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Getting Better…Faster

Medical Rehabilitation

In the context of climbing health-care costs, researchers are devising new ways to make rehabilitation affordable and accessible, while doctors and therapists strive to prove it saves lives and money. As patients more frequently live through life-threatening conditions, including cancer and stroke, doctors are finding that rehab is key to recovery.

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Steve Cole/iStockphotography

When Earlene Davis’ house caught fire last February, she had one thought—save her 4-year-old grandson. Davis carried the boy out of the house in her arms. Her body shielded him from harm, but Davis, 64, was badly burned.

The long hospital stay that remedied Davis’ burns led to additional problems. Because she was immobilized during her months of treatment, Davis’ muscles grew weak. By May, when she was transferred to a rehabilitation facility, she could not stand or even sit up.

Today, Davis is much more mobile, thanks in large part to all the tennis she played in rehab. She wasn’t on the courts, however; she was hitting virtual balls using the center’s new Nintendo Wii video-game system.

“I had to get the hang of it,” Davis says, who wasn’t in the habit of playing video games but quickly caught on. “It relaxes me, helps me to concentrate, and I exercise the upper part of my body. I could sit there and play all day.”

Davis’ experience epitomizes many of the current issues in rehabilitation. Effective treatments for conditions, such as burns, spinal cord injuries, heart disease and cancer, often leave patients weak, exhausted and out of shape. Motivating sick patients to get back in shape has traditionally been a challenge—but therapists are adapting new technology, such as the Wii, to make it easier and sometimes even fun. Mind you, technology is no substitute for a therapist’s human touch, a critical component of physical rehabilitation. But new technologies, including products and programs for in-home use after their hospital stay is over or their insurance coverage has run out, are poised to help patients get better faster.

Further, doctors and therapists increasingly are promoting rehab as a means of prevention, especially in the areas of heart disease and cancer. Cardiac rehab can prevent secondary cardiac events, such as a second heart attack, or a first attack in a patient with chronic heart failure. Rehab during cancer treatment can ease the muscle stiffness, nausea, pain and other side effects of grueling treatment regimens. And in the area of stroke, new concepts in rehab hold the promise of restoring more of stroke patients’ pre-stroke capabilities than ever before.

RETHINKING STROKE REHAB. Each year, nearly 600,000 Americans survive  stroke. Today, there are roughly 4 million Americans living with impairments due to stroke. Some are unable to walk or even swallow. Computer technology is reshaping stroke rehabilitation in hospitals and homes across the country. Researchers are developing video games, online programs and robotics to help stroke patients recover lost mobility and muscle control and make therapy accessible after discharge from the hospital.

Many of the latest technologies are guided by the principle of neuroplasticity. The idea behind neuroplasticity is that even though the human brain has a finite number of neurons, or nerve cells, the brain contains a storehouse of unused neurons that can be tapped. New stroke rehabilitation tools are based on the idea that by repeatedly coaxing a disabled muscle or limb into use, the brain can establish new connections between that muscle or limb and the brain’s stored neurons.

Repeatedly exercising a muscle that’s been compromised by stroke can be frustrating. Grigore Burdea of Rutgers University in Piscataway, N.J., says that it’s important to turn that repetitive muscle movement into a fun activity, so the patient is eager to exercise the debilitated muscle.

In 2006, Burdea and colleagues modified an Xbox video-game system into a hand-rehabilitation workstation by connecting it to a virtual-reality glove. As a patient plays video games on the modified Xbox, the glove senses and records the flexibility and motion in his/her hand. The system also can transmit this data via Internet to a therapist.

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