State of the Art Equipment

WHAT IS IT? 

Ampcare’s Effective Swallowing Protocol is a form of electrical stimulation that provides options for both facial and throat placement allowing for more effective chewing and swallowing. 

 

HOW LONG ARE THE TREATMENTS? 

Typically, 30 minutes with the stimulation being used in conjunction with traditional swallowing and/or oral-motor exercises.  

 

WHAT IS THE TARGETED PATIENT POPULATION? 

Per the research, the most significant outcomes have been with the neuro population, most specifically strokes, with new and encouraging research coming out about severe COVID as well as Head and Neck Cancer patients responding positively to this treatment.  

 

WHO CAN PROVIDE THIS TREATMENT? 

There are multiple Speech-Language Pathologists across the continuum of care at Upstate (acute care, inpatient rehab, and outpatient) who have participated in the Ampcare course. Only those that have completed the training can provide this specialized treatment. 

Andago

The Andago® is a body weight support system that is used for over-ground walking training.  It has mobile robotic technology that senses and actively follows a person’s movement. 

How does it work?

This device allows people to be challenged with balance and walking activities while wearing a harness that will provide full support to decrease the risk of falls and allow patients to focus on normalized walking patterns.

Your therapist will perform a complete evaluation to determine the physical therapy plan to ensure that Andago is an appropriate tool for you.

In the first session the therapist will:

• Fit the harness and leg straps to you for comfort and safety.
• Set up the machine
• Determine the appropriate amount of support the machine will give you
• Begin overground walking training

Who is a Candidate?

The Andago is used for people with walking and balance deficits.  People with diagnoses such as stroke, traumatic brain injury, spinal cord injury and Multiple Sclerosis and other neurological diseases and disorders may benefit from the use of the Andago as part of their physical therapy program.

What are the benefits?

• Provides full support and eliminates the risk of falls
• Provides body weight support for people who have difficulty walking
• Allows a person to be challenged without fear of falling

 

What to Wear to Your Appointment

It is important to wear appropriate clothing when using the Andago. Please wear comfortable clothes that allow you to move freely such as sweat pants or jogging pants. Please wear comfortable and supportive sneakers.

Armeo
The Armeo spring helps to support the weight of a person’s arm while allowing the individual to move easily to perform reach and grasp activities, as well as other movements of the arm.

 

How does it work?

By supporting the weight of a person’s arm, the Armeo allows an individual to use their own minimal self-initiated movements to perform activities in a 3D workspace.  It uses software to personalize activities in order to improve and regain the function of their arm and hand. As all activity during the training is based on the patient’s own movements, this repetitive training leads to better, faster results and improved long-term outcomes.

 

In the first session, the therapist will:

• Assess ROM, strength, pain
• Position the arm in the Armeo
• Adjust the machine to ensure a proper fit of the arm
• Set up custom 3D workspace
• Select appropriate games based on the individual's active movement

 

Who is a Candidate?

People who have limited use of their arm due to weakness from various neurological conditions may benefit from the use of the Armeo as part of their rehabilitation therapy program.  These diagnoses may include but are not limited to stroke, traumatic brain injury, spinal cord injury, Cerebral Palsy, Multiple Sclerosis and Parkinson’s disease. 

 

What are the benefits of the Armeo?

• Aids a person with an impaired arm to move successfully through a larger range of motion while performing functional tasks
• Improves motor control and cognition (attention, problem-solving, visual attention/scanning, neglect)
• Provides visual biofeedback
• Allows an individual to move in a 3D workspace
• Provides a wide range of motivating, fun and functional exercises
• Adjusts to patient’s needs and is customized to each patient

 

What to wear?

It is important to wear appropriate clothing for the Armeo, starting on your initial appointment. Please wear comfortable clothes and allow you to move freely.

The Physical Medicine and Rehabilitation Department offers biofeedback to treat a variety of medical problems including chronic pain, muscle tension, and headaches. Biofeedback uses a simple and completely painless computer program to allow you to see how your body handles such things as muscle activity, breathing rates and temperature.

Who Benefits from Biofeedback in Physical Therapy?

This program is for men and women of all ages who:

• Have chronic pain in the back or neck
• Have chronic headaches
• Have muscle tension/pain
• Have pain directly related to stress

What to Expect from Therapy

Biofeedback will teach you how to control body functions such as muscle tension, respiratory rate, and heart rate in order to manage your pain more effectively.

You can expect to work with a therapist who will listen to your problems and discuss your treatment goals. You will receive education regarding your specific problem and biofeedback therapy options. You will be asked to participate in a home program designed to meet your goals.

Preparing for your First Visit

• Please dress comfortably in clothes that are easy to move in and bring your complete medication list.
• During your evaluation, a therapist skilled in biofeedback will thoroughly discuss your medical history and previous treatments for your problem.
• You can expect to perform movements of the lower back, arms, and legs in sitting, standing and lying positions.
• Your therapist will then discuss the findings along with your treatment plan and treatment options.

Treatments may include:

• Biofeedback
• Relaxation training
• Education
• Home-exercise programs

Frequently Asked Questions

What exactly is biofeedback?
Biofeedback is a pain management tool for patients with chronic pain. It monitors certain body functions such as muscle tension, breathing rate or heart rate with simple, painless technology. Biofeedback acts as a mirror into your body; you will not feel anything from the biofeedback unit.

Do I need a prescription?
Yes, a prescription from your physician is required for therapy. Any physician who provides your care can write this prescription.

Will my insurance pay for this type of therapy?
Biofeedback for chronic pain may be covered by your insurance. Our insurance authorization clerk will assist you in determining your coverage benefits.

What should I wear?
You should wear clothing you are comfortable in which will allow you to easily move.

How long does the appointment take?
You will be asked to arrive 15 minutes early for your first appointment to fill out the necessary paperwork. The evaluation will then take about 1 hour. Your follow-up treatment appointments will last from 45-60 minutes.

How often do I come to therapy?
Most people with chronic pain are seen once a week for 4-6 sessions, although this may vary widely. Your therapist will be happy to discuss your treatment schedule at the time of your evaluation and will adapt your program to meet your scheduling needs.

How long will it take to reach my goals?
Each person is different and the severity of your condition can affect the length of treatment. Your therapist will be happy to discuss this question with you at the time of your evaluation.

A physician's referral is required for examination and treatment within this program.

Bioness System
The Bioness System is designed to treat the complications associated with upper limb impairment caused by stroke and other disorders of the central nervous system. It is a lightweight device that supports the wrist in a functioning position, allowing the fingers and thumb to move efficiently while reaching, grasping and pinching. This may allow you to regain hand function and get back to performing ordinary and essential activities of daily living.

How does it work?

The H200 Bioness Hand Rehabilitation System uses mild electrical stimulation to stimulate the nerves and muscles of a person’s forearm, wrist and hand.  This helps to re-educate the weak or paralyzed muscles and aids in retraining the proper movement and function of the hand and wrist.

In the first session, the therapist will:

• Assess range of motion, strength and pain
• Place the Bioness on the person’s hand/arm
• Custom-fit the orthosis to the individual.
• Set up the control unit with a therapy program custom-designed for the individual

Who is a Candidate?

People who have limited use of their hands may benefit from the use of the Bioness system as part of their rehabilitation therapy.  These diagnoses may include but are not limited to stroke, traumatic brain injury, spinal cord injury, or other neurological conditions. 

Benefits of the Bioness

• Increases hand function to help you return to your everyday activities
• Increases or maintains the range of motion of your hand
• Reduce muscle spasms in your hand
• Prevent muscle loss
• Assists with neuromuscular re-education

What to wear?

It is important to wear clothing appropriate for the Bioness, starting at your initial appointment.  A short-sleeved shirt would be ideal so that the clothing does not interfere with the fit of the bioness on your arm and wrist.

 

Bioness L300 Go FES System

The Bioness L300 Go Functional Electrical Stimulation (FES) system is a wireless device worn on a patient’s lower or upper leg to assist with improving motor function and restoring a patient’s walking ability. It can be used in patients with neurologic conditions such as stroke, brain injury, cerebral palsy or multiple sclerosis, as well as in patients with orthopedic conditions including total knee replacements and many other diagnoses to address quad or hamstring weakness. The Bioness L300 has 3D motion detection that automatically senses a

 person’s walking pattern and automatically adjusts to reduce foot drop or improve knee stability over a variety of surfaces and walking environments including stairs, ramps, and uneven terrain. The wireless device maximizes a patient’s independence and participation in walking by allowing users to wear a variety of footwear with minimal limitations.

Dynavision D2

How does it work?

The Dynavision D2 is an interactive light

RT300 Electrical Stimulation Bicycle from Restorative Therapies

A functional electrical stimulation bicycle that can be used on a person’s arms, legs and core musculature.    This combines electrical stimulation with a functional, task-specific activity in order to maximize therapeutic outcomes. 

How does it work?

The RT300 electrical stimulation bicycle delivers electrical impulses through your skin that help to illicit muscular contractions.  The occupational or physical therapist will perform an assessment to see if the electrical stimulation bicycle is an appropriate tool for you.  The settings on the electrical stimulation bike will be customized for each specific muscle group in order to elicit the best muscle response while maintaining the stimulation at a safe and comfortable level for you.  During the first session, the therapist will:

• Assess ROM, strength, pain
• Attach the electrodes to your leg or arm
• Position you and the chair appropriately to ensure a proper fit
• Set up the machine and customize the settings that work best for you

 

Who is a Candidate?

People who may benefit from the use of the electrical stimulation bike as part of their rehabilitation may include but are not limited to those with the following diagnoses: spinal cord injury, stroke, Multiple Sclerosis, traumatic brain injury, and cerebral palsy.

 

What are the benefits of the RT300 Electrical Stimulation Bike?

• Decrease muscle atrophy
• Decrease muscle spasms
• Muscle strengthening
• Improve circulation
• Maintain or increase range of motion
• Assists with muscle re-education
• Tone reduction
• Improve coordination
• Improve cardiovascular system

 

What to wear?

It is important to wear appropriate clothing for the electrical stimulation bike, starting with your initial appointment.  Please wear comfortable clothes. If using the electrical stimulation on the legs, please wear shorts or loose-fitting pants.  If using the electrical stimulation on the arms, please wear a loose-fitting t-shirt.

Lokomat

The Lokomat from Hocoma is a robotic-driven walking system that guides a person’s legs on a treadmill while supporting the person’s body weight in order to promote a more normal walking pattern.

 

How does it work?

• The Lokomat uses treadmill training with body weight support, with or without robotic legs, that can be adjusted to fit each person’s specific needs.
• In the first session, the therapist will:

• • Measure your leg length

• • Fit the harness, leg cuffs, and leg straps
  • Set up the machine
  • Determine the amount of body weight support to start
  • Hook up the harness
  • Raise you off the treadmill
  • Strap you into the robotic device
  • Adjust the settings for your best walking pattern
  • Start the treadmill and lower you to begin body weight-supported treadmill training

Who is a Candidate?

A variety of people can benefit from the use of the Lokomat.   Diagnoses such as stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, Parkinson's disease, cerebral palsy, and other neurologic diseases and disorders may benefit from the use the Lokomat as part of their physical therapy program.

 

 

What are the benefits?

• Use of the Lokomat has been shown to help improve over-ground walking
• Allows walking re-training while promoting neuroplasticity for a more normalized gait pattern
• Provides walking re-training for people who cannot walk or have difficulty walking
• Allows people to walk longer distances
• Ensures safety while challenging the patient

What to wear to the appointment?

It is important to wear appropriate clothing for the Lokomat®, starting on your initial appointment. Please wear comfortable clothes that allow you to move freely such as sweat pants or jogging pants. Please wear tall socks and sneakers. Denim pants and shorts are not suitable. Avoid zippers and buttons on your pant legs or shirts.

The MotionGuidance System
How does it work?
The MotionGuidance system provides patients with feedback on their movements. Often pain, whiplash, surgery, or vestibular impairments can disrupt how we move. The MotionGuidance system uses a laser, which can be attached to different body parts to provide the patient with information on how to correct movements. You will be trying to stay on target while tracing patterns, lines, and shapes.

Who is a Candidate?

• Orthopedic Patients (neck, back, arms, and legs)
• Concussion patients (whiplash)
• Vestibular patients

What are the benefits?

The MotionGuidance system provides a patient with feedback for movement and after several sessions can help improve strength, pain, and mobility.

What to wear?

Please wear clothes that are comfortable and easy to move in. We will be placing a cap on your head when using the laser for the neck to help with cleanliness.

Micromedical VisualEyes^TM 505 by Interacoustics is a Video Frenzel Goggle system used to help aid in the evaluation and diagnosis of vestibular disorders.  A camera within the goggles records a person’s eye movements which are simultaneously displayed on a computer screen.  A trained therapist is able to observe the images displayed on the screen to assess for vestibular dysfunction.  

 

How it works:

The goggles are positioned over a person’s eyes and secured by a head strap to hold the goggles in place.  Once the goggles are in place, a front cover plate is attached so that no room light is visible to the person wearing the goggles.  A camera within the goggles is connected to a computer software program that populates a live image of the person’s eyes on a computer screen.  The trained therapist working with the person can view the live images and is then able to look for the presence of nystagmus.  Nystagmus is an involuntary eye movement that can occur when a person has a vestibular or neurological disorder.  The presence of nystagmus can aid in the diagnosis of a vestibular or neurological dysfunction, however, nystagmus is often not observed in room light.  Thus, the use of this equipment helps to remove light so that this eye movement, if present, can be observed so a more accurate assessment is obtained. 

 

Who is a candidate?

People who are experiencing dizziness or imbalance may benefit from an assessment using the Video Frenzel Goggles, especially those diagnosed with vestibular dysfunction.

 

What are the benefits?

The goggles are able to detect a person’s eye movements that would otherwise not be visible in room light.  Therefore, using this technology enables a therapist to more accurately detect someone who may have an underlying vestibular diagnosis, versus someone being assessed without this equipment.  Accurate detection allows for the development of a more effective treatment plan to help a person recover from their symptoms.  

 

What to wear?

It is not critical that you wear any specific attire, however, it is recommended to wear comfortable clothing you can move freely in.  The therapist assessing you will likely have you move in different positions, therefore you may want to avoid wearing dresses or skirts.

Neurocom Basic Balance Master & InVisionThe NeuroCom Basic Balance Master and InVision is a computer program that assesses your balance and vision. Balance and vision are required for safe function in daily life.  The program also has treatments for balance and vision.

 

 

How does it work?

• NeuroCom Systems uses a computer to evaluate the following:
  • Vestibular system (inner ear)
  • Visual system (eyes)
  • Somatosensory system (nervous system, foot/ankle and hip sway)
  • Slowed or weakened automatic motor responses
  • Impaired center of gravity alignment and control
  • Impaired planning and coordination of weight transfers
• The Basic Balance Master utilizes a force plate to measure your position and balance while standing.
• The InVision software with head tracker measures your ability to maintain vision while moving your head in a seated or standing position.
• In the first session, the therapist will perform a series of standing balance tasks using the Balance Master force plate and/or a series of visual tasks using the InVision headpiece.

Who is a Candidate?

People who may benefit include but are not limited to those with vestibular disorders, post-

concussion syndrome, and balance impairments.

What are the benefits?

• Determines your ability to use vision, vestibular, and somatosensory inputs to maintain upright standing.
• Improves standing balance on firm and soft surfaces to decrease the risk of falls.
• Determines your balance reactions, and then is able to provide treatment to improve balance.
• Improves reaction time and balance in standing.
• Determines your body’s ability to stabilize your vision during head movements
• Can help with problems such as blurring, jumpy vision, or dizziness while moving.

What to wear?

Please wear clothes that are comfortable.  If using the BalanceMaster, please wear clothes that you can move around in and shoes with socks.  If using the InVision, please simply wear comfortable clothes.