Physiotherapy and Rehabilitation

Updated: Dec 3, 2021


Physiotherapy
Physiotherapy and rehabilitation is a direction in medicine, the purpose of which is to increase body functions to the maximum level, restore working capacity, teach independent living skills to a level where there is no need for help, and improve the quality of life of people who, for some reason, have lost their functionality and mobility body.

Physiotherapy and rehabilitation, offering the most effective recovery programs, has a special place in the treatment of neurological diseases such as diseases of the muscles, joints, bones and spine, orthopedic problems such as sports injuries, rheumatic diseases and paralysis.


Physiotherapy methods include hot / cold treatments, ultrasonic and electrical stimulants, water exercises, and traction treatments (stretching of various parts of the skeletal system). In addition, exercise and proper use of the body is one of the essential treatments in physiotherapy and rehabilitation.


In our center, equipped with modern equipment, a team of experienced specialists plans and applies treatment procedures in the light of the latest advances in world medicine.


Space Therapy


Space therapy is a treatment that has been developed in the field of physical therapy and rehabilitation in recent years and is used for many neurological diseases, especially cerebral palsy. Space therapy is used in many situations such as cerebral palsy, stroke, spinal cord injury, traumatic brain injury, and neuromuscular disease.


The space therapy method is based on an intense and specific exercise program. The elimination of pathological reflexes and the installation of new, correct and functional patterns of movements are of great importance. Reduces pathological reflexes. It restores general body posture and smooth movements. Provides external balance and supports weak muscles. Improves the appearance of the body.


Walking with robots; ability to walk; It is a system for imitating the walking of paralyzed body parts, especially legs, using a robotic device in patients who have lost weight as a result of a stroke, spinal cord or brain injury, orthopedic or neurological diseases.With this method, the movements of the brain and spinal cord when walking are reminded again by a robot.



Therapy

Observing and feeling patients walk away from the mirror, even with the help of the system, also positively influences their motivation. We can compare this to using a walking aid to overcome the patient's difficulty in walking while the child learns to use the bicycle, first learning with the tricycle or optional auxiliary wheels and gradually raising the support wheels.


How does the device work?


The patient is suspended in an upright position on a treadmill in the area surrounded by the robot, which reduces body weight. The investigation begins after assessing how much the patient should contribute and how much the device should contribute. The sensory parts of the robot device are installed on the patient's legs with the help of clamps, focusing on the hip and knee joints.

With the help of these sensors, the legs are moved to create a natural walking pattern, while, on the other hand, the receivers evaluate and measure the body's response to movement, and the graphical data obtained on the device's computer informs the doctor at what stages and what size the patient has. trouble walking.


The robot supports the patient as much as possible, but as little as possible, adjusting to the individual functional level of each patient. While the robot does not intervene while the patient is moving in a specific and desired shape, when the patient leaves the desired shape, the robot generates a corrective force and activates the "help as much as needed" principle.


Thus, the movements that form the physiological walking pattern are repeated many times, and the patient tries to walk again.

The best way to restore walking function is to lift the patient up and start walking as early as possible. The affected area of ​​the body of paralyzed patients responds to movement in a normal walking pattern, even if there is no muscle strength to create movement.





Treatment with this method ensures the formation of reflexes that are transmitted from the legs to the spinal cord. Research shows that repeating certain sequences of movements triggers sensory memory and reminds the spinal cord how to start walking. In these cases, the spinal cord itself can act like a small brain, controlling movement when walking. In a sense, the spinal cord tells the muscles how to walk properly.



While repetitive walking helps the brain and spinal cord recover signals interrupted by illness or injury in a ne

Rehabilitation

w way, stimuli to the brain during normal walking similarly disappear when the robot walks, so that the center of motion in the brain is stimulated in the most appropriate way. physiological patterns.


Thus, through sensory and visual perception from the legs, the reflex gait pattern is transmitted to other cellular tissues in the brain that should be in the brain, but not to defective cell groups.Therefore, when a paralyzed patient receives this walking and strengthening therapy, the brain and spinal cord discover new neurological pathways for walking.


In cerebral palsy (CP), which is cerebral palsy in children, there are problems with the central nervous system in transmitting walking patterns to the muscles of the legs due to the loss of nerve cells that control motor pathways. Spasticity, one of the most fundamental problems, manifests itself in a logarithmic increase in signals from our brain to the corresponding leg muscle and uncontrolled excessive contraction.This is an important factor that makes walking difficult and prevents efficient and coordinated use of muscles.




Lokomat

Thanks to Lokomat, the

y are trying to use new connections that will provide connections between our brains and muscles that allow us to walk, and existing connections will adapt to new neural pathways.




Who can benefit from this treatment?


The main goal of treatment is to improve or restore the ability to walk. For this reason, it is most often recommended for patients after traumatic brain injury, stroke, spinal cord injury, cerebral palsy, multiple sclerosis, Parkinson's disease, various orthopedic diseases, hip prostheses. Treatment, even years after the injury, is beneficial. As with other exercise programs, patients should be fully examined by a physician prior to the program.



ROBOTIC REHABILITATION IN PHYSICAL THERAPY


The use of robotics in physiotherapy and rehabilitation has been gaining momentum in recent years, amid numerous studies showing that long training and countless repetitions of exercise are required to dramatically improve the functional ability of severely injured patients.


ROBOTIC TECHNOLOGIES


According to WHO reports, neurological problems are the most serious problems in developed countries. due to disability. While the number of patients in our country is estimated at 1,2 million, 23 million patients worldwide continue their lives annually with neurological dysfunctions. For patients who cannot properly use their lower or upper limbs, various robot models have been developed to speed up patient care and reduce the burden on therapists.


WALKING ROBOT


The walking robot helps patients who have partially or completely lost the ability to walk on their own. This robot helps patients improve their walking ability.


Groups of patients who are recommended to treat this way

  • Hemiplegia after CP (cerebral palsy)

  • Injuries to the spinal vertebra

  • Brain injury

  • Parkinson's disease

  • Multiple sclerosis

After hip and knee replacement surgery

After operations of the anterior and posterior cruciate ligaments


How does this system work?


The main treatment approach is to activate the non-functional lower limbs in normal walking mode and monitor load transfer.


In this way, the robot tries to activate motor learning in order to bring the patient's complex gait cycles into a standard cycle.



            
              The robotic walking device consists of two main parts.
 In the first part, the patient is suspended on a treadmill in an upright position and tied to the robot's upper body using straps.
As the program progresses and the patient's muscle strength develops, the load on the patient increases.
 In the second part - robotic motor skills with computer control.
These parts of the robot are attached to the patient's legs with tapes, focusing on the hip and knee joints.
 When walking begins, the legs move to create natural movement when walking, and sensors on the parts of the robot assess the body's response to movement and transmit it to the computer.
 

Walking Robot


WALKING ROBOT

The stage and level of the walking problem is determined using graphic data generated on a computer.

The robot moves the patient's legs in a natural walking sequence.

While the robot does not intervene when the patient is in natural walking mode, the robot intervenes at the required level when the gait is disturbed.

The patient can observe himself through a mirror or virtual reality screen.

Since the patient perceives the sensation of walking in different environments on a virtual reality screen or sees himself walking in a mirror, he has the opportunity to do walking exercises without getting bored during treatment.

With this method, the patient's healing process is accelerated and walking styles develop in almost normal forms.


DATA COLLECTION


Since robots can collect data on patient compliance and performance, they can receive information about the exercise performed and can easily compare the patient's previous condition with the current one.


How does a robotic walking device help a patient learn to walk?


  • For patients who have lost the ability to walk, it is very important to start exercising as early as possible to restore the ability to walk and prevent problems associated with inactivity.


  • In case of gait disturbances caused by neurological diseases such as stroke and spinal cord injury, signals from the brain cannot reach the muscles.