How the Bionic Leg supports rehabilitation
The Bionic Leg builds on the increasing appreciation of the components of conventional and body weight support treadmill therapy (BWSTT) that could contribute most to neuroplasticity and functional recovery of gait – specifically,
- Patient intention/initiation of functional activity – the patient, and not a therapist or robot, must initiate effort by applying weight to the affected foot. Sensors within a Bionic Leg shoe insert detect when the patient has applied a PT-specified minimum force, after which motors within the Bionic Leg provide a PT-specified percentage of body weight support solely to the affected leg.
- Intensity of functional therapy – enabling the patient to work hard and productively at ambulation. Once the Bionic Leg “matches” affected leg strength with the unaffected leg, the patient can safely be encouraged by the PT to work intensely – without compensatory techniques, aids or therapist intervention – at conventional sit-to-stand, overground walking, and reciprocal stair-climbing exercises.
- Repetition of functional tasks – critical component of neuroplasticity. Patient weakness, fear of falling and avoidance of therapist risk, all combine to limit the number of steps and repetitions possible with conventional rehabilitation therapy. The Bionic Leg enables hundreds – even thousands – of repetitions in a typical two-session therapy week.
- Practice functional tasks, in a natural environment – sit-to-stands and walking overground without aids or compensatory techniques. Bionic Leg-equipped clinics take their patients on walks to the cafeteria for a cup of coffee, out in the sunshine, and up and down stairs – reprogramming their expectations as well as their neuronal pathways.
- PT modulation of Bionic Leg support – as the patient regains confidence in therapy sessions, Bionic Leg assistance is dialed back. The therapist reprograms the Bionic Leg to demand more patient-applied force on the affected foot to initiate Bionic Leg support, less support provided in standing up and climbing stairs, less resistance in descending stairs and sitting down.
- Exploitation of post-Bionic Leg carry-over for home exercise – in post-therapy periods, patients display “carry-over” of Bionic Leg training effects when the robotic leg is removed. Patients can extend and exploit those carry-over periods to reinforce apparent neuroplastic effect by repeating clinic exercises at home.