HyperMED Spinal Cord Injury

HYPERMED SPINAL CORD INJURY

This Video Clip below demonstrate the difficulty providing accurate BWSTT (Body Weight Support Treadmill Training) - note the heavy load placed upon the patients whilst walking. These issues and the potential for complication for both patient and exhausted therapists are completely overcome using Robotic Gait Assisted Walking (LOKOMAT).

HyperMED Kyle Porteous - Spinal Cord Injury 'Walking Tall' Nov 2011

HyperMED Australia
Spinal Cord Injury Protocols Are Unique - We Are About 'Driving Functional Changes'
HyperMED provides saturative blocks of Hyperbaric Oxygenation (HBOT) combined with Australian first LOKOMAT (Robotic Gait Training - Adult and Paediatric) to promote neuroplasticity - the ability of neural pathways to foster and develop new connections and ‘learn’ new functions. Other supportive modalities include MonoRail Walking, Median Nerve Stimulation, Whole Body Vibration and immune stimulating supplements
HyperMED combination protocols ‘awakens’ dormant neural pathways and provides accurate neurological repetition enhancing and re-training connections and pathways in the brain and spinal cord. Patients have the ability to ‘salvage back’ what has been damaged - the capacity to wake-up dormant pathways, rewire, retrain and reconnect function improving brain and spinal cord function. Do Wheel Chairs Inhibit Recovery?

The Final Frontier - 'Repair and Functional Restoration'
The final frontier in the treatment of complex degenerative neurovascular disorders including brain and spinal cord injury is focused on ‘repair and functional restoration’. This involves the use of growth factors including Cerebryolysin and Gangliosides (GM1 ganglioside is a glycosphingolipid) to promote axonal sprouting, activation of idling and non-functional neurons whilst promoting neovascularization (new capillary formation) of damaged areas. Research efforts to bridge spinal cord and brain cell lesions are also underway experimentally, using transplanted tissues and bridging devices.
HOWEVER the ultimate success in these reconstructive methods and efforts are directly dependent on tissue vitality (neurovascular integrity). Spinal Cord insult causes a cascade of secondary degeneration due to hypoxia (inadequate Oxygen). What Happens With Spinal Cord Injury?
The extent of neurovascular deterioration can be significantly diminished with Hyperbaric Oxygenation (HBOT) which 'expands the therapeutic window'. Spinal Cord Injury & Hyperbaric Oxygenation
Hyperbaric Oxygenation provides the available fuel to damaged nerve cells and acts as a positive catalyst to spinal cord hypoxic degeneration.
American Journal Physiology - Heart and Circulatory Physiology (2005) Stem Cell Mobilization by Hyperbaric Oxygenation reports a single 2-hour exposure to HBOT at 2 ATA doubles circulating CD34+ progenitor stem cells (primordial cells targeted to salvage and restore damaged structures); and at approx. 40-60 hours HBOT: CD34+ cells increases eight fold - 800%!
Hyperbaric Oxygenation primes the body and provides a fertile neurovascular platform for mobilizing the patient’s own immune and circulating stem cell capacity whilst preparing the body for further stem cell implantation techniques. Hyperbaric Oxygenation activates dormant and inactive nerve cells hastening recovery.

Adv Ther. 2005 Nov-Dec;22(6):659-78.

Hyperbaric Oxygen in the treatment of cerebral stroke, brain trauma, spinal cord injury and neurologic disease

Life Support Technologies, Inc., and NewTechnologies, Inc., The Mount Vernon Hospital, Westchester Medical Center, New York Medical College, New York, USA.

Abstract

Hyperbaric Oxygen (HBO) therapy has been used to treat patients with numerous disorders, including stroke. This treatment has been shown to decrease cerebral edema, normalize water content in the brain, decrease the severity of brain infarction, and maintain blood-brain barrier integrity. In addition, HBO therapy attenuates motor deficits, decreases the risks of sequelae, and prevents recurrent cerebral circulatory disorders, thereby leading to improved outcomes and survival.

Hyperbaric Oxygen also accelerates the regression of atherosclerotic lesions, promotes antioxidant defenses, and suppresses the proliferation of macrophages and foam cells in atherosclerotic lesions. Although no medical treatment is available for patients with cerebral palsy, in some studies, HBO therapy has improved the function of damaged cells, attenuated the effects of hypoxia on the neonatal brain, enhanced gross motor function and fine motor control, and alleviated spasticity.

In the treatment of patients with migraine, HBO therapy has been shown to reduce intracranial pressure significantly and abort acute attacks of migraine, reduce migraine headache pain, and prevent cluster headache. In studies that investigated the effects of HBO therapy on the damaged brain, the treatment was found to inhibit neuronal death, arrest the progression of radiation-induced neurologic necrosis, improve blood flow in regions affected by chronic neurologic disease as well as aerobic metabolism in brain injury, and accelerate the resolution of clinical symptoms.

Hyperbaric Oxygen has also been reported to accelerate neurologic recovery after spinal cord injury by ameliorating mitochondrial dysfunction in the motor cortex and spinal cord, arresting the spread of hemorrhage, reversing hypoxia, and reducing edema. HBO has enhanced wound healing in patients with chronic osteomyelitis.

The results of HBO therapy in the treatment of patients with stroke, atherosclerosis, cerebral palsy, intracranial pressure, headache, and brain and spinal cord injury are promising and warrant further investigation.

LOKOMAT (Robotic Gait Assisted Walking) Gait Training
For the past 15-years bodyweight supported treadmill training (BWSTT) has become a prominent gait rehabilitation method in leading rehabilitation centers throughout the world. Experiments conducted on spinalized cats demonstrate that spinal circuitry (reflex generators) below the level of injury remains active and functional neuronal properties can respond to peripheral input from below the level of injury.
Treadmill cats can be ‘trained to sit, stand and walk’
Lack of appropriate stimulation induces functional incapacity called the ‘learning non-use’. Simply stated if you teach the remaining active spinal circuits to sit they will sit! Motor cortex centers in the brain re-allocate functional capacity lost through spinal cord injury – it is imperative to keep this ‘window open’. Do Wheel Chairs Inhibit Recovery?
Body Weight Support Treadmill Training (BWSTT) and more recent studies on LOKOMAT (Robotic Gait Assisted Walking) demonstrate the potential of functional neuroplasticity - the ability to re-learn and re-organize function.
This type of locomotor training has many functional benefits but the labor costs are considerable. To reduce therapist effort, Robotically Gait Assisted BWSTT (LOKOMAT) has been shown to be more accurate and financially feasible, compared to the other BWSTT modalities. Currently 70+ Lokomat systems are in use in large Neurorehabilitation hospitals in the USA and approximately 200+ Lokomat systems found in 31 Countries.
Internationally Lokomat (Robotic Gait Assisted Walking) and Body Weight Support Treadmill Training programs are payable under Third Party Insurance for spinal cord injury and a range of neurodegenerative and neurodevelopment gait disorders.
HyperMED/Lokomat - The Australian LOKOMAT Experience

HyperMED Protocol for LOKOMAT Gait Training
Patients receiving LOKOMAT are scheduled daily; initially 1-hour session and then as the patient builds we recommend up to 2-hours each day attending.
LOKOMAT is NOT passive involvement. The LOKOMAT is constantly adjusted to best assist the functional responses of the patient. Patients commence with passive assistance however as the patient compliancy builds the LOKOMAT settings and various programs are tailored to the patient performance and capabilities. Some patients have high level spasticity and others a complete loss of tone. Each patient's presentation is different - Lokomat provides excellent opportunity to 'best-fit' the patients specific capabilities and capacity to re-train function. And this is replicable on every separate training session!
In addition the support harness treadmill system are utilized independent of the LOKOMAT to promote functional changes. Functional changes being driven by 'man and machine' are then put to the test with the patient then able to implement strategies being focused on during each LOKOMAT session. MonoRail Walking and other supportive tools are utilised to promote and develop functional changes acquired whilst on LOKOMAT.
This combination effect is both unique and significant towards each neurologic patient developing a sense of supportive assistance whilst focusing on improving functional independence. Walking requires a 'fluid like connection between spinal reflex generators and higher brain centers'. The combined approach is invaluable to promote functional changes - neuroplasticity (the ability to salvage back what has been damaged).

HyperMED Clinical Research/Clinical_Report_LS_UT LOKOMAT Southwestern_en_0904_small_en.pdf
HyperMED Clinical Research/Clinical_Report_LS_ LOKOMAT Spaulding_en_0905_small_en.pdf
HyperMED Clinical Research/Lokomat_Clinical_Report_ LOKOMAT Shepherd_0706_en_small_en.pdf

Kids With Spinal Cord Injury May Be Overlooked for Walking Rehabilitation - Use of Lokomat
Activity Based Restorative Therapies - Concepts And Applications In Spinal Cord Injury Related NeuroRehabilitation
HyperMED/Lokomat - The Australian Experience - HyperMED NeuroRecovery.pdf
HyperMED/HyperMED Lokomat 2009.pdf
HyperMED Newsletters/HyperMED Newsletter Spinal Cord Injury.pdf
HyperMED/Victorian Neurotrauma Initiative (VNI) - HBO, Lokomat, Cerebrolysin Submission - October 2009.pdf
HyperMED/Transport Accident Commission (TAC) - Funding Application Evidence Based Support 2009.pdf
Gary Allsop Hon Director Spinal Cure Australia.pdf - Letter endorsement to various government departments
HyperMED Australia : Beyond Therapy - Treatment Program
The economic cost of spinal cord injury and traumatic brain injury in Australia (1.31Mb)
HyperMED/University of Michigan Spinal Cord Care.pdf
International NeuroRehabilitation Symposium Feb 12, 2009 - The Use of the Lokomat System in Clinical Research