In February 2016, MossRehab launched a comprehensive locomotor training program for all patients with spinal cord injury that incorporates innovative technology designed to uniquely complement activity-based therapy. The program will serve to bridge the transition between inpatient and outpatient rehabilitation therapy.

“We have long wanted to establish a framework for leveraging all of the wonderful technology that we have here at MossRehab, in a way that might best benefit the patients we serve in our spinal cord injury (SCI) program,” says Wesley Chay, MD, clinical director of MossRehab’s Spinal Cord Injury Rehabilitation Program. “Because we provide lifetime follow-up for all of our SCI patients, it made sense for us to develop an overarching structure for using all of the treatment modalities at our disposal in one seamless continuum. This program will address the individual needs of patients at all levels of mobility.”

The new program was designed by Dr. Chay; SCI nurse specialist Beth Jacobs, RN, CCM, CRRN; SCI team leader Naomi Greenberg, DPT; SCI senior therapist Janet Parker, MSPT; outpatient supervisor Theresa Toczylowski, MPT; and research consultant Andy Packel, PT, NCS. It was made possible in part by a donation from philanthropists Barbara and David S. Loeb, Jr., long-time supporters of novel initiatives at MossRehab.

“The Loebs have been very generous, once again,” says Dr. Chay. “This new donation helped to spur our acquisition of new pieces of equipment that are particularly geared toward use during transitional stages of rehabilitation and mobility, and it helped support all of our efforts to get this program off the ground.”

Measurement and monitoring

The new locomotor training program will feature the use of sophisticated tools for measuring and documenting the progress of each patient, to enable closer and more precise monitoring throughout the continuum of care.

“The framework we have established, and the treatment we are currently providing, is setting the stage for us to engage in more research down the road,” says Jacobs. “We are incorporating the use of evidence based SCI measures as a standard part of our protocol, which for research purposes will help us better gauge measureable functional and quality of life outcomes. The new program will use advanced flow charts, or algorithms, to guide clinicians in making the best treatment decisions for each patient, at each stage of treatment, with the goal of ultimately enabling patients to be as independent and functional as possible.”

Special equipment

While most of the advanced equipment used in the locomotor training program is located at the Elkins Park main campus, a number of satellite clinics are available for higher functioning patients in search of a location that is more convenient, or closer to home. Patients are offered flexible arrangements depending on the level of clinical support, expertise and technology they require.

“Our tailored therapeutic strategies ensure that patients always feel safe, while at the same time they are being challenged to work harder and smarter to achieve their rehabilitation goals,” says Jacobs.

Customized therapy designed to enhance the restoration of movement now involves the use of a wide range of state-of-the-art equipment, including Andago® for balance and over ground gait training, Lokomat®Pro for weight shifting and balance activation, and SafeGait™, a dynamic bodyweight support system that prevents falls and allows free movement during therapy.

“We have received a lot of positive feedback from our patients who have been using SafeGait,” says Dr. Chay. “When they are just learning to do things for the first time, it’s normal for individuals to have a great deal of anxiety. Previously independent people who were accustomed to walking and doing things for themselves without thought, who are suddenly coping with neurological conditions that result in weakness and sensory loss and loss of balance, can be inclined to avoid new movements. However, SafeGait provides a high degree of safety and protection from falls, which encourages patients to try new activities. Patients consistently report that they feel secure while using this system.”

Harry Schwartz, MD, clinical director of MossRehab’s spinal cord injury outpatient program, oversees the transition of patients from in-home therapy to outpatient treatment. For qualifying patients, ReWalk is another mobility device available to trial in MossRehab’s outpatient clinic. Its use allows patients to potentially incorporate this technology into their every day life through mobility in their home and community outside of MossRehab’s walls.

“With time and experience this brand new program will continue to expand,” says Dr. Chay. “And thanks to the expertise of our Chief Medical Officer, Dr. Esquenazi, a renowned leader in the area of rehabilitative technology, I am confident that our program will continue to feature pioneering equipment as well as comprehensive strategies for optimally fine-tuning tailored treatment plans at all levels of mobility.”