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Neurokinex: Breaking new ground in stroke rehabilitation

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Neurokinex

Neurokinex is renowned for its advanced and unique activity-based rehabilitation protocols for people living with paralysis.

The majority of our clients have a spinal cord injury but we also have great success treating people who have had a Stroke and live with neurological conditions including Multiple Sclerosis and Transverse Myelitis.

We provide rehabilitation to people who have recently sustained their injury and wellness programmes to those who have been living with their diagnosis or injury for longer.

  • Our rehabilitation programmes aim to optimise the individual’s function through encouraging neuroplasticity. These use the principles of intensive, task-specific and engaging activities completed in weight-bearing positions where possible.
  • Our wellness programmes seek to minimise the risks of secondary complications such as cardiovascular disease, diabetes, contractures and pressure sores by focusing on attaining good cardiovascular fitness, strength and endurance alongside maintaining muscle length and flexibility.

Three key protocols

Activity Based Rehabilitation (ABR) is a form of neurological rehabilitation devised to encourage functional recovery following spinal cord injury by utilising multiple strategies to encourage neuroplasticity within the nervous system.

Crucially and importantly, ABR focuses below the point of injury and has people standing where possible during their sessions.

This approach is immediately different from traditional, more conservative approaches where the focus is on maximising the functioning areas of the body, rather than trying to recruit and engage the nervous and musculoskeletal systems that are unresponsive.

Locomotor Training (LT) provides activation of the neuromuscular system below the level of lesion with the goal of retraining the nervous system to recover specific motor tasks such as those required for posture and mobility. The benefits from this restorative approach reach far beyond its ultimate goal.

Cardiovascular and pulmonary function, increased bone density, reduced spasticity, decreased skin lesions and a greater ability to tolerate glucose are a few of the life-enhancing outcomes often attributed to this intervention.

Generally, it is delivered with participants using body weight support systems suspended over a treadmill. Youngsters and adults alike engage well with this training which is both precise and personalised.

Neuromuscular Electrical Stimulation (NMES) is a form of electrical stimulation we use to activate muscles superficially to promote the benefits of traditional stimulation whilst stimulating increased central activation.

The therapy comprises placing electrodes on the skin over the corresponding muscles which are associated with a particular functional movement which the participant consciously performs.

Consistent, high repetitions are completed to strengthen the neural connections.

Working with Stroke clients

These repetitions are extremely important for neuroplasticity – the ability of the brain to form and reorganise connections between a neuron (a nerve cell) and an effector (a muscle cell).

In brain stroke clients in particular, the executive processing (a set of cognitive processes that are essential for the cognitive control of a person’s behaviour) can be impacted so it’s of paramount importance that each client is treated as an individual.

We have had some remarkable success with stroke clients as explained in these three case studies.

As anyone involved with rehabilitation will know, while we therapists love to see the scientific gains and evidence, our clients are driven by lifestyle goals.

Most recently, one of our clients underwent ABR sessions twice a week with the sole aim of to ascend and descend the stairs at his son’s wedding and be able to fully participate in the day. (He nailed it!)

Aatish, 39

Aatish, 39, had a spinal stroke in February 2019 following emergency surgery for a bacterial infection in his heart.

When Aatish left hospital, he was unable to walk and hadn’t regained any sensation or movement on the left side of his body.

Now, thanks predominantly to Neurokinex, he can walk slowly around his home.

“Neurokinex got me from standing to walking slowly and I’m hopeful for further improvement,” says Aatish.

“I’m also beginning to regain some sensation in my left arm and who knows how far I can progress? I am realistic, but positive, and set myself the challenge of improving 1 per cent each day.

“The way Neurokinex works is amazing: physically I’ve progressed well but they’re also helping me psychologically to process having had a stroke and have built up my confidence.

“Going to Neurokinex feels more like going to the gym than going to a therapy session: I used to train a lot and really enjoy that upbeat energetic setting.”

Aatish attends three one-hour sessions each week and his work varies from session to session, evolving as change occurs or as he presents on the day.

His therapy looks to both increase physiological capacity (eg strength or endurance) and enhance technical capacity (eg movement skill).

Jasper, 9

Jasper started at Neurokinex in 2016 aged three after suffering a spinal stroke in hospital where he was being treated for dilated cardiomyopathy (an enlarged heart).

A blood clot had damaged his lower spinal cord leaving him paralysed from the waist down.

As he has grown from being a toddler to a young boy, Jasper has become a much more motivated participant rather than just an active participant.

When he was little the team were exceptional at motivating him to take an active part in exercises, for example by supporting his stepping to kick a ball.

Now, Jasper comes with the idea that he wants to get stronger so he can beat his friends in school at swimming races!

The main protocols Jasper uses are the LT and NMES because they provide the most ‘input’ and therefore provide the greatest potential for recovery, enabling him to maximise the efficacy of every moment spent at Neurokinex.

Most recent gains for Jasper are increased muscle response in his lower legs when he is doing stimulation therapy.

His next include him having surgery for hip tightness (contractures).  Releasing this tightness will allow for better stepping in LT and, hopefully, increased leg muscle strength.

“Everywhere we go Jasper’s “can do” attitude is remarked upon, and I think that has so much to do with the trainers at Neurokinex and their positive attitudes, not to mention how physically strong he is thanks to his therapy,” says Kate Thornton-Jones, Jasper’s mother.

Shereen, 33

Shereen suffered a major brain hemorrhage in January 2021 that left her paralysed down her left side and unable to breathe, eat, talk or walk.

Despite everyone’s best efforts, by the time she returned home to her family in September 2021, she needed a hoist to hold herself up and was being peg fed.

Since going to Neurokinex, Shereen has built up her strength to the point she can use a commode, complete assisted walks on the treadmill and eat and drink entirely on her own with her peg being removed in February 2022.

Shereen’s strength improvements mean she can now hold her own head up and sit unaided for short periods of time. She has also regained movement in her left arm and leg.

The hope is that Shereen will build back enough strength to look after her young children, aged six and one.

‘Since attending Neurokinex every week, Shereen has seen huge improvements to both her mental and physical health,’ says Shannaz, Shereen’s sister.

‘She doesn’t get as easily fatigued and her willingness to participate in sessions has come on in leaps and bounds, which is a great deal down to the enthusiasm of the staff.’

Looking ahead

While alarming and life-changing, the impact of both brain and spinal strokes can be mitigated and managed through cutting-edge rehabilitation.

Coming down the track are at-home electrical stimulation and emerging technology – such as virtual reality programmes – to both challenge and redefine conventional therapies.

To defy diagnoses and progress beyond the usual expectations following a Stroke, the future lies in combining unique rehabilitation protocols with expert trainers who believe possibilities have no limits.

This is an excerpt from our Special Report – Innovations in Stroke

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  1. Pingback: Visionable: A new vision for connected stroke care | Health Tech World

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