Activity-Based Rehabilitation

For several years, the therapy process of Activity-Based Rehabilitation has been in practice for individuals with brain injury, spinal cord injury, and neurological diseases. Locomotor TrainingIn this process, stimulation is applied to the nervous system through sensory processes to create motor responses. This takes advantage of neuroplasticity, or the nervous system’s ability to adapt using the body’s own power but under the direction of a stimulus.

Check with your healthcare professional to ensure you are physically ready for this type of activity. Some hidden issues may include blood, contractures, and decreased bone density. It is critical for those with higher-level spinal cord injury or some brain injuries to manage autonomic dysreflexia (AD) responses. There could be other health concerns that are unique to you as well.

Some types of Activity-Based Rehabilitation include:

Range of motion, especially to parts of your body that are movement challenged. Observe as the range of motion to your joints is being done. Think about what is occurring such as toe up, toe down, ankle up, ankle down, ankle rotating, etc. This sends a signal from your brain down your body as the movement sends a signal up.

Weights and Resistance Bands: Utilize equipment to help strengthen your muscles, especially those with movement. Milk bottles with no water, then a little water, and progressively increasing the fluid can serve as weights. Resistance bands are fairly inexpensive and can be increased in tension over time. Do not forget your lungs. Resistance can enhance lung capacity, such as using an incentive spirometer.

Participate in Physical and Occupational Therapy: Once your official rehabilitation has occurred, continue the therapy activities at home. Video your therapy session so you can continue, have a helper present during therapy to learn the techniques, and follow along with prepared handouts.

Gyms: Local gyms often have resources for individuals with differing abilities. Visit a few gyms to see which are right for you.

Standing: Most payor policies allow for a standing frame. This is a form of activity even without movement. Because your body is upright with your weight through your bones, it can be advantageous to use this therapy at home. Many standing frames have reciprocal hand gliders that will move your legs as you stand.

Aquatic Therapy is available in many areas. The buoyancy of the water assists in the movement of weak muscles. Once a movement is identified, strengthen those muscles. You can learn to replicate the movement on land. Look for a heated pool to reduce AD episodes and tone (spasticity).

Functional Electrical Stimulation (FES) is the application of an electrical stimulus through the skin or even implanted. Many individuals know about the FES bikes. There are also smaller simulators that can be applied to one or two muscles. Many new devices are coming to market. If you have been frustrated about getting an FES bike, hold on; more opportunities will soon be available.

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Locomotor Training includes suspension of the body in a harness while the legs are stimulated into a walking pattern on a treadmill or over the ground. Relying eventually on reflex walking, movement is continued under your own power.

Soon much of these therapies and equipment will be available to everyone. Now is the time to think about your desire to participate if you choose. Knowing about these developing trends gives you the knowledge to think about and prepare for your decision-making.

Pediatric Consideration:

Surprisingly, many of these activity-based rehabilitation therapies are more widely available for the pediatric population. This is because the developing nervous system has an enhanced outcome making the potential even more successful.

Some equipment can be written into the Individual Education Plan (IEP) at school. Activity-based therapies might be included in classroom activity and physical education time. Use all your parental ability, healthcare providers, and teacher’s input to request these treatments if appropriate for your child.

About the Author - Nurse Linda

Linda Schultz, Ph.D., CRRN is a leader, teacher, and provider of rehabilitation nursing for over 30 years. In fact, Nurse Linda worked closely with Christopher Reeve on his recovery and has been advocating for the Reeve Foundation ever since.

Nurse Linda

The opinions expressed in these blogs are the author's own and do not necessarily reflect the views of the Christopher & Dana Reeve Foundation.

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $10,000,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, ACL/HHS, or the U.S. Government.