- Lian Yun-Perng, Physiotherapist
Back to Basics for Rehabilitation
I am a supporter of combining rehab with technology because it makes rehab more interesting and new. I came up with an idea of playing a game whilst trying to balance yourself on a wobble board. This idea is similar to that of Nintendo’s Wii Fit + Balance board. However, the difference is it is relatively cheap and you need not purchase a game console. I will post a video of this idea later on.
As much as I love rehab with technology, there comes a point where what matters most is simplicity.
I’ve been seeing a pt that has a 2 year history of Motor Neuron Disease (MND). It is safe to say she has minimum to nil tone chest down onwards, she’s on an invasive ventilator and the only palpable or visible muscle activity are her ULs and Neck. I would give it a grade of 1-2/5 on the MRC/Oxford scale. Her sensation is intact, has dysphagia, ? dysarthria, and has to sit with maximum support. Cognition is intact as well.
I started off my rehab by asking her to tap on a virtual piano on my smartphone and the activity had visual and auditory feedbacks. This activity was able to capture her attention and motivate her to move her fingers but her movements were too sluggish to play according to the tempo set. I continued this activity for a few sessions and I decided to put it on hold. I was afraid she might feel inadequate because the activity demonstrated her inabilities and weaknesses.
So, I regressed back to conventional rehab. The activity was simple- It involved active physiological movements of her ULs and neck coupled with loud and stimulating voice and some passive assistance! These simple movements were more meaningful and achievable at her stage and I could see more physical movements. I plan to continue treating her with the same method and hopefully, I will come up with something more exciting.
PS: I started with the virtual piano activity expecting to promote more motor learning because it is easier to activate your muscles when you’re performing a familiar/functional task (My opinion).