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ReoAmbulator ™ Advance Gait Training Platform
January 2015
The ReoAmbulator ™ A Leading Advanced Gait Training Platform
Introduction
Presentation Intention
• ReoAmbulator ™ - The winning solution
• ReoAmbulator ™ – Features & Benefits
• ReoAmbulator ™ – PT’s and Patient’s experience
2
Gait Rehabilitation Market
• REHABILITATION POST-SURGERY
– hip: partial/total hip replacements
– knee: total knee replacements
• NEURO-REHABILITATION
• Strokes; Multiple Sclerosis ;Parkinson; Cerebral Palsy.
• PROSTETICS REHABILITATION – Amputees (VA, IP, OP )
• REHABILITATION POST SPORTS / RECREATIONAL INJURIES
Background ReoAmbulator was introduced in 2002
150 sites, >100,000 patients up to date
Bridging the Technology Gap • HW- System design-√
• SW- user interface (Software screens, intuitive flow, Reports)- √
• Clinical applications:
Gait analysis and Biofeedback- √
Multi-tasking interactive program- √
Real-time measurable outcomes (distance, speed, Body weight)- √
• Patient engagement (motivation, level of interest ) -√
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The ReoAmbulator ™
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The ReoAmbulator ™
The ReoAmbulator ™ is composed of:
• Ergonomically Designed Advanced Robotics Platform
• Body Weight Supported Treadmill
• Gait Analysis Module combined with audio/visual Feedback
• Virtual Reality -Multitask interactive training program
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Ergonomically Design - Hardware
Folding robotic legs and detachable hand rail
Extra-wide treadmill
Integral 40” patient monitor
Separate 22” therapist monitor
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Intuitive Software Flow
A dedicated, 22” therapist monitor
An intuitive user interface,
Customized training parameters
to each patient
Data collection and PDF report: • Detailed gait analysis and biofeedback
• Monitoring and tracking patient’s session parameters & performance
• Ability to print reports and graphs
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Integral VR system
40” screen
Virtual Reality
• Real images
• Coordinated with treadmill speed
Real time feedback about speed and distance travelled
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Harnessing Design Short set-up time
• Easy harnessing
• Quick Connection
• Computerized control of robotic legs
Easy to use
Natural Gait Pattern
Natural Hip , Knee and Ankle Movements
Natural Center of Gravity movement
3 Physiological Gait Profiles
Optimal weight bearing
Natural Pelvic Rotation
Natural Pelvic lateral shift
Natural Gait Profile
Anterior View Lateral View
What Makes ReoAmbulator the winning Solution
Different Ambulatory / Activity Level
Full Continuum of Care
IP, OP, SNF, LTC
Adults and Children
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Acute Stages Chronic Stages
ReoAmbulator fits wide spectrum of patients populations, different stages in rehab and variety of ages
Wide Spectrum of Patients
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• Neurological and Orthopedics • Adult and Pediatrics
• Low and High level of Gait Training • Various Ambulatory Levels
What Makes ReoAmbulator the winning Solution
Clinical Rehabilitation and Research are moving toward Activity participation, Motor learning.
Motor learning – “a permanent change in motor behavior as a consequence of experience”.
• Practice
• Feedback during and after the activity
Active participation influence the plasticity of the brain and enhance or speed up recovery of motor function
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ReoAmbulator enhance Active Therapy- Motor Learning
Active Participation
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• “More learning will occur with more practice and repetitive trials” (Schmidt and Lee 1999)
– Butefisch et al. 1995
– Parry et al. 1999
– Taub et al. 1997
• The patient should learn maximally. The learning takes place through repeated experience with the
environment. (Affolter and Stricker, 1980)
• Increasing amount/intensity => Decreased degree of impairment and functional limitations
Neuroplasticity- change structure and function
“The idea that the brain can change its own structure and function through thought and activity is, I believe, the most important alteration in our view of the brain since we first sketched out its basic anatomy and the workings of its basic component, the neuron” (Doidge, 2009).
Image from www.socialphy.com
Doidge, N. (2009). The brain that changes itself. New York, NY: Penguin.
ReoAmbulator - Innovative Active Therapy
Training modes: includes the Active Ambulatory Therapy mode for an advanced active participation.
Active participation and enhancement of motor learning during various gait critical events.
Enhance Active movement at Loading Response, Midstance, Terminal Stance.
Facilitate learning process through repetitive practice and feedback.
Point 3- Terminal stance
Point 2- Mid stance Point 1- Loading response
Active Gait Training
• Active/Passive Therapy
• 2 Assisted Modes
• Real time Feedback
Point 1- Loading response Point 2- Mid stance
Patient Active Participation
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Innovative Modes of Operations
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ReoAmbulator ™ - Enhance motor recovery
Enhance symmetrical pattern
• Functional training
• Active participation
• Self-initiated movements
• Intensive and repetitive
Exercises Improves recovery
Stroke- Left Hemiparesis
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Intensive and controlled gait training
• Uneven stride length • Decreased stance time • Decreased eccentric control
during stance. • Compensatory gait pattern
CVA- Rt. hemiparesis
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Gait Coordination Training
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• Accuracy in step length
• Frequency
• Compliance score
• Real time Visual/Auditory Feedback
Audio-Visual Feedback
Audio Visual Feedback
Enhance gait symmetry • Gait coordination training with visual
and auditory biofeedback
• Step and stride length
• Weight Bearing, Speed and Distance
Progress to:
Less BWS + Higher speed
Higher steps length
Dynamic Balance Training- Multitasking
Comparison Rt Vs Lt -Accuracy
Stroke- Lt. Hemiparesis
Gait Coordination
Multi-Tasking Training
Multi-Tasking Training
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Gait training combined with Upper limb Motor & Cognitive challenges
Arch Phys Med Rehabil. 2009 March ; 90(3): 381–387
Multi Task- Motor and Cognitive training
Moving the upper extremity in a motor- cognitive interactions contribute to the challenge of gait regulation and postural control:
Changing the center of gravity location – challenge the control of gait function
Adding additional protuberance as a result of the external movement
Require a cognitive decision in real-time
Allow development of task-coordination skills
Allow improvement in walking speed during multi task activities.
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Pediatric- VR
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Motor and cognitive rehabilitation:
Enhances motivation
Improves gait & balance
Motion detection sensors follow patient movement in real time
Multi-tasking training:
Upper extremity exercises
Cognitive tasks
ReoAmbulator ™ - Benefits Intensive and controlled gait training therapy,
Online dynamic monitoring of the rehabilitation process,
Passive and Active mode of training,
Increased patient awareness , understanding, engagement,
Increased motivation by integrating multitask motor and cognitive training,
Improved therapy management by monitoring session's information and patient's progress.
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Clinically observed effects
Current patients experience:
• Improved confidence
• Improved stance stability
• Improved sensation in affected leg
• Decreased muscle spasticity with activity
• Improved endurance
• Decreased compensatory strategies
Testimonial
“Fast set up”. (M.S.)
“Gait pattern felt efficient movement” (S.S.)
“The active participation allows re-enforcement of hip extension” (M.S.)
“Gait feedback enhance my step length control” (Y.E.)
“At the end of my session I wonder -When can I come again..” (S.S.)
“I have got again the experience of a normal walking after 1.5 years…”(S.S.)
“It gives me hope!” (S.S.)
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ReoAmbulator ™ -The Winning Solution
Ergonomic design, Integrated Therapy Platform
Maximal Flexibility for patients at different stages of Rehab
Efficient ambulatory Therapy
• Natural Gait Pattern
• Short Set Up time
• Active training mode
• Integral VR -Multi-tasking
• High level of gait coordination
training.
35
Thank you!
www.motorika.com
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