New techniques can make physical therapy a gameby Cara Hetland, Minnesota Public Radio
New technology is helping people who are paralyzed a chance to use of their arms and legs again. Studies show the device called Bioness, works with stroke patients. A Sioux Falls rehabilitation center is testing how it works with patients suffering from a spinal cord injury.
Sioux Falls, S.D. — Jim Kapperman was injured in a construction accident ten years ago. Because of his spinal cord injury he has limited use of his arms and legs.
"I have a C-3-4 injury," Kapperman explains. "I'm what they call a walking quad."
The accident left him in a wheel chair. His left hand is able to grip the toggle of his motorized wheel chair but his right hand is clutched in a permanent tight fist.
According to Dr. Peter Johnson, Kapperman's doctor, the nerves aren't telling the muscles to relax.
"(That's) Because the signal that comes from the brain can't get to nerves to tell them to relax," Johnson says. "That's a simplistic way of describing what we call spascisity - a kind of muscle spasm that occurs when there's not a lot of input from the brain telling it to stay relaxed."
New technology gives Johnson more options when prescribing therapy exercises, options that didn't exist even a year ago.
The Bioness device is one of those options. It's a plastic brace-like device that fits on the forearm. It's attached to a small black box that sends electronic signals directly to muscles to help them work again.
An occupational therapist places the Bioness on Jim Kapperman's right arm as Kapperman reflects on what it's like to be paralyzed.
"I miss reeling in a big fish, putting the boat in and fishing, hunting, anything to use both arms at the same time," he says. "You miss a lot. Even doing a little cooking is tough."
Kapperman tries to force his right side to relax while therapist Jay Clayton programs the first set of exercises.
Clayton explains what will happen next.
"(You) trigger it and the light will come on here and that means the extension part is on and that will help with the wrist and fingers."
Kapperman's fingers slowly unfold and his right hand opens. When the electric pulses stop, his hand becomes a tight fist again.
It takes almost the maximum amount of electricity allowed to open Kapperman's fist.
"It's just a little, not a jolt a little tingling and then it shuts off," Kapperman says as he describes the sensation he feels during the therapy session.
It'll take about 20 minutes before his hand relaxes enough to stay open and then the exercises focus on moving his thumb and forefinger to grip and pinch objects.
Kapperman is waiting on his insurance company to approve having one to use at home.
He'll be able to perform household tasks while wearing it several hours a day. South Dakota U.S. Sen. Tim Johnson, who's a stroke victim, uses a similar device with his legs to help him walk.
It's not clear yet how these exercises will improve Kapperman's mobility - he says he's willing to try anything whenever it's available.
Changes in technology give all of Dr. Peter Johnson's patients more therapy choices. In fact, the latest one is a popular children's game the Nintendo Wii.
The kind of motions used playing with the Wii are exactly the kind of movement Peter Johnson wants for his patients.
"Anything that you can do to get patients to use an effected limb more increases the signal to the brain to say this is how I want you to work again," he says.
Anytime Johnson can make therapy fun the patient will want to work harder and recover faster. Johnson says changing technology makes his job easier and he predicts in another ten years there may be some kind of electronic stimulus patch implanted directly in a patient.
- Morning Edition, 01/28/2008, 7:50 a.m.