The Norton Neurosciences & Spine Rehabilitation Center continues to meet the needs of physicians and patients with the addition of new equipment. The DIERS formetric scanner allows a radiation-free and markerless surface topography scanning method, including a 3-D reconstruction of the spine, in less than 60 seconds. It will provide spine and postural images in both a static and functional imaging. This is in addition to the center’s Schroth scoliosis program, which is a nonsurgical approach to treating scoliosis. The DIERS scanner also will be used with neurological patients to assess balance and spinal alignment in functional movement tasks.
The center has added the Bioness Integrated Therapy System (BITS) to its vision and off-road driving assessment. The BITS allows therapists to combine visual, cognitive and vestibular therapies in one unit. It is a multidisciplinary tool to assess, treat and track progress through 24 different programs, including four assessments.
For visual impairments, the BITS is broken down into the following categories: visual scanning, visual pursuit, cognitive, visual motor, charts and assessments. Depending on the type of injury, the BITS allows a therapist to quadrant load stimuli for patients with superior and/or inferior deficits, as well as nasally or temporally. A therapist is able to focus on increasing a patient’s ability to increase his or her preferred retinal locus skills and focus on eccentric viewing. The therapist is able to increase or decrease stimulus size, contrast, and background and stimuli colors to upgrade and downgrade tasks.
The BITS allows a therapist to work with patients with use of vision on the lateral crescent (monocular field) and/or peripheral visual skills. It provides the therapist a means to work on visual scanning and the ability to adjust the patient’s fixation point, as well as allowing the patient to focus on increasing his or her smooth pursuit and saccadic movements.
Using the memory programs, a therapist is able to focus visual processing as well as visual memory skills and can implement four different assessments to assess the patient’s visual skills. The therapist can use the maze test, bell cancellation, trails A and B, and visual scan and reaction (VS&R). The VS&R assesses visuomotor coordination, peripheral awareness, hand speed and reaction time and endurance. The bell cancellation assesses for attention deficits as well as possible visual neglect. The trails A and B tests assess the patient’s mapping skills, visual scanning, processing speed and executive functioning. The maze test assesses the patient’s attention, executive function and visuoconstructional ability. Each of these four assessments has been part of the Driver off-road assessment package.
Dysphagia patients will benefit from the addition of the fiberoptic endoscopic evaluation of swallowing (FEES) and neuromuscular e-stim for swallowing (NMES) treatments available through the speech therapy service line. The FEES assessment is an alternative to the traditional modified barium swallow study. It will allow a speech therapist to assess a patient’s swallowing in the clinic via endoscopic study and assess the fatigue of swallow and visualize the anatomy of the swallow. The benefits include no radiation exposure, the ability for the patient to consume an entire meal and to capture microaspiration and fatigue while eating or drinking. This allows for a more individualized recommendation and produces color images for the physicians, patients and their families.
With the addition of the neuromuscular e-stim for swallowing, the time a patient spends in swallowing therapy has decreased from months to weeks. Combining NMES and traditional therapy allows clinicians to accelerate strengthening, restore function and help the brain remap the swallow. Research supports the combination of these therapies to improve treatment outcomes.
If you have any questions or would like to refer a patient to the Norton Neurosciences & Spine Rehabilitation Center, call (502) 629-2501 or fax (502) 629-2526.