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Stroke Rehabilitation @ No Barriers Foundation

Stroke is a common condition seen by many physiotherapists, often leading to motor dysfunction and in some cases permanent disability. The rehabilitative objective of stroke patients is based on independent living by improving their functional disabilities. Therefore, rehabilitation training for stroke patients should focus on improving flexibility, muscular strength, coordination, and sense of balance to maintain an independent lifestyle through the recovery of physical functions. Rehabilitation treatment needs to be consistent and long-term.

Exoskeleton has in recent years emerged as a reliable and safe alternative to standard physiotherapy rehabilitation techniques. At the No Barriers Foundation, the exoskeleton is used to provide rehabilitation training and for walking assistance to patients affected by post-stroke disability. Lower-limb rehabilitation robots such as the Ekso GT we currently operate can help patients to carry out reasonable and effective training to improve the motor function of paralysed extremity in a safe effective manner. Exoskeleton rehabilitation allows high intensity repetitive and progressive gait training that is not achievable in many settings.

Another piece of equipment we have at our disposal is the EasyStand Glider which helps many clients in many ways. For example, in stroke survivors aids the reduction in tone while increasing joint range of motion. The EasyStand Glider features state-of-the-art active standing technology found in no other stander. Active standing provides lower body range of motion and upper body strengthening. There are several excellent research studies documenting the benefits of passive standing programs for an individual’s long-term health. The EasyStand Evolv stander allows the user to move in and out of standing without having to be lifted or transferred making it ideal for exercise in its own right but also as an adjunct to the exoskeleton training performed.

Reformer training involves low and intermediate intensity resistance and repetition that matches the patient’s physical ability and can be a remedial exercise program that can improve physical ability and influence quality of life. With hemiplegia, there is a strong tendency to shift completely to the unaffected side, which only reinforces the weakness and poor motor control of the affected side. Reformer Pilates helps to correct that.

At the No Barriers Foundation, we offer a creative rehabilitation program experience that considers both physical and mental components of rehabilitation for improving balance, strength, mobility and ability to walk when using specialist exercise therapy for recovering functions in stroke patients.

Contact us at hello@nobarriers.ie for more details

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Things we all need to know about stroke

Only a person who has survived a stroke survivor can really understand what it’s like living post stroke although that does not always mean that we can’t help and relate to the warrior within. During these difficult times with Covid-19 many people will suffer a stroke or be recovering from a stroke with reduced services all over the country. It can be a long road………. warrior like!!

However, the more we understand what stroke recovery involves, the more we can help our friends, family members or loved ones recover. However, to do this it’s important to be educated about stroke and how it affects a survivor every day.

As a physiotherapist we always want to make sure that we are using the most effective evidence-based tools to rehab someone post stroke. However, the physical injuries from stroke are only one part of the rehabilitation process and rather than focusing on the physical challenges post stroke I want to look at the hidden challenges for many.

I have NOT suddenly become stupid!!

A stroke is a “brain attack” that reduces the brain of oxygen rich blood. The resulting damage post stroke may affect different skills, like language and speaking. However, this does not mean the person has lost intelligence. Rather, it means they might need more time to find the right words………. Just be patient!

Again, Be Patient!!

Recovery from a stroke can often mean relearning the simplest tasks like it was the very first time. This can be very frustrating for stroke survivors so be patient!! Be patient with when chatting to someone as memory both short- and long-term memory may be affected but remember it’s not personal if someone can’t remember your name or where you live.

If a stroke survivor nods off it’s simply the brain healing and has nothing to do with laziness.

Stroke causes damage to the brain that must be healed. Just like any injury the brain requires time to heal. When a stroke survivor is overcome with regular tiredness early in their rehabilitation it’s not because they’re being lazy. It’s because their brain is healing and requires rest to recover. Tasks that once felt effortless may require a tremendous amount of effort now.

If I need help, I will ask.

Recovering from a stroke for many requires some help from those around you, however, always remember the stroke survivor needs to do as much as they can for themselves. The reasons for this are simple movements or tasks are important for recovery, so avoid helping too much. If a stroke survivor needs help, most often hey will ask.

Emotional Fragility During Recovery

Occasionally the emotional part of the brain may be affected by the stroke, some stoke survivors may laugh, and some may cry at various times throughout their recovery and for various reasons. This does not always mean they are sad or that they are laughing at something inappropriate it’s sometimes difficult for some stroke survivors to control their emotions. It’s a condition called emotional lability. Put yourself in the shoes of a stroke survivor. If everything suddenly changed, and you had no control over it, wouldn’t you feel emotion too?

Finally, the goal for any stroke survivor is to get back to “normal” this maybe the old normal or new normal.

Please remember when you meet someone that has survived a stroke the challenges they have faced already and will face during recovery are varied from the emotional, behavioural, and even personality changes never mind the physical deficits that may occur after stroke.

We can all help by allowing stroke survivors or stroke warriors to be themselves in the now instead of what was in the past.

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Exoskeleton & Stroke Rehabilitation

Stroke is the leading cause of serious long-term disability with many survivors sustaining functional limitations in activities of daily living as a result of stroke. Many stroke survivors have long-term walking impairment due to hemiplegia or hemiparesis. Impaired ambulation due to hemiplegia or hemiparesis is associated with increased fall risk, limited community participation, and an overall decreased quality of life.

Post-stroke, the long-term goal of rehabilitation is successful reintegration into the community, with recovery of walking ability as a key functional objective. This recovery of function is achieved with progressive, task-specific, repetitive training based on the principles of motor learning and neuroplasticity. Targeted rehabilitation can help to reorganise the brain to relearn skills that may have been lost during, or because of, stroke, with the goal of helping survivors regain their independence. Rehabilitation goals may include coordinating leg movements, shifting weight to walk, or balancing during sit-to-stand transfers.

Functional Improvements

Advances in technology are changing the rehabilitation process. Robotic exoskeletons used during stroke rehabilitation assist with walking during the recovery process by providing earlier mobility and restored independence. Exoskeletons may enhance post-stroke gait training, helping to guide weight shifts and improve step patterns and cadence and enabling individuals to stand and walk over ground early in the recovery process.

For gait rehabilitation after stroke, the technology applications typically include a wearable device such as a robotic exoskeleton, with hip and knee motors providing assistance during walking. A key part of the rehabilitation process is therapy progression, and exoskeleton technology provides options to encourage progress and document improvements. The device chosen should have options for asymmetrical control of the lower limbs and facilitate pre-gait training, transfers, stepping, and balance training.

Additional Benefits

While functional improvement is the primary goal of stroke rehabilitation, exoskeleton devices also have the potential to empower and motivate patients. Initial gait training sessions in the exoskeleton often include meaningful walking time indoors and outdoors, which can improve patient morale, motivation, and enthusiasm. Over the past year using the Ekso GT exoskeleton, we have also seen increased steps per session, improved gait symmetry and balance, and improvements in functional independence throughout many patients rehabilitation.

The ultimate goal of the No Barriers Foundation is always be to maximise recovery of function to support the patient’s ability to maintain independence at home and in the community.

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