25 June 2009

Physical therapist explains machine that helps patients walk

Jun 22, 2009 (Lodi News-Sentinel - McClatchy-Tribune Information Services via COMTEX) --

Lodi Memorial Hospital is the only place in the greater Sacramento and Modesto areas that has a new piece of equipment available to patients seeking to improve their ability to walk normally again.

This includes those who have suffered from a stroke, an incomplete spinal cord injury, cerebral palsy or, like Linda Barnard, of Sacramento, multiple sclerosis.
After being diagnosed with multiple sclerosis 10 years ago, Barnard was steadily losing her ability to walk. The disease worsened until the former athlete struggled to walk independently from her office to a nearby restroom at work.
Barnard, a marriage-family therapist in the Sacramento area, learned about the machine through one of her clients, who saw a segment on the "Today" show. When she Googled the nearest location, she found it in Lodi.

In the last six months, Barnard has regained enough mobility to stroll around a golf course. The 59-year-old attributes her full recovery to the NESS L300, a new FDA-approved wireless electronic device.

"It really works. I can already see positive benefits," she said.
The NESS L300 is worn in two parts, a small transmitter in the shoe and a device strapped below the knee. When a patient tries to walk, the L300 sends electronic signals to stimulate the peroneal nerve which, in turn, signals under-active muscles to help patients lift their foot off the ground and get them walking again.
Barnard's physical therapist, Jason Locke, at the hospital's outpatient clinic, explained how the NESS L300 can help people learn to walk again.

How does this machine work?Basically how the machine works is, we use a cuff that goes on the lower leg, which we connect electrodes to that stimulate the muscles of the foot.

A gait sensor in the shoe acts as a switch. When the person is walking, the machine will sense the pressure and turn the machine off ... so there's no contraction of the muscle. When your foot is on the ground, you don't need that muscle.
When you lift your foot, that sensor turns the machine on.
When it comes to physical therapy, what is 'foot drop'?It's just a general term for the foot not to be able to come up for walking.

For Linda, who has MS, it's a central nervous system disorder. If you compare it to an electrical generator for our home, it sends power to turn on the lights. Our brain is very similar. It sends a message through our brain to our muscles.
How is this machine unique to others that offer similar results?We've been using electrical stimulation for a long time. (The NESS L300) is just the wireless technology that enables us to make a big impact for patients.
It's more functional for them because the physical therapist doesn't have to program anything. In the past, we would have to get the electrodes in the right place every time to stimulate the muscles.

I understand there are not many of these machines around. How did Lodi Memorial come to acquire one?We heard about the technology about a year-and-a-half ago, and we were able to acquire it by a generous donation by the hospital and the auxiliary.
They are very expensive. A take-home unit is about $6,000 and doesn't include all the auxiliary equipment we need here, including a PDA that stores all of the patient information.

How have you come to believe it can help people regain mobility?I think the biggest thing is that it provides some functional return. It makes people more functional again.

Most of these people who have foot drop are using some sort of brace. It's cumbersome and not natural at all. This unit has created a functional way to improve their lives. Lots of people walk faster, their gait improves and they can walk on uneven ground a little better, especially stepping over hills.

It also reduces tone (in the leg). It's like the idling speed in your car. The patient who has had some sort of brain injury, their tone usually runs too high in the legs. It's just more rigid, and it's hard to move. This machine allows people to move a little better.

What have patients who have used the machine said about it?I had one patient who wasn't able to walk very well because of fatigue. This machine has enabled her to walk further.

A year-and-a-half ago she was able to walk around Disneyland when she was only able to walk from bench to bench before, because she would lose her balance or fatigue.
It's been amazing to see people who have had a life change and how this has positively affected their lives. We've had some patients come from Nevada, and one from as far away as Bakersfield.

Free patient screeningWhen: Wednesday from noon to 4 p.m.
For more information: 333-3136.

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