It looks like a high-tech video game. But the CAREN system’s purpose is surprisingly serious: to help patients with neurological diseases re-educate their nerves and muscles.
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CAREN stands for Computer Assisted Rehabilitation environment. The high-tech system allows a health care team to measure and analyze a patient’s balance, movement and coordination.
Patients with neurological diseases such as such as Parkinson’s disease or multiple sclerosis use the system as part of medical therapy to improve their motor skills.
Immersed in therapy
Typically, patients undergoing rehab walk a straight line on a treadmill surrounded by the sights and sound of a clinic or hospital.
But patients using the CAREN system virtually experience, for example, walking a gravel path. The path feels rocky and uneven; the route twists, turns and goes up and down hills. Surrounded on all sides by trees, chirping birds and blue skies, the patient can even hear the gravel crunch with each footstep.
The patient walks on a treadmill that has separate belts for each foot. The base moves to mimic different surfaces and can react and adjust to a patient’s movement. A wrap-around video screen completes the real-life scenario.
Benefits of being challenged
Research shows that exercise can help neurological patients maintain their balance, mobility and the ability to carry out daily living activities.
The advantage of the CAREN system is that its game-like appeal spurs patients to try harder. At the same time, the patient is working under the close supervision of a therapist.
“We know in neuron-rehabilitation you have to challenge patients for them to get better,” says biomedical engineer Jay Alberts, PhD, director of the Cleveland Clinic Concussion Center. “This provides a very safe environment for that to occur.”
Dr. Alberts leads the CAREN system initiative at Cleveland Clinic, which is the first nonmilitary installation of the platform in North or South America.
“What we can do now is change the environment in a very dynamic fashion,” he says.
Real time feedback
During weekly appointments, patients follow a specially designed rehab program that helps them with specific skills. The system measures, records and analyzes the patient’s movements in real time. This helps health care providers to know quickly the areas in which the patient needs to improve and how to help the patient improve.
Sandy Williams, a patient undergoing rehabilitation for Parkinson’s disease, uses the virtual reality treadmill at Cleveland Clinic.
She works with her therapist on her gait and increasing her stride length by touching her toe to a box. Other times she will swat at birds and butterflies while walking on the treadmill.
“I know once I slow down, it could come to a point where I couldn’t move. So I am willing to do whatever I can to keep myself going,” Ms. Williams says.
Working with the CAREN system helps Ms. Williams improve her balance – and satisfy her competitive spirit in a fun way.
“When I go up a hill, you can really feel it in the machine,” Ms. Williams says. “I do enjoy the challenge of, ‘Can I get them?’”
Plans are for Cleveland Clinic doctors to use the CAREN system to evaluate concussion patients and to help determine when it’s safe for athletes to return to play.