Central Cord Syndrome Helped by Robot Rehab


SAN FRANCISCO, Calif. (Ivanhoe Newswire)— Each year, approximately 18,000 Americans suffer a spinal cord injury. Among that number are those diagnosed with central cord syndrome. Symptoms can include paralysis as well as loss of control in the arms and hands. However, a new exoskeleton device, resembling something out of a Terminator movie, is making the rehab process a lot more effective.

One of the simple joys for Pravin Vazirani is the quiet moments he spends with just his guitar. However, a few months ago, he wasn’t sure if he would have the chance to ever play again.

“I was in Hawaii on vacation with my family and got thrown by a wave and was instantly paralyzed. They got me out of the water and onto the beach, and that’s when I realized it was a pretty serious problem,” Pravin recalled.

After emergency surgery to stabilize his spine, Pravin was flown to Santa Clara Valley Medical Center in Northern California for rehabilitation.

“He had a type of spinal cord injury that we see fairly often, it’s called central cord syndrome,” explained James Crew, MD, chair of physical medicine & rehabilitation at Santa Clara Valley Medical Center.

(Read Full Interview)

Lindsey Rainey, an occupational therapist at Santa Clara Valley Medical Center  described, “He wasn’t able to move his arms, at that point, too much yet against gravity.”

And so Rainey decided to introduce Pravin to the Armeo, a futuristic-looking, exoskeleton device.

“It is a little bit intimidating,” Pravin shared.

“The Armeo power helps unweight a patient’s arm and then helps them to move it while they participate in a game,” Rainey illustrated.

The concept is similar to being in a pool, which also eliminates the force of gravity.

“And so, people can move more freely,” Rainey added.

“And then it’s connected to a computer and you play various video games that require you to move your arms around,” Pravin described.

A high game score means you’re improving.

“It’s actually really motivating for a patient,” Pravin admitted.

It shows. Two months later, Pravin is making so much progress that doctors say a full recovery is within reach.

“Yesterday, I went and played basketball!” Pravin exclaimed.

Doctor Crew also adds that the Armeo works best alongside traditional physical therapy treatment. The Armeo is also often prescribed for those recovering from neurological issues such as a stroke or brain injury.

Contributors to this news report include: Cyndy McGrath, Executive Producer; Jennifer Winter, Field Producer; Rusty Reed, Videographer; Roque Correa, Editor.

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REPORT:       MB #4894

BACKGROUND: Central cord syndrome is a spinal cord injury that is an incomplete injury to the cervical spinal cord. The cervical spinal cord is the portion of the spinal cord that runs through the bones of the neck. This injury usually results in weakness in the arms more so than the legs. This type of injury is considered “incomplete” because patients are usually only partially paralyzed and not completely paralyzed. Central cord syndrome, also called CCS, usually occurs in patients with existing arthritis changes in the bones of the neck. In these situations, the canal through which the spinal cord travels can be narrow, so that if the neck is forcefully extended, such as when the head is tilted back, in, say, a car accident, the spinal cord can be squeezed. There is typically no obvious break or fracture in the bones of the neck and spine may be stable.

(Source: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Central-Cord-Syndrome#:~:text=Central%20cord%20syndrome%20(CCS)%20is,more%20so%20than%20the%20legs)

CURRENT TREATMENT METHODS: CCS is typically treated with traditional physical therapy to reserve range of motion and enhance of mobility skills. Also, the strengthening of any preserved lower extremity musculature is essential, as are trunk balance and stabilization. Occupational therapists also work on goals such as safe transfer and wheelchair mobility prior to the initiation of gait training. Even though there is usually a preservation of some lower extremity strength, upper extremity deficits can limit the use of possible assistive devices and, ultimately, the functional quality of ambulation. The restoration of the basic activities of daily living (ADLs), upper extremity strength, and range of motion (ROM), are the main goals of occupational therapy. Splinting is often used for maintenance of the functional position of the hand while also preventing the formation of contractures in the fingers.

(Source: https://emedicine.medscape.com/article/321907-treatment)

NEW TECHNOLOGY: Now, a new exoskeleton device is improving the effects and outcomes of physical therapy. The ArmeoPower has been specifically designed for arm and hand therapy in an early stage of rehabilitation. This upper extremity focus is the main point of rehabilitation for many CCS patients. The device enables even patients with severe movement impairments to perform high intensity exercises, or exercises with a high number of repetitions, which is vital for relearning motor function. Using sensors and intelligent algorithms, it is able to recognize when the patient is not able to carry out a movement themselves and assists the patient’s arm as much as needed to successfully reach the goal of the exercise. It automatically adapts the guidance to the individual needs and changing abilities of each patient, from full movement guidance for patients with very little ROM, to no support at all for more advanced patients. Also, a large library of game-like augmented performance feedback exercises has been designed to train core movement patterns as well as motivate the patient to preform the exercises.

(Source: https://www.hocoma.com/us/solutions/armeo-power/)





If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

Doctor Q and A

Read the entire Doctor Q&A for James Crew, MD, Chair of Physical Medicine & Rehabilitation

Read the entire Q&A