Confidence is everything when a patient is trying to walk or move hands and arms again after experiencing something like a stroke.
Henry Mayo Newhall Hospital in Valencia is now using state-of-the-art technology to better assist those in physical and occupational therapy. During a recent demonstration of the equipment for The Signal at the hospital, therapists showed how the ArmeoSpring and Andago machines are game changers for the industry.
The Andago anti-gravity walking therapy machine is used for patients who struggle to walk. The ArmeoSpring self-initiated movement therapy machine, which was first up in the demo, is used for those experiencing trouble with arm and hand movement.
Lori Vandergrift, an occupational therapist at Henry Mayo, said the latter machine has patients playing, well, video games.
“So, we use it with a lot of our outpatients that come in,” she said. “The benefits we’re seeing from it are: The patients are more motivated — because they always say, ‘Oh my God, I play my games.’ And we always tell them, ‘They’re not games, it’s a therapy.’ … We always explain to them what they’re working on when they’re using it.”
Of course, in addition to motivating patients to do what many consider to be work, the “games” offered by the ArmeoSpring give scores and track a patient’s progress.
“We’re using it with our patients who have some limited arm function,” Vandergrift said. “So, that could be from a stroke, could be from a brain injury, could be a spinal cord injury. We’ve also used it for patients who have Parkinson’s.”
Michelle Asuncion, another occupational therapist who was putting volunteer Constance Bullock into the ArmeoSpring for the demo, compared the setup to a type of virtual reality system (without the headset) that has the patient moving the arm in various ways in multiple repetitions to get the arm working again as it can and should function.
Bullock took a seat in front of a video monitor. Asuncion then aligned the ArmeoSpring unit, a mechanical arm and hand grip stationed behind where Bullock was seated, with Bullock’s left arm and hand, and secured straps around Bullock’s bicep and wrist.
Once strapped in, therapists will assess the patient’s range of motion, limitations and pain, and establish a baseline. The therapist will then essentially plug that data into the ArmeoSpring, and the patient will choose from a screen of games to play to work out his or her muscles.
Bullock was eager to get started, though she admitted she did not “play video games.” As she got going, she was moving her hand and arm through a set range of motion.
“When people are recovering from strokes and brain injury, the more repetitions they can get out of an exercise or an activity is better for the recovery process,” Asuncion said as she watched Bullock begin to move. “So, with this, you’ll see, when she starts using it, her repetition of movement of the arm is so much more than we can do if she were sitting here on the mat and we were moving her arm through some reaching activities or something like that.”
Arcade-like sounds began piping out of the ArmeoSpring video monitor, and Bullock quickly seemed to forget she was participating in a therapy session or the demonstration for The Signal.
And while Bullock admitted she was having fun, the objective, Asuncion said, is for the patient to take the developing motor coordination and skills home with them.
“I mean, the ultimate goal isn’t going to be, ‘How did we do on the videogame?’” she added. “How do we have the skills carry over into real life?” she said, is the big question.
And just as Asuncion was making the point, Bullock was reviewing her score from one of the activities she completed.
“Why do I have a 26 when I got ’em all?” she seemed to be asking the machine with that archetypal gamer frustration.
Before the hospital began using the ArmeoSpring, occupational therapists like Asuncion and Vandergrift would spend about an hour with patients on traditional therapy on the mat, bending and stretching, and doing what Vandergrift called “more hands-on therapy.” She added that they still do much of that work, but about 20 minutes of a patient’s hour-long therapy session might be dedicated to the ArmeoSpring. Patients typically do about two sessions a week, Vandergrift said.
She told The Signal that the hospital got the ArmeoSpring back in September and, after training employees, began implementing it as part of their therapy in October.
The Andago is a machine that physical therapists at Henry Mayo have been using for a little over three years to help patients walk, according to Ace Aledia, a physical therapist aide at the hospital. One quick note here from the Henry Mayo professionals in the room: Physical therapists focus on improving their patients’ ability to move their bodies. Occupational therapists like Asuncion and Vandergrift help patients with functional, everyday tasks that require the use of arms and legs.
And out came a piece of technology that looked somewhat like a rolling metal detector with a harness system coming down from above the patient to help hold the patient upright. An advertisement for the machine says that the Andago bridges the gap between treadmill-based walking and free walking.
“So, the whole idea of this is that it can, it’s like — let’s say you had a stroke on one side of your body,” said Laurie Cavin, a physical therapist from the hospital who helped demonstrate the Andago machine. “So, you can’t really put a lot of weight on that side of your body — you’re not strong enough — we can take weight off of your body through the harness.”
Volunteer Bullock found herself being strapped into this machine to test it out. The harness setup looked somewhat like what you might see used in those baby swing jumpers. Once Bullock was ready to go, she began to walk, and the Andago rolled right along with her. Therapist aide Aledia held a remote control nearby, assisting the machine as needed.
The Andago was able to move in straight lines with Bullock, but it also has a freestyle mode that, with the turn of Bullock’s hips or a lean one way or another, adjusted directions.
“We don’t have to have as much hand on you,” Cavin told Bullock, “so you’re not going to fall.”
And having said that, Cavin then suggested, “I think we should have her fake a fall.”
Bullock’s eyes grew big like those of a cartoon character in exclamation. After some instruction, Bullock let herself sort of drop and, as expected, the harness of Andago held her upright.
Previous to using this machine, Cavin said therapists would have hands all over their patients. That type of work was certainly more limiting, she said, and according to the therapists in the room, not as free-feeling for the patient as they might like.
According to TJ Morsey, another physical therapist at Henry Mayo, he and his colleagues will try to get their patients’ perception of their own confidence before they start therapy.
“Confidence has a very strong correlation to falls,” he said. “We have a questionnaire that’s standardized. You know, like, ‘How confident are you from zero to 10?’ Or, ‘How confident can you do these different items within your home?’”
Morsey said a lack of assurance can be paralyzing.
“(Patients) need that confidence up,” he continued, “otherwise, it’s like, ‘If I’m up, I need someone or I need something, because if not, I’m on my face.’”
Indeed, Henry Mayo seems to believe that confidence, and even the distraction of the challenging video-game-like component of the ArmeoSpring — which also builds a self-reliance in patients as they level up — is everything when someone is trying to walk or move hands and arms again after experiencing something like a stroke. Physical and occupational therapists understand this and, with new tools and their expertise, they say they’ve been helping patients more effectively than ever.