HEALTH: Israeli Takes a Step Forward

• by Pierre Klochendler (ramat gan)
• Friday, July 15, 2011
• Inter Press Service

<a href='www.stepofmind.com' target='_blank' class='notalink'>An Israeli company</a> has developed a shoe that 'teaches the brain to take the right step.' The 'Step of Mind' shoe artificially alters angles and orientations of the sole randomly, fosters brain elasticity, and helps regain motor control abilities, effectively stepping up the process of learning how to walk with brain damage caused by stroke, cerebral palsy, or by a bad fall.

Four years ago, Miriam stepped out of hospital, confined and consigned to a wheelchair, unable to get up, stand up and walk. She tried all kinds of therapies. One day, she came to the Ilan Rehabilitation Centre and, like a Cinderella, tried on these 'magic' shoes, stepped back into her own shoes, and regained her balance, strength and self-confidence, almost like before.

And, never again heard people say, 'Step aside to let the wheelchair through'.

'This invention changed my life. My legs are now solid like the roots of a tree,' she attests, walking while accompanied, from afar, by a therapist. 'I keep my head up and eyes looking straight ahead, thanks to Dr. Simona.'

For 15 years, Simona Bar Haim conducted research on how to help people walk again. Four years ago, she invented these experimental, basket-like, robotic shoes, equipped with engines, batteries, sensors, and memory and sound systems.

'This device doesn't rehabilitate muscles as it restores affected areas of the brain,' the neurophysiologist explains. 'When you walk, you don't know your next step. The brain asks itself, will I walk up, or down, on sand, or grass? The shoes' pistons induce a challengeable environment best for brain plasticity. The brain re-learns to walk.'

Bar Haim transfers data to the shoes, and orchestrates exercises that are specific to each patient's needs. She then analyses the progress made. 'See the symmetry of the healthy leg, the asymmetry of the ailing leg,' she demonstrates on a computer screen.

The treatment is ineffective for persons who have no walking abilities at all, that is, those who permanently lie or sit down. But it helps chronic patients who've suffered a stroke several years before, but preserved some walking abilities.

A treatment course of 25 sessions costs 1,800 dollars. The development was funded by the Middle East Research Cooperation and USAID in cooperation with the Cerebral Palsy International Research Foundation. CPIRF's medical director Mindy Aisen believes the experiment is 'a smashing success' and that 'data and information will help care worldwide.'

Thus far, 20 teenagers with cerebral palsy and 15 seniors with hemiplegia following stroke have been treated clinically.

It's Meir Magal's turn to walk. 'Five years ago, I suffered a stroke, couldn't move half my body half-a- millimetre, even in bed. Then, I moved to the wheelchair. Then I walked the walker, till I came here,' he recalls. 'These shoes returned self-confidence and stability to my body. Today, I dare venture outdoors without a walking stick.' He walks away proudly.

How do you once more learn doing what you did once? How do you live with what you lost and yet become again what you used to be? How do you regain the simple things of life, like walking again without a thought, on your own?

Before she thought of the 'Step of Mind' shoes, Bar Haim had to change her own state of mind.

Conventional therapy tries to 'correct' so-called abnormal movements, to recreate motions that are typically, generally, perceived as aesthetic. But for the disabled, what matters isn't the way you look while walking, but the fact that you can walk independently.

'The brain finds its own solutions, efficient ways of functioning. If you're trained to walk artificially in a clinical surrounding, your accomplishments vanish,' Bar Haim cautions. 'We've developed a motor- learning concept for everyday life that induces you into your own natural way of walking and shortens the rehabilitation period. Most importantly, achievements are sustainable.'

To her surprise, Bar Haim soon realised that, contrary to what's accepted as common scientific knowledge, a healthy brain functions in disorderly ways. Actually, it's the damaged brain that's too orderly. And that's what causes walking difficulties. In short, chaos, randomness and disorder is healthy; order is pathology.

'Our brain operates chaotically, with degrees of freedom. There's a multitude of variable ways of walking. If you suffer from brain damage, you lose this adaptability, this variability, and you walk only one way. Such persons should be challenged in a chaotic way, by training back to the healthy, disorderly brain. Here, people with movement disorders apply walking patterns that perturb the environment and force plasticity of the brain in the areas of motor control.'

Supported by the therapeutic shoes, the 'walking pattern' creates deliberate disturbances, prods chaotic training and forces the brain to be constantly attentive, proactive, thus to solve problems. This results in improvement of the functions of the parts of the brain that are responsible for the control of walking. 'Try to walk the regular mathematical way, two-plus-two-is-four, two-plus-two-is-four, you'll fall,' warns Bar Haim.

David Carus, an honorary research fellow at the Strathclyde University’s Faculty of Engineering in Scotland, which helped construct the shoe's mechanical features, says, 'people can re-learn the process of walking in later years and take that approach into real life situations.'

'We have the idea of manufacturing a line of 'Re-step' shoes that you'd put on to train at home, without a clinician,' says Bar Haim. 'You'd just practice two-to-three times a week like with gymnastics. The home version would roughly cost 900 dollars.'

© Inter Press Service (2011) — All Rights ReservedOriginal source: Inter Press Service

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