Three Main Types of Spinal Cord Injuries

Safe Ways To Treat Chronic Pain

Safe Ways To Treat Chronic Pain Amidst The Opioid Epidemic

Safe Ways To Treat Chronic Pain
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 Safe Ways To Treat Chronic Pain

For someone suffering from chronic pain, even simple daily tasks can feel like arduous chores. From crushing joint, muscle or bone aches to psychological side effects like depression, it’s no surprise that results from the National Survey on Drug Use and Health revealed nearly 38 percent of adults in the US were prescribed opioids in 2015. But after President Trump declared the opioid epidemic a national public health emergency, alternative treatments for chronic pain may be put into motion sooner rather than later. 

Regardless of the future of opioids, NewGait offers some suggestions for managing chronic pain a safe way. 

Why opioids are dangerous 

Aside from side effects like nausea, confusion, depression, sleepiness, and a decrease in sex drive, those using opioids are at risk for addiction and dosage increase due to tolerance development. Even more alarming, provisional counts from the Centers for Disease Control and Prevention show that 45,788 people died from opioids over a 12-month period ending in January of 2017. One need not be an addict or abuse the drug to put themselves at risk, which is what makes safer alternatives a more desirable form of treatment. 

Don’t neglect mental health

 Safe Ways To Treat Chronic Pain

The mental side effects are just as taxing as the physical — especially if it’s the patient’s first time experiencing discomfort via illness or injury. Clinical studies showcased evidence that mindfulness meditation can reduce chronic pain by 57 percent — over 90 percent if the participant has previous meditation experience. Remarkably, photos of the brain taken during meditation reflect calmer brain patterns that continue to improve with treatment. It’s because of positive results like these that hospital-affiliated pain clinics can prescribe this type of therapy to help patients cope with mental health in relation to chronic pain. 

Oftentimes, anxiety and depression accompany chronic pain. Fortunately, there are other methods that can help with these side effects and they include psychotherapy, pet therapy, massage, yoga, art and music therapy, yoga, and tai chi. Physical activity may seem like the last thing someone in pain may want to do, but some exercise — even minimal — provides a natural painkiller because the body produces hormones called endorphins that work to increase pain tolerance, while endorphins unite with brain receptors to alter one’s perception of pain.

 

Find ways to reduce stress and anxiety

Anyone with chronic pain understands that stress and anxiety can often cause flare-ups, which, in turn, make stress and anxiety that much worse. If you find it difficult to clean your house, or the amount of clutter in your living space has gotten out of control, take steps to correct the problem. In addition to bringing in a cleaning service to give your home some TLC, you can also put some of your unused furniture into storage so you’ll have more space — and less clutter. 

There are also some simple steps to take to help mitigate stress found at the workplace, an especially — and unfortunately, common — aspect of the job for those in leadership positions. One strategy is to replicate those who seem to be keeping their heads while others are losing theirs during trying periods. Sit down with them when things are calm and find out what their thought processes are, and be intentional about incorporating the same methods when trouble comes calling.

Try out a natural remedy 

While it may be hard to get used to accepting natural remedies for chronic pain after taking prescription medication, research has proven that there are effective alternatives with virtually no side effects.

While it may be hard to get used to accepting natural remedies for chronic pain after taking prescription medication, research has proven that there are effective alternatives with virtually no side effects. For example, a study conducted by the American Association of Naturopathic Physicians revealed that after 75 days of taking fish oil — an anti-inflammatory supplement — more than half of the 125 patients in the study stopped using their prescription painkillers. Turmeric is another anti-inflammatory supplement that has been proven to be effective. 

Researchers found that the resveratrol found in berries and red wine (in moderation) works on a cellular level to regulate pain. On a more traditional level, old-school heat and cold therapies (think hot Epsom salt baths and ice packs) are still used as instantaneous ways to calm inflammation, as well as the mind. 

Acceptance 

 Safe Ways To Treat Chronic Pain

No matter what path to relief a patient chooses, it’s helpful if acceptance is incorporated into a chronic pain treatment plan — particularly where mental health is concerned. Finding ways to manage the pain both physically and mentally can create the foundation for navigating this diagnosis and give you a better sense of control. 


Photo credit: Pixabay

 

What Are The Four Types of Multiple Sclerosis?

Safe Ways To Treat Chronic Pain

According to the National Spinal Cord Injury Association, as many as 450,000 people in the United States are living with a spinal cord injury (SCI)

 

Spinal cord injuries are commonly seen in traumatic incidents such as gunshot, motor vehicle accidents, falls, etc. These injuries can result in various symptoms ranging from sensory symptoms such as pain, numbness, tingling, etc., to motor control deficits such as paralysis. To understand spinal cord injury and its management, you should first know the structure and function of the spinal cord.

 

Spinal Cord – What Is It?

 

The spinal cord is a structure made up of neurons (cells) that connects your brain to the rest of your body. It lies within the center of your body and is present inside your spine (vertebral column). It is the continuation of your brain and starts from the point where the brain ends (beneath the skull). It then runs down in your spine and transmits signals from the brain to the rest of your body.

 

So if you want to move your hand to pick up a glass, your brain will generate a motor signal. This signal will travel down the spinal cord and ultimately reach your muscles via nerves originating from your spinal cord. Not only this, but the spinal cord also serves the function of carrying sensory signals to your brain. You can feel pain only when this sensation is conveyed to the brain via sensory nerves to the spinal cord to your brain.

 

This helps to understand that signal transmission is affected if the spinal cord is damaged, resulting in several sensory and motor symptoms.

 

What is Spinal Cord Injury?

 

Any damage to the spinal cord either because of trauma (gunshot, fall, assault, motor vehicle accident) or an infection (meningitis, transverse myelitis) is called Spinal Cord Injury (SCI).

 Types of Multiple Sclerosis

 

Here we will focus mainly on traumatic spinal cord injury.

 

Trauma to the spinal cord can result in a variety of injuries. Spinal cord injuries are divided into several types based on the etiology and location of spinal cord injury.

 

Brown-Sequard Syndrome

 

Spinal cord injury (SCI), in which there is an injury to only one-half of the spinal cord, is called Brown Sequard Syndrome.

 

This injury commonly occurs because of penetration wounds such as gunshot or stab wounds.

 

Anterior Cord Syndrome

 

In this type of spinal cord injury, the anterior part of the spinal cord is damaged. This commonly occurs because of hyper-flexion of the spine at the neck that disrupts the blood supply of the anterior region coming from the anterior spinal artery.

 

Central Cord Syndrome

 

This is the most common syndrome associated with spinal cord injuries. In this type of spinal cord injury, the central part of the spinal cord is damaged due to hyper-extension of the spine at the neck. It is also associated with congenital narrowing of the spinal canal.

 

Cauda Equina Syndrome

 

This injury affects the terminal part of the spinal cord, i.e., Cauda Equina. It results from herniation of lumbar discs (outward movement of discs present between lumbar vertebrae). It can also occur due to traumatic injury in the lower back.

 

Signs and Symptoms of Spinal Cord Injury

 

The signs and symptoms of spinal cord injury depend upon the type of injury. Some common symptoms of spinal cord injuries are as follows.

 

  • Decreased muscles strength (paresis)
  • Paralysis of muscles
  • Sensory disturbances

 

  • Inability to feel touch and pressure below the site of lesion
  • Inability to feel pain or temperature below the site of lesion

 

  • Inability to sense the position of the body part in space (proprioception)
  • Problems with urination and defecation
  • Sexual problems
  • Problems with balance and coordination

 

Management of Spinal Cord Injury

 

The management of spinal cord injury is divided into the following sections.

 

  • Immobilization
  • Surgical Management
  • Pharmacological management
  • Physiotherapy Management
  • Orthotics Management

 

Let’s have a look at each section one by one.

 

Immobilization

 Types of Multiple Sclerosis

 

It is necessary to immobilize the spine if you suspect spinal cord injury due to trauma to your vertebrae/spine. This is important because the injury can get worse if the patient is handled carelessly. Immobilization is achieved by using several braces such as soft and hard collars, Sterno-Occipital Mandibular Immobilization (SOMI) device, Halo vest, etc.

 

Surgical Management

 

Surgery is indicated following spinal cord injury to remove any foreign objects or ruptured discs, reduce fractured vertebrae, and decompress the spinal cord. Not all spinal cord injuries require surgical management, and some injuries can be managed non-operatively.

 

Pharmacological Management

 

Steroids play an essential role in suppressing secondary events following spinal cord injury and are widely used in SCI management. Several other drugs such as NSAIDs, Gabapentin, antidepressants are also used in SCI management.

 

Physical Therapy Management

Spinal Cord Injury

 

Physiotherapy management plays a crucial role during sub-acute and chronic phases of spinal cord injuries. It involves respiratory muscles training (injury at cervical level), muscles strengthening and stretching exercises, balance and coordination exercises, gait training, etc.

 

It consists of the maximum protection phase, intermediate protection phase, and minimum protection phase. Outcomes of physiotherapy management depend upon the level of spinal cord injury—the higher the level of injury, the poorer the outcomes. Nearly 25% of spinal cord injury patients cannot ambulate independently if the cervical spine is involved.

 

Orthotics Management

 

Like the treatments mentioned above, orthotics management plays a vital role in managing spinal cord injury in acute, sub-acute, and chronic phases of recovery.

 

Orthoses help stabilize the spine so that the healing is not affected by unnecessary spine movements. They also provide support to the body that helps in functional rehabilitation.

 

Individuals with spinal cord injury at the cervical (neck) level are instructed to wear a halo brace that immobilizes the neck region. For managing the injuries involving the neck and upper back, cervical-thoracic orthosis (CTO) is recommended. Similarly, Thoraco-Lumbar-Sacral Orthosis (TLSO) covers your whole back.

 

Lower limb orthoses such as Knee-Ankle-Foot Orthosis (KAFO) or Hip-Knee-Ankle-Foot Orthosis (HKAFO) are also used for assisting in ambulation following spinal cord injuries.

 

No matter which level is involved, spinal cord injury management is always multi-disciplinary and involves several healthcare professionals. Early detection of an injury is always a key to achieving better outcomes.

 

Importance of movement big or small: How activity keeps people healthy

Importance of movement

Importance of movement

Movement is essential no matter how big or small it is. We keep hearing this line from people, but most of us do not know WHY this is important.

 

Let’s have a closer look at this WHY.

 

Though our bodies are very much different from cars, let’s assume for some time that they are like cars. What happens to a vehicle if you do not drive it for a while? What happens if it remains in a place and does not move for a certain period? You know the answer. The same thing happens to our body if we do not move regularly like:

 

  • Our body tends to stiffen.
  • We start feeling pain and aches in different parts of our bodies.
  • We get prone to many diseases.
  • We might feel weak. 

 

And the list goes on.

Movement affects our body as a whole. It generates signals in our muscles and bones. These signals are then transferred to our brain. Movement helps in building strength and keeping our body fit. It keeps our body flexible, and at ease.

 

Besides improving strength and flexibility, moving our body has several other beneficial effects.  These effects are unknown to most people.

Movement and Joints’ Health

Did you know that the large joints in our body have a covering around it known as the capsule? This capsule contains a fluid called synovial fluid. Synovial fluid acts as a nourishing agent for our joints.

Our movement enhances the function of this fluid. It helps in reducing friction on articular cartilage.

The movement also increases blood circulation. Thus, exposing this synovial fluid to a constant blood supply and nourishment. A healthy synovial membrane protects our bones from friction which in turn protects our joints.

Movement and Blood Circulation

We all know that blood circulates in our bodies. Our heart pumps blood to all parts of our body via arteries which then goes to the heart via veins. These veins in our legs are present between muscles. When the muscles contract, it has a squeezing effect on the veins that push the blood towards the heart. Owing to this effect, some people experience swelling in their legs if they sit for a long time.

Movement and Blood Pressure & Cholesterol

High blood pressure and cholesterol levels can increase the risk of heart stroke. Movement, however, can help in lowering blood pressure and blood cholesterol levels.  Carrying out small exercises helps us to keep these diseases under control.

Movement and Blood Glucose

Here’s another reason for which you might want to exercise: your blood sugar level. Most of us are unaware of the fact that high sugar levels can have harmful effects on our eyes, kidneys, nerves, etc.

Importance of movement

Movement helps us to lower elevated levels of blood glucose and keeps you healthy.

There are several other benefits of movement so you can’t list them all here. All we need to do is to focus on the significant outcomes of moving to keep ourselves motivated. If you have not been moving or exercising for the past few days, months, or years, it’s time to do it now because

IT’S NEVER TOO LATE TO START

What Is Footdrop And How You Can Treat It.

Foot drop is a common word used in healthcare settings. But do you know what foot drop is?

Foot drop is a condition in which the foot is hanging downwards, and the person is unable to bring their foot up. It is not a disease itself but a consequence of an abnormality in the brain, spinal cord, nerves, or muscles.

The picture is of a person suffering with dropfoot.

Two major movements that occur at your ankle joint are Dorsiflexion (when you bring your dorsum (uppar facing part of foot) of the foot towards your shin) and Plantarflexion (when you move your plantar surface (sole)  towards the ground).

In foot drop, the foot is constantly in plantarflexion and the person is unable to perform dorsiflexion movement

What Causes Foot Drop?

To understand the cause of foot drop, you must understand how movement occurs in your body. Muscles are responsible for moving our bodies. A network of wires (known as nerves) supplies messages to these muscles. These nerves originate from the spinal cord (in your spine). The major control center is your brain (in your skull).

So if you want to move the dorsum of your foot towards the shin, your brain generates a message that travels down to the nerve (common peroneal nerve) which is then supplied to the dorsiflexor muscles via the spinal cord.

When this nerve stimulates the dorsiflexor muscles present in your leg, your foot moves towards your shin (Dorsiflexion).

If you know how you are able to move your foot normally, you’ll also understand that any condition that affects your brain, spinal cord, nerve (common peroneal nerve), muscles (dorsiflexor) can cause foot drop.

Following are the major causes of foot drop.

  • Trauma to the common peroneal nerve (fracture of fibula, knee or hip replacement surgeries)
  • Conditions affecting brain and nerves (Stroke, Multiple Sclerosis)
  • Conditions affecting muscles (dystrophies)

Foot Drop and Gait

Foot drop can result in alteration of gait pattern of individuals. A person may lift his foot high in the air by bending their hip and strike their foot on the ground with a high force (Stepagge gait pattern).

Another commonly seen strategy is that the person swings their leg from the side to avoid dragging the foot while walking. This gait is known as the circumduction gait pattern.

Treatment Options

Treatment of drop foot depends upon the cause. If the major cause of foot drop is compression on the common peroneal nerve, it can resolve on its own when the compression is relieved. On the other hand, if this condition results from a complete tear of the common peroneal nerve or irreversible damage to the brain or spinal cord, foot drop persists and makes walking difficult.

Minor cases of foot drop (with the capability to resolve) can get better with physiotherapy, focusing on dorsiflexor muscles’ training and electrical muscle stimulation.

Surgical options include repair of the common peroneal nerve and tendon transfer of Tibialis posterior to substitute the action of Tibialis anterior.

 

The most commonly used option for managing foot drop is Orthosis or Bracing.

 

The orthosis or brace holds the foot in a neutral position. During walking, when a person’s foot touches the ground, the brace allows the foot to go down (in plantar flexion) and pulls it back into a neutral position when the person lifts his leg and swings it to take a step.

 

The suitable treatment option for each case of foot drop varies from person to person

Watch the foot drop recovery story of our patient MaryEllen Grage. Multiple Sclerosis has nearly immobilized MaryEllen with foot drop and balance/stability difficulties. She believes that with The NewGait, she can walk normally again.

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Chronic Pain Talk With Cathy Ruprecht

NewGait CEO, Benga Adeeko, had the opportunity to ask Cathy Ruprecht, PT, NewGait Clinician, and pain specialist, a number of questions regarding the treatment of chronic pain, and how The NewGait has changed the way she practices. Also features Kim Spranger, PT and NewGait Clinician

Chronic Pain Talk - Video Interview

Watch the video version here. Cathy Ruprecht, NewGait Clinician and Physical Therapist, gives us an in depth discussion regarding chronic pain. Moderated by Benga Adeeko, NewGait CEO. Also features Kim Spranger, PT & NewGait Clinician.

CATHY: My colleague at the time, Kim Spranger, had just come across this product, and was using it with a client. One day brought it out, dumped it onto the table and said, “Look at this neat thing that I have here. Let’s try it and see what we can do with this, because I think this has great potential to help people.” So I looked at it and I said, “Ok…I’m game.” So we started to use it with clients in the clinic and four years later now, it’s been quite an evolution and revolution in our practices.

CATHY: Well, chronic pain is how we classify pain that is long term and persistent. Usually when someone has an accident or an injury or surgery, there is some sort of a tissue damage. It is usually repaired in about three months. Most people heal right up and go on about their business, and they don’t have much pain at all remaining. But in some individuals, pain is persistent and can linger for years after someone has had an accident or injury. We’ve also learned that pain can come on without an accident or an injury of some significant level of tissue damage, and so these individuals find this pain to be life-changing and very disturbing for them, so my job is to try to teach them about pain and get them moving again, and that’s been the journey that I take them on. We have now in recent times begun to look at pain a bit differently. We always equated tissue damage with pain, but we’ve now learned that some individuals have no tissue damage and significant levels of pain, some people have significant tissue damage and no pain, and so pain is very complex and we now define it, instead of a biomechanical model, we now look at it as a bio-psychosocial model where there are many aspects of our emotion and our memory and our brain thought processes that contribute to someone’s pain experience.

KIM: I would like to add to that, you know, Cathy’s journey with chronic pain has been very interesting. In the 1990s we were asked to get involved with developing a chronic pain program for our region. Cathy took it to a totally different level and actually in the last couple of years, she has developed a long-term philosophy on how to treat chronic pain that all of us have now adopted and are using in our clinics. I think of a patient this fall who came back and she said, “This has changed my life. I want you to know how much you’ve changed my life by the way that you’ve approached my pain.” So I want to give a whole lot of credibility to what Cathy is saying and she has changed the way we are treating chronic pain across the upper peninsula of Michigan.

“She has changed they way we are treating chronic pain across the upper peninsula of Michigan.”

CATHY: Many individuals have been to multiple doctors over time and have had multiple procedures done, for which their pain seems to be unrelenting and ongoing, and at that point, sometimes the physicians will say, “Well, this looks like a chronic condition for you. We don’t see anything that’s life-threatening. We don’t see anything that needs surgery or operations, you’re medically stable, so at this point we are going to diagnose you as having chronic or persistent pain and perhaps a different approach for therapy may be helpful for you.” That’s oftentimes how people find their way to me.

CATHY: What I practice is pain is not just a tissue damage issue, so people come in, they bring their minds, they bring their thoughts, they bring their ideals, they bring their beliefs, they bring this history of their pain and so with the practice that I use, it’s a bio-psychosocial model of pain, so we look at pain in multiple levels as far as what’s your stress level like, are you getting good sleep, what other aspects of your health might be contributing to your long-term pain and how might we utilize those aspects to help you change and regain control of your pain, so oftentimes I’m not there to try to change pain…I will explain it…I don’t have the magic exercise, I don’t have the magic power in my hands to take your pain away right now, but we’re going to recognize and build on that you’re medically stable and that what you have you can do things with and over the course of time as you increase your activities and as you start to lose some of your focus on the pain, you’ll find that it does become less intense and less frequent and less debilitating as we move forward in this different way to look at pain, and so I spend a lot of time working with people on body awareness. Many people when they have chronic and persistent pain, they really don’t have a great mind/body connection. They’re not very aware of where they are in space. They really view sometimes their own body as the enemy. They don’t want to think about it. All it is, is a source of pain and so I try to reconnect them to their whole self and that’s the fun of what I get to do, so we work on all sorts of aspects; use of mirrors to see where we are in space, focusing on movement patterns that are comfortable, body parts that don’t hurt, and so I have a whole toolbox of things that we go through and teach, but we also really try to work on understanding lifestyle’s contribution to pain, anxiety’s contribution to pain, fear and worry and anxiety’s contributions to pain, and so we want to try and break this cycle of how someone might be living by giving them something new and different to do that then will allow them to move forward with less frequent, less intense pain.

“They view sometimes their own body as the enemy. They don’t want to think about it. All it is, is a source of pain so I try to reconnect them to their whole self.”

CATHY: You know, each therapist develops their own beliefs and their own toolbox in working with folks with chronic and persistent pain, for instance, someone comes to me with back pain. Typically, a therapist might do some manual therapy on them, massage, electrical stimulation, certain exercises to build the core, that kind of thing. But my philosophy is to spend a lot of time on education, on really understanding the nervous system, how they function to keep us safe and then how that nervous system can be manipulated through some tools like your breathing can change the way your body is perceiving itself and to create changes within our nervous system’s connections to the brain, and so what I do is a lot of education, a lot of mindfulness, a lot of breathing and, again, body awareness, and so we try to build different tools into a box that a patient might not have seen before because many times when a patient comes to me, they’ll say, “Well, I’ve been to therapy before,” you know, and “been there, done that. What are you going to do that’s different,” so in order to really do something different, I have to have something different, and so that’s one of the tools that I use is the NewGait because that also is something new and different in helping people with chronic and persistent pain.

CATHY: I wish I knew exactly. If anybody wants to do some research, call me… but I have some ideas and some theories on it and taking what I know and combining it with what I see, and so there are a couple of things that I really have some strong opinion and belief about — there’s a woman named Amy Cuddy…she’s a Ph.D., and if you’re not familiar with her, she’s written a book called Presence. She has this fabulous Ted Talk on YouTube about posture, and in her Ted Talk, she talks about our bodies and our minds, and she says that our bodies change our minds, our minds change our bodies, and our minds change our behaviors, and our behaviors can change our outcome, and to me that’s a really very powerful statement, and, in that, when we walk, walking is a really important component for treatment of chronic pain. When we walk and when we do cardiovascular exercise, it changes our blood flow, it changes all sorts of physiological responses within us, and for many people with chronic and persistent pain, it can really help to decrease their level of their pain, and so when you have people with chronic and persistent pain, the last thing they typically want to do is go for a walk and so the NewGait allows me to make some changes in how they walk, it allows me to change their postures, and so by changing our postures — Amy Cuddy again, relating back to her — has done a lot of research to show that when we change our posture into a more powerful, upright, balanced alignment, we really are changing our body’s physiology. We’re decreasing cortisol and stress levels. There’s a powerfulness that almost feels like it exudes from you when you change your postural alignment and positioning, and the NewGait, by putting it on, it gives my own self…plus what I hear from my clients…it gives us a sense of grounding, if you will, or a sense of scapular depression is what I often feel, and I feel myself draw taller, and when I do that…and from what Amy has stated in her research…we are making a change in our physiology, and any time we can decrease stress and cortisol levels, we’re also then able to change the nervous system to a more relaxed, comfortable positioning, and so therefore then many clients report that they feel less pain, and that has been a really interesting and rather unexpected benefit of the NewGait’s use with clients and patients is when they literally turn to me and say, “I walk now and I don’t have any pain,” and that was really not something I had anticipated or expected, but I tell you, when I heard it the first two or three times from patients, I said, “Wow. There must be something going on here,” and so that’s when I really started to embrace the NewGait as a device to help change peoples’ movement patterns. Many people when they come in with persistent and chronic pain, they have a really distinct posture. They are very withdrawn, pulled in, pulled down, and so if you change physiologically by straightening and being taller and standing and occupying more space, then that’s a huge benefit again in pain management, plus when I put people into the NewGait, I also believe there are some other factors happening. I recently read a book called Explain Pain by Lorimer Moseley and David Butler, and they had some ideas which I grabbed a hold of when I read through that also then relate to the NewGait for me. A couple of things that they had said was, you know, your body, your sensory system, your nervous system, is reporting constantly to your brain different things. It senses temperature, it senses mechanical pressures and stimulations, and it senses chemistry within you so, certainly, when we are in a state of stress, then we are going to have more bombardment of those stress hormones and that can, again, elevate someone’s pain, so when we are able too change physiologically their posture, that, to me, is soothing for the nervous system. The other thing about the NewGait is it creates a joint congruence and once again, relating back to explaining pain, when we have joint congruence and there is an approximation increase at the joint, specifically I feel it through the scapula and at he hip joint at the greater trochanteric joint, when I experience that sense, my body feels more calm from that congruence, and also when we’re in a stress state, we also tend to operate with our bigger, extrinsic musculature because we’re going to heighten state of arousal, ready for flight or fight, but when we’re able to become more relaxed and more confident within our bodies, the smaller intrinsic muscles like your multifidus and your postural control muscles and your ability to breathe deeper with your diaphragm, is also changed and the body finds that calming as well, so there is definitely, from the NewGait, a sense of deep pressure hug. You feel it around your thighs and calves from the limb strap, from the shoulder harness, from the waist strap, that’s changing sensory input to the brain and that then is what I believe is giving people a sense of decreased pain as they move through space. What’s been interesting is also how people move with chronic pain, their gait pattern. You see a real lateral, side-to-side gait pattern. Their movements are slow and guarded. They’re usually dragging along some sort of a limb, so oftentimes I see people who have had knee pain, hip pain, back pain. They might have piriformis syndrome where they’ve got a lot of gluteus maximus pain in that region. They also might have some sort of sensory impairment like they’ve lost dorsiflexion or they’ve lost their ability to push-off/toe-off, and they’ve got no power in those gastrocs to push off. Well, every time you bring your leg forward into swing phase, that creates this lurching motion, but with the NewGait, I can change that. I can change their step width to make them more balanced. I can change the ease with which they get hip flexion, I can give them a quicker break-over at the ankle for a faster push-off at that toe-off moment to start the swing phase, and so it’s been really interesting to see the changes in gait. Again, with an improved posture, I can initiate trunk rotation and arm swing, and so the result of use of the NewGait with my chronic pain patients has been really quite remarkable, not only for me, but for them.

“The NewGait allows me to make changes in how they walk, it allows me to change their posture, and by changing their posture, we change into a more powerful, upright, balanced alignment, we really are changing our body’s physiology.”

CATHY: I pretty much have it on everyone, at least…when people come to me, I really want to see how they move. I want to increase their walking confidence. I want to increase their walking speed. We know now that walking speed is indicative of someone’s longevity, and so I want to make changes in how they move because that is so essential to life. Walking and walking briskly to cover ground allows us to take our minds out to explore and it allows us to do the things we no longer have been doing because of our pain, and so I really focus a lot on gait and movement and walking as a treatment strategy, and so I videotape everyone. I get a walking test on them to see how fast they’re moving. I analyze that video. I look at their movement pattern and then we look at it together and they can see how they can move differently, and the cool thing is sometimes when we get the bands just right, and I don’t know exactly where that’s going to be. There are different configurations of the NewGait that I will apply, and what I’m looking for is that individual’s nervous system to tell us when we hit that eureka moment when they suddenly say to me, “Wow. I’m walking without pain,” or “Wow. My pain is down significantly from when I can in here,” and for some people, there is carry-over. They have less pain…it might be for an hour after they see me. Sometimes it’s three or four days after they see me, so there is a huge neurological change happening within them when they use this device, and so it…I don’t know exactly who that person’s going to be…for whom they break into tears and say, “Oh my gosh…I haven’t walked like this in years,” but if I don’t put it on someone, I won’t know who that person’s going to be and I may have missed an opportunity to really change their life and change their gait with this really unique tool that gives them a different feedback to give them a different output of their pain than they had experienced ever before.

CATHY: I let the clients guide me. They’ll come back and I’ll say, “How did you feel after you were here? What was your experience,” and many times they’ll say, “You know, I went to the grocery store and I walked or my family noticed I was walking differently, or my father said, ‘Oh my gosh. Look at your posture. Look how straight and tall you’re standing. Look at how fast you’re walking,’” and so I get their feedback, and if they feel like they are now doing better, they may not need it again. They have that change of perception in self that we were looking for…boom, we’re good to go, but sometimes they’ll say, “You know, I want to try that again. I can’t wait to get back in that because I felt so different, so much more powerful, so much more confident, like I could walk like I used to.” That’s what they’re looking for with me, so each person has their own response to it and I let them guide me.

CATHY: Well, what we work on then is body awareness, so we’ll go to the mirror and we’ll work on posture. We’ll work on balance in single limb stance. We’ll work on “Well, where are my shoulders, where is my levelness in my waist, how am I aligning myself,” and so we’ll look at all of these different changes that we’re trying to establish as they’re standing and trying to recreate a new sense of self. I’ll have them climb stairs. I’ll have them do step-ups. “Where is your weight, using your gluteus to give yourself a lift, think of the weight through the heel.” It’s a lot of, you know, “Where are you in space,” and so we work on proprioception again, both with the mirror, sometimes without the mirror. We’ll work with SportCord. I’ll have them do some upper body work with resistance bands while they’re stabilizing their posture, while they’re stabilizing the lower portion of their body while they’re wearing the NewGait. Sometimes we’ll go for a walk in the parking lot or, depending on the weather, we might go over some hill and dale, up and down some different levels of terrain, so we’re using it in the clinic to walk, we’re using it in the clinic to stand and reshape where we feel our body and, again, it’s that mind-body connection I think that’s helps people have a new perception of how they move, that they can move differently and by moving differently, they sometimes feel a whole lot better.

CATHY: Remember, many times, people have been to therapy elsewhere and so in order to try and provide something different, I will say, “Hey, I have this special suit that we can try and many people find it very helpful for teaching you about where you are in space and some people really love this to walk in and you might too find that it’s helpful for getting you to move like you used to, to move more comfortably and more confidently,” and so they’re so wonderful…they’re so wonderful to give it a try, and I tell them too, “You know, if you don’t want to or if this isn’t comfortable, you…you just have to tell me and we will be done, but let’s see how it feels because your body is going to give us a response just like it’s responding to the fact that it’s unhappy about something by giving you the perception of pain, right?” When we get it different, suddenly your body goes, “Hey, I’ve been waiting for a long time for you to change up the way you’ve been walking. Now I don’t have to report about that pain anymore,” and so we play with the…we’re really just manipulating the nervous system maybe and that’s what we do…we think of it as fun and it’s playful and I try to make it entertaining, and so they’re pretty game to give it a go, and the best ones are the ones that give you that skeptical eye…that they’re quite sure that you are just nuts and this isn’t going to make a change, but they’re the ones that are most rewarding, of course, because they’re the ones that go, “Wow. I didn’t expect that,” so that…that’s really…it’s a joyful day for me to go to work. It’s a joyful experience to get this on people and to do the magic that I get to do with them and share what I am so passionate about and to have them respond to it so positively.

CATHY: It’s been a very joyful experience…one of the most rewarding of my life, especially at this point in my career, so to be able to go to work and to bring to someone a sense of hope that their life can be different, and so that’s a pretty joyful experience right there, and so we’ve now taken the NewGait to some clinics and shared with other therapists while they have their own clientele there and to see the response from their own patients, to have a clinic of several therapists tearful and joyful. Literally, patients walk and blossom before your eyes. It’s almost for me a euphoric high. I mean I just can’t tell you how cool it is to be able to use something like this in a clinical setting and to have such a dramatic result in such a short amount of time. That’s just been a game-changer for me. It’s like putting on an erector set on someone and just manipulating a band here or trying a band there or working as a team with the other therapists and the patient’s input to just get the right combination to have that person move with ease and confidence, and it’s just been the most joyful thing.

“I just can’t tell you how cool it is to be able to use this in a clinical setting and have such a dramatic result in such a short amount of time. That’s just been a game-changer for me.”

KIM: I love how adaptable this is and how quick I can manipulate and change it. That is the absolute appeal of it to us clinicians is that you can be inspired and in a moment’s notice, you can react to your inspiration and change their world.

CATHY: The results are instantaneous. I mean, you put it on and they move three steps away from you and you can see the result of it. You don’t have to let them walk for five minutes or three days. You know instantly whether that band is right where you want it or not and if not, you just change it up and put it somewhere else and go with another option for the use of the device. But from…again, from a therapist’s perspective, from trying to really change walking, what tools have we had in the past. We’ve had Ace wraps and we’ve had some Thera-Band, but this…when you put this on as a therapist and you feel what this can do, you will be amazed…blown away…because then you’re going to know exactly like what patients…” Oh, I should have used this…I should call up so-and-so and have them come back. I’ve got this new tool. I bet I could manipulate that part of their gait pattern. It is just really fun, and sometimes therapists are a little intimidated by it, of course, because you want to do the right thing, but, you know, and sometimes we’re very analytical about it, like, “Well, I don’t know what muscle is not working. I need to put this right in the right places.” You know, sometimes I think I know what this person is going to need and I put it on and they go, “It’s not working for me,” so then I’ll go, “Okay. Let’s try this here. Let’s try this there,” and all of a sudden, boom…you get it, and so it is so easy to use. You can put the bands in any combinations and your client is going to give you immediate feedback on whether that was the way to go or not, and they, too, will offer suggestions like, “Well, what if we put a band here.” “Well, let’s try it,” and then, boom, off they go and they’re happy as a clam. So it has been, again, a really cool manipulative tool in the clinic that we’ve tried to use before, and there is research out there, even though this is a relatively new product and, boy, there is a lot more research I’d love to do, as with my partners, too, but there is research to support the use of Thera-Band in a gait-assisted pattern and this is, again, a Thera-Band type elastic band manipulation of movement, and so there are also different suits that have been designed over the years that we recently came across that also have support to show that this type of an idea is beneficial and this, again, this product is so easy to use, so affordable really for clients to purchase for home if they need it for long term. And the other things about chronic pain is people often say, “Well, but it’s chronic pain, you know…it’s not a neurological condition. It’s not an orthopedic condition.” Well, yeah, it is. My people often have orthopedic conditions. They’ve had knee replacements. They still have pain. They’ve had all sorts of surgeries on all sorts of body parts, fused ankles. They have had stroke. They’ve had failed back surgery. They’ve had MS. They’ve had all sorts of chronic and persistent pain from a multitude of neurological and orthopedic, and sometimes both, and this device has been able to help any and all of them, and so that’s what’s so cool about it.

Cathy graduated with her Master of Science Degree in Physical Therapy from Grand Valley State University in Michigan. After having worked in a variety of therapy settings for 20 years, Cathy discovered a passion for helping people with Chronic Pain. Cathy is using the NewGait daily with a variety of patient conditions after discovering how helpful the device can be.

Kathy Tooman and Jozie Weiler Discuss “Miraculous” Experiences with the NewGait

gymnast

Kathy Tooman & Jozie Weiler Video Interview

Watch the video version here. Kathy Tooman, PT & Jozie Weiler, DPT discuss their “Miraculous” experiences with the NewGait. Moderated by Benga Adeeko and Cathy Ruprecht

Kathy Tooman & Jozie Weiler are licensed physical therapists at West Michigan Physical Therapy. Together they have more than 40 years of experience with diverse backgrounds and specializations, along with great energy and passion. Listen to their “Miraculous” experiences with the NewGait.


QUESTION: Can you each give us a little introduction?

KATHY: I’m Kathy Tooman. I’m a graduate of the University of Michigan, and we both work in an outpatient private practice clinic in Ludington, Michigan. I’ve been working for over 30 years. And my specialization, is probably manual therapy and analysis emotion. I also work at the local gymnastic center. So that’s a real prime interest of mine.

JOZIE: I’m Jozie Weiler. I graduated from the University of Puget Sound in Washington State. I’ve been practicing with Kathy at this clinic for a year now in August. I’m a new graduate, so I guess I’m specialized in generalization. But I really enjoy working with athletes. I have a passion for oncology, so I want to play with that in the future too.

QUESTION: When we first met at the Michigan Physical Therapy Association Conference, we had the NewGait on display and you two had both tried it on. Can you give us your thoughts about that? What it felt like for you?

JOZIE: At first I was like, “Oh, I don’t know what this is, but, yeah we’ll try it. Why not, you know?” So they strapped me in and then I walked and Kathy was like, “Whoa, she’s walking way better!” I didn’t know I was walking wrong in the first place, but I actually felt like I had more rotation, more movement, and it felt easier and more free. I took it off and it kind of stayed with me for a little while and then eventually wore off. We played with it in the clinic too, demonstrating for our colleagues here about how to strap it in and all that stuff. I did a single leg lateral step down, and I’ve had knee pain for a long time now, and I actually could do that without pain. That was even more intriguing. This actually does something, I don’t know what yet, but we played with it and firsthand I experienced how it can help movement.

KATHY: I’ve had a chronic recurring hip pain since I was 29. I actually have instability in the left hip. No matter what I do, I cannot get it stronger, I cannot be pain free. We put the NewGait on me, and much to my surprise, I felt like I was loading in my left leg. I hadn’t been aware that I don’t walk with my left leg and it wasn’t connected. I had a sense of “whoa, I have two legs here.” The chronic pain that I had in my hip and SI joint went away after that little trial and it lasted for 10 days! We brought it home and had so much fun with it. We’re kind of thrilled that there’s not a lot of research. We’re kind of glad that we are the people helping to provide the data and coming up with the protocols. So we’re glad to be part of this. We first did the trial offer, I actually called a lot of patients that I thought it might help. And I just said, “We’ve got this new toy I want you to try.” Every single one of them, every single one of them, when I put it on them, felt dramatic change. One person I did videos before and after, and then they came back the next time, their gait pattern had changed 360. That was cool. And then one person I know is totally unstable. I don’t think she has any proprioception in any of her joints. She put it on and she literally started to cry. Because she said, “Now I feel my body,” and she didn’t want to take it off. And I think down the road, we’ll just order her one for home. She feels absolutely high in it. But the real best one, I’ve got two case studies on these two clients. Both of them I’ve known since they were in early elementary school, and now they are seniors in high school. Both of them had no functional neurological ability to push off their feet. One was a gymnast, so through the years, we’ve been able to retrain her to use her body but she can’t move her ankles. She had faulty range of motion and no ability to jump even when she was 10. The other gal was a runner, who I’ve also seen off and on since she was a young girl. And this kid had the most horrible posture. Her head was forward, back is rounded like this, no matter what we did we could not change it. Both of those girls, six months later now, are jumping as high as they’ve ever jumped in their life. They’ve had to retrain their whole loading and running techniques because they are so fast and they’re pushing off so high. Miraculous! For 30 days we tried all these people and had positive results on everybody. So we bought the NewGait and now we use it clinically.

“One person I know is totally unstable. I don’t think she has any proprioception in any of her joints. She put it on and she literally started to cry. Because she said, ‘Now I feel my body,’ and she didn’t want to take it off.

QUESTION: Thinking about what you know about neuroscience of movement, and pain, what do you think is the mechanism whereby this is giving people the sensation that they’re experiencing?

KATHY: We are trying to work on a theory for that. But all of us know that it is adding more proprioception and compression through the joints. Muscles move in functional patterns, they don’t move alone. We know that from earliest development, we have to have a core established before we can use our extremities. We also know if one part of the body is injured, the whole body gets screwed up. And the other thing we know, and have fought with as physical therapists, is that movement is not cognitive. You cannot think yourself to move. And although we’re all incredibly good therapists, find ourselves saying, “Shift your weight like this, do it like this.” And these intelligent athletes try to do it, they try to think how to change their running. As soon as they go out into their sports, they can’t do it. Now when you’re getting all of this compression, all this proprioceptive feedback into your joints, something else is happening too. I think maybe what’s happening is that we are giving an environment for the neuromuscular system to reboot itself internally. And we’re ending all that external cortical confusion. So the body has a chance to go, “Oh, yeah, I get this.” I think that might be what we see. It’s like the antidote for movement gone astray.

QUESTION: I agree with what you are thinking. If there are any listeners that have access to move this research forward in some way, please contact us because we certainly want to know more about what’s happening here. Do you have any other comments about your clinical use?

JOZIE: I thought about having a shoulder pain patient try it, and just see what happens. It’s not necessarily for shoulders, it’s more for lower extremity and posture. But you know what the heck, why not? So we tried it and this lady loved it, she’s like, “I feel taller. I don’t feel so warped.” She’s really enjoyed it she wants to keep using it and coming back.

“We tried it and this lady loved it, she’s like, ‘I feel taller. I don’t feel so warped.’ She’s really enjoyed it she wants to keep using it.”

KATHY: I have a friend who is six-foot-eight and he actually had what I thought was stroke like symptoms. He couldn’t get in to see a doctor so I virtually appointed him. I said, you know, there’s this thing called NewGait that we work with. Then he ordered the NewGait just for the leg that was weak, he retrained himself to walk just through me virtually seeing him in a matter of three weeks. And speaking again about athletes and their techniques, it’s mind blowing. Because once they’ve been hardwired into a certain technique, it’s hard to break through. But the NewGait does! Kind of like I said, “It reboots them and they can learn. They can learn whole new techniques.”

JOZIE: Our colleague had a young kid, he was like 15, and he had several knee dislocations. He ended up having a revision surgery to his entire system, and he was so afraid to walk. Stiff-legged, limping, he was terrified. Which, he should be, this was the third time he had dislocated his knee, and he finally got this massive surgery. The NewGait helped him not be fearful of movement. He’s still using it, and now he’s walking so much better. And we’ve also used it on a chronic stroke patient too. We see him walking around all the time, and it’s crazy.

“He was so afraid to walk. Stiff-legged, limping, he was terrified… The NewGait helped him not be fearful of movement. He’s still using it, and now he’s walking so much better.

KATHY: I really want to use it on gymnasts. That group as a population usually have no sense of where their joints are in space. You can spend hour after hour after hour trying to place your hands on them to show them how to feel it, but they don’t know what you mean. You have to keep doing it. And then you have to keep spotting. So it’s labor intensive and frustrating for the gymnast and the coaches and the parents. I was thinking we could set up NewGait on them so that we can get the flexed knees so they don’t hyperextend them and keep the thoracic spines back and their core in. So I’m very excited to try it. I think it’s a huge population to make a big difference.

CATHY: Well, we certainly appreciate your enthusiasm and your ability to use this as creatively as you have. I know it’s very exciting for the clients and it’s very exciting for you as staff and we really appreciate you sharing this.

KATHY & JOZIE: Thank you guys for developing it. It’s been really fun and we found a lot of usefulness out of it and our patients really do enjoy it.

What I do is a lot of education, a lot of mindfulness, a lot of breathing and, again, body awareness. Change the way your body is perceiving itself and to create changes within our nervous system’s connections to the brain.
Key Words From Kathy and Jozie
Pain is very complex and we now define it, instead of a biomechanical model, as a bio-psychosocial model where there are many aspects of our emotion and our memory and our thought processes that contribute to someone’s pain experience.
Key Words From Kathy and Jozie
We look at pain in multiple levels as far as what’s your stress level, are you getting good sleep, what other aspects of your health might be contributing to your long-term pain and how might we utilize those aspects to help you change and regain control of your pain
Key Words From Kathy and Jozie
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Dr. Stephen Kanter’s experience with NewGait

Dr. Stephen Kanter , Chronic Pain Talk

Dr. Stephen Kanter has a vast resumé and is an avid NewGait Fitter at the International Multiple Sclerosis Management Practice where he is the Director of Rehab Services. In the interview, Dr. Kanter reflects on his "Dream" for the NewGait.

Chronic Pain Talk - Video Interview

Watch the video version here. Dr. Kanter discusses his “Dream” for the NewGait. Moderated by Benga Adeeko and Cathy Ruprecht.

BENGA: Thank you everyone for joining. Today We have Cathy Ruprecht, one of our NewGait clinicians, as well as Dr. Stephen Kanter. Dr. Stephen Kanter is a licensed physical therapist and athletic trainer in New York and New Jersey. Dr. Kanter works primarily with patients with balance, gait, and endurance impairments. He earned his Master's of Science and doctorate in physical therapy at Rutgers University. He is the Director of Rehabilitation Services at the International Multiple Sclerosis Management Practice in New York City. He is a nationally recognized expert in rehabilitation for people with MS and has worked to develop the AthCare MS Rehabilitation Professionals Network to promote education and clinical collaboration to improve the care provided to people with MS and their families. In 2015, Dr. Kanter was inducted into the National MS Society Healthcare Professionals Volunteer Hall of Fame. Dr. Kanter is a professor at Seton Hall University where he teaches Biomedical Ethics, Human Anatomy and Sports Pharmacology. Thank you Dr. Kanter, That's quite a resume you've got, thank you for joining us.

DR. KANTER: The short answer is that my father had multiple sclerosis. Neuro rehabilitation was not something that I thought I had enough skills to do. When I came out of physical therapy school, I had a stronger sense and background in sports health care, and became a certified athletic trainer working in professional sports. I really worked that route. After working in professional sports, and thinking about where I wanted my career to go, I had a couple of opportunities in home care in New York City. In that home care experience, I started to work with many people with neuro based disorders, including multiple sclerosis. During that time, developed the skill set that I did not feel like I originally had. In 2008, I interviewed for the job at the International Multiple Sclerosis Management Practice to take over the leadership of the department and develop it to what it is now. Cathy, your patient population was primarily neuro? Geriatric? Both?

CATHY: Primarily folks with chronic pain. A lot of them have gait abnormalities, but we work on some confidence engagement, and we work on changing up some parameters of gait and the most amazing thing is that they’ll tell me, “My pain is gone.”

DR. KANTER: Why do you think that is?

CATHY: Well, if you know anybody that wants to do research, I would like to know why that is. I have some ideas, based on my pain-neuroscience background, in that there’s something about the device that creates a postural realignment, it depresses the scapula. I think it helps to change the breathing from that secondary musculature. I think it helps to create some step with confidence. A lot of people walk with a very narrow gait pattern and they seem unbalanced, with a very lateral trunk sway. A lot of times my people with chronic and persistent pain have had some sort of unresolved orthopedic or neurological issue. So someone that has no plantar flexion, you know, never has any sort of toe off. You’ve got to bring that leg through somehow and swing but there’s something about getting that assistance and suddenly, the nervous system says, “Well, hey, thanks for figuring that out.” Now, I don’t have to use, my quadratus, or my back extensors, or whatever compensatory movement pattern I was trying to do to achieve that movement. They find pain relief with that. It’s just been amazing.

DR. KANTER: That this is a key tool that you’re using is very insightful. We’ll definitely take that into consideration in our program. We are about to open up a big Wellness Center which will incorporate, not just the NewGait, but a lot of state of the art products that can help people with MS walk better and improve their balance. I’ve been on the road to improving the lives of people with multiple sclerosis, and bounce dysfunction ever since.

DR. KANTER: When I started working with people with multiple sclerosis, I started to identify a series of common mobility limitations. Foot drop is a very common one that most physical therapist’s and movement professionals are aware of. Neuro physical therapist’s have a little bit more insight to work with orthotist to manage foot drop, but using an AFO, I quickly found was not very useful. In thinking out of the box, we start to work with different products on the market. During that time, foot drop wasn’t always the primary issue that patients needed to manage because it could be managed through an orthotic or a brace, but the hip drop or the hip weakness really became an element of impairment that we couldn’t really solve. Strengthening it couldn’t help it, and the hip flexion assist orthosis was a product that was developed, as well as a couple other products that became potentially useful for hip flexion weakness and hip drop. None of them really worked as well as I would have wanted it to, or there was a price limitation so patients weren’t willing to try it outside of my clinic. My goal is always to provide something to a patient in the clinic that they can take home and use in their home program and in their day to day life if possible. A patient introduced me to the NewGait. When I saw the NewGait, it clicked right away that it would make sense for people for walking. Also the other major impairment, which is actually stairs or curbs, and ever since then, I’ve been using it with patients on a regular basis.

“When I saw the NewGait, it clicked right away that it would make sense for people for walking… Ever since then, I’ve been using it with patients on a regular basis.”

DR. KANTER: Once they get into NewGait and realize that their hip is engaging better through the energy that’s created by the device and realize that they’re able to move better. And then the conversation gets into where we go from there in regard to balance and gait training, and create some prognosis, which is within reason.

Dr. KANTER: We have a couple of patients who are on the road to getting it. I would be surprised if they didn’t. Previously, I think I’ve had three people who either purchased it or expressed interest in purchasing it. Of those three patients, I know at least two of them have used it beyond just myself. Either in other facilities somewhere, or they have it on their own.

DR. KANTER: I’ve probably tried it on approximately 30 patients in the past year. The big holdup is obviously the past several months of having fewer patients because the clinical services sort of went down. When we started speaking, I went back and looked, and seemed to be about 30 patients myself, my colleague, tried in on five to eight patients. And then our occupational therapist has started to look into how she would integrate it into certain balance and standing activities for her ADL training.

DR. KANTER: I could definitely feel the forces that are being created, which is what my mind focuses on. How to create potential energy from end stance, to toe-off, to initial swing, even if there’s a compensation. I’m not worried as much about the compensation if they can clear the foot, but to see that this can be more efficient, and obviously create a change in how the patient feels with that swing phase, which is really a limiting factor with gait, as you know.

DR. KANTER: The most rewarding were a couple of patients that I trialed it with. They took a step up on a curb in a simulation, that they hadn’t been able to do in a very long time. It was much easier and they got a sense that they can do it without overly compensating, without overly circumducting, and without using their hands. The next step with it, at the MS clinic, is to work on a whole staircase with patients and to be a little more aggressive in their stair training. For patients who need to negotiate that in their house or work, this is the modality of choice for me. When you consider neuroplastic changes, there is a bunch of evidence out there, where, if you’re going to have a muscle do something, it needs to do it in the specific way you want it to. Unfortunately, too many patients are doing sitting exercises, or laying on their back. They say, “I work on this muscle all the time, and I feel stronger, but why cant I do it standing.” When they work with the NewGait, they’re getting the benefit of more reps, rather than harder reps. Patients with MS, many times, are willing to work hard, but they obviously want to see results. You don’t need to fatigue out by over-exerting, when it’s unnecessary. With the NewGait, providing what is equivalent to an active assist at times, will, to me, create more contraction of the hip flexors, and obviously other muscles as well. But the hip flexors I focus on because it really is one of those areas of rehab in MS that we’ve had a lot of difficulty with.

“They took a step up on a curb in a simulation, that they hadn’t been able to do in a very long time. It was much easier and they got a sense that they can do it without overly compensating, without overly circumducting, and without using their hands.”

DR. KANTER: If they see me, they can use it each week or every other week. We’ve had a couple of patients who have done that. The majority right now, come and use it for their first trial, maybe come for a second trial, with the intention that they’ll get it on their own and integrate it into their home program. Or they will find a local PT who either will get it, or has it, or something similar. My dream is that many PT’s out there, would have the NewGait, so that we can do the trial and then say, “Go to a therapist who can utilize the NewGait to perform their exercises with.” Ultimately, I do believe getting it for a home based program is really what would make the biggest difference. It’s not an expensive product in the big picture of rehabilitation modalities. Like I have said, there are other hip flexion products out there, some are reasonably priced, and some are not. The NewGait has variability that the others actually don’t. Technological based FPS products for people with MS to help them walk are thousands of dollars. A neural based approach would be to incorporate this device and supplement it with a musculoskeletal and strengthening program. But if they only do the strengthening program, and don’t do the neural based program, then they miss out. I hope if anything that patients therapists gain from this conversation, is to get a neuro based closed-chain, standing program, and if they have hip flexion weakness, then incorporate this device. My role at the IMSMP is to try to gain a network of therapists who are willing to accept referrals for patients with MS. After I see them and develop a plan of care, I’m looking to pass them on because I can’t see them locally. The network was created for people who are in wellness and rehab, medicine, nursing, or social work, who want to get referrals from myself and our practice, to work collaboratively. I’m still looking for any physical therapists, occupational therapists, and wellness professionals who are looking for people to get referrals from people with MS. Let me know and we’ll speak and hopefully get you on the network list. They can contact me directly, email is probably easiest at skanter2@imsmp.org. If you go to the International Multiple Sclerosis Management Practice site, you’ll be able to call the number there. We’ve had good stuff so I’m looking forward to getting the word out there.

“My dream is that many PT’s out there, would have the NewGait… Ultimately, I believe getting it for a home based program is really what would make the biggest difference. It’s not an expensive product in the big picture of rehabilitation modalities.”

Dr. Stephen Kanter has a vast resumé and is an avid NewGait Fitter at the International Multiple Sclerosis Management Practice where he is the Director of Rehab Services. In the interview, Dr. Kanter reflects on his “Dream” for the NewGait.

Phuong Vu’s experience with NewGait.

Rehab Institute of Michigan

Phuong Vu was an early believer in the NewGait. She has been using the NewGait at the Rehabilitation Institute of Michigan for more than two years, ever since a patient introduced it to her. We had a great conversation with Phuong about her experience using the NewGait.

Phuong Vu Video Interview

Watch the video version here. Phuong Vu discusses her experience with the NewGait.

NewGait CEO, Benga Adeeko, had the opportunity to ask Cathy Ruprecht, PT, NewGait Clinician, and pain specialist, a number of questions regarding the treatment of chronic pain, and how The NewGait has changed the way she practices. Also features Kim Spranger, PT and NewGait Clinician

PHUONG: I actually heard about the NewGait through a client of mine. He had an incomplete spinal cord injury and was researching different modalities and treatment techniques for spinal cord injury. He came across the NewGait and asked me to look into it.

PHUONG: I think we have been using it for about two years or so now. We use it with both our inpatient and outpatient clients and really anybody with a neurological disorder, but primarily spinal cord injury and stroke patients. We have had a lot of positive results from the NewGait, usually improved strength. We’ve had a couple clients get some motor return.

“We have had a lot of positive results from the NewGait, usually improved strength. We’ve had a couple clients get some motor return.”

PHUONG: A couple of our patients have purchased the NewGait and use it as a home exercise program, which I think has definitely helped speed up recovery. Two particular patients that have purchased it are ambulating better, their steps are smoother, they’re actually able to clear their toes when they are walking, and it just makes everything more safe at home.

“Patients that have purchased it are ambulating better, their steps are smoother, they’re actually able to clear their toes when they are walking, and it just makes everything more safe at home.”

PHUONG: I know it looks intimidating with all of the pieces that come with it, but that’s the best part, you can customize it to your patient. It really doesn’t take long to set up, if that is a concern. Once you start using it, it is a fairly easy process and it only takes a few minutes.

PHUONG: With the cost, it is inexpensive compared to some of the other products out on the market. This one allows patients to purchase it for home use to get the carry over. I think that’s been one of the positives that I’ve seen from NewGait, that the cost is pretty inexpensive.

Terry Tripp’s experience with NewGait

Terry Tripp

Russ and Terry Tripp were some of the earliest NewGait adopters during its transition from sports performance to healthcare. They believed in the NewGait from the beginning, and now have a NewGait in every one of their outpatient clinics!

I had the benefit of working with Benga and Jordan during the inception of the NewGait. From the beginning, I was intrigued by the product. One of our therapists, Kim Spranger, had the epiphany of taking the SpeedMaker, and using it to change gait. The result with the first client was incredible. The client sustained a spinal cord injury and had surgery to stabilize her spine and decompress her nerves. The client had to use 2 canes to walk before she used the NewGait. After her treatment with the NewGait, she could run while wearing it. This prompted a study at NMU. This study found that when clients who have MS wear the NewGait, their gait speed improved statistically which of course made the client more energy efficient which is a life changing effect.

“One of our therapists, Kim Spranger, had the epiphany of taking the SpeedMaker, and using it to change gait. The result with the first client was incredible.”

Being a PT who owns his own business, I was very excited to support my team of therapists who wanted to use the NewGait. It has been very successful with multiple client types in our practice. One of our physical therapists, Cathy Ruprecht, has been using the NewGait on clients who suffer from chronic pain and is seeing remarkable results. I have seen the improvements first hand with my father-in-law, who was treated by Cathy for chronic low back pain. He can now walk with improved cadence and duration with much less pain and has improved his quality of life.

“I have seen the improvements first hand with my father-in-law, who was treated by Cathy for chronic low back pain. He can now walk with improved cadence and duration with much less pain and has improved his quality of life.”

I know that it works, I see it every day in our practice. I believe in this product and we currently have a NewGait in every one of our outpatient clinics. I have no financial interest in this product. I support this product because I see the results firsthand that it works! I strongly endorse this product to be utilized by all therapists who want to improve their client’s quality of life, improve their client’s functional mobility and lessen their client’s pain.

“I believe in this product and we currently have a NewGait in every one of our outpatient clinics. I have no financial interest in this product. I support this product because I see the results firsthand that it works!”