Palsy   Back to the top CASE STUDY - TRAUMATIC BRAIN INJURY   DIAGNOSIS AND INITIAL FUNCTIONAL ABILITIES Nathan is a 15-year old male and a motor vehicle accident (April 1997) survivor who sustained a head injury. The accident particularly affected his left side. He was in a coma for approximately three months. His memory remains affected, but is improving. His voice is weak and he has trouble speaking. Upon admission to the NeuroTherapeutics Program, he was able to walk using a wheeled walker, bilateral ankle braces, bilateral forearm supports and the assistance of one person for balance and walker control. He required frequent verbal cueing. He was unable to stand alone and required significant assistance with transfers. He was unable to use his left upper extremity to assist in any functional task. GOALS Nathan was referred to the NeuroTherapeutics Program for EMG biofeedback and physical therapy to increase independence in standing balance, gait and upper extremity functioning. PROGRAM A detailed evaluation was conducted and an individualized treatment plan established. Weekly treatment included. EMG biofeedback to increase more functional neuro pathways to the lower extremities and back muscles. Physical Therapy to help Nathan learn to utilize the newly established neuro pathways for improved strength and functional use of his legs and back. OUTCOME Nathan has made significant functional changes since beginning the 12 EMG biofeedback sessions and physical therapy treatments. His balance has materially improved thereby allowing him to stand independently for five to ten seconds. With no assistance, he is beginning to take steps. He continues in aquatic therapy to further improve upon skills learned. Gait speed with a platform walker has improved, allowing him to walk one-quarter mile in 16 minutes vs. 40 minutes prior to receiving any treatment at the clinic. Additionally, sitting and standing posture have significantly improved.   Request more information for the Neuro Therapeutics Program - Traumatic Brain Injury   Back to the top CASE STUDY - SPINAL CORD INJURY DIAGNOSIS AND INITIAL FUNCTIONAL ABILITIES Tom is a 38-year old male who survived a riding lawnmower accident one-year prior to his initial evaluation at the NeuroTherapeutics Program. Tom sustained injuries that resulted in severe decreases in movement and strength in his lower back and lower extremities. His physician felt that he would not regain ability to move his legs and diagnosed the injury as paraplegia at the L2 level.   GOALS During Tom's initial evaluation, he demonstrated voluntary hip and left knee movement and demonstrated ability to increase EMG signals to the paraspinal muscles. The treatment team established Tom as an excellent candidate for the program. Individualized goals included further increasing useable EMG signals (alternative neuro pathways) to the paraspinal muscles, improving seated balance, reducing risk of falls, and transferring independently from a seated to standing position. Tom's personal goal was to re-learn independent walking skills.   PROGRAM An individualized treatment plan was established and consisted of: EMG biofeedback to establish an increased neuro pathway to the back and both legs. Physical therapy to help him learn to use the newly establish neuro pathways for increased muscle strength and movement. OUTCOME After completing seven treatment sessions of EMG biofeedback and physical therapy, Tom has made significant gains in muscle strength and movement allowing him to surpass initial goals. He goes from sit to stand by himself when sturdy furniture is available and increased leg strength enables him to sustain a standing position. Additionally, he is able to walk up to 10 feet utilizing a walker and bilateral lower extremity braces with moderate assistance of two therapists to help guide the walker and stabilize the knees. Tom is continuing with the Program and remains confident that he will walk again - independently.   Request more information for the Neuro Therapeutics Program - Spinal Cord Injury   Back to the top Back to NeuroTherapeutics Back to the New Castle listing