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Neurological conditions can create limitations that directly impact everyday activity and exercise. The Calgary Nardella Clinic’s neurorehabilitation program is using the latest technology in rehabilitation gait training – ICARE (Intelligently controlled assistive rehabilitation Elliptical). The ICARE was developed at the prestigious Madonna Rehabilitation Hospital in Nebraska, by Dr. Judith Burnfield. The technology was developed to provide a gait training rehabilitation option for individuals that best represents a normal gait pattern. The ICARE allows individuals who may otherwise be unable to partake in physical activity, to participate in cardiovascular exercise and improve their gait.

ICARE is a motorized, bodyweight assisted, elliptical trainer for repetitive gait training. Integrated sensors detect the level of assistance needed and the motor reacts accordingly to provide the correct level of support. Repetition of the motion during walking is the most important factor when gait training and repetition is required to achieve lasting neuroplasticity gains. ICARE allows the user to remain active regardless of their ability. Body weight support systems are quickly becoming the industry standard in gait rehabilitation, the results have been extremely positive in their ability to improve and possibly restore walking function. Conditions benefitted from ICARE training are outlined below.

ConditionBenefits of ICARE

Parkinson’s disease Cardiovascular exercise, Gait training, Neurological repatterning
Multiple Sclerosis Cardiovascular exercise, Gait training, Neurological repatterning
Traumatic Brain Injury/ Post-concussion syndrome Cardiovascular exercise, Neurological repatterning
Stroke Cardiovascular exercise, Gait training, Neurological repatterning
Spinal Cord Injury Cardiovascular exercise, Gait training, Neurological repatterning
Cerebral Palsy Cardiovascular exercise, Gait training, Neurological repatterning
Age-related weakness or balance issues Cardiovascular exercise, Increase muscle tone, Partial body-weight support, Prevents falls
Pre/post joint replacement surgery Cardiovascular exercise, Decreased body-weight on affected joint
Hip Fracture Cardiovascular exercise, Body-weight assisted, Gait retraining
Arthritis Decreased body-weight on affected joints, Cardiovascular exercise
Cancer Partial body-weight assisted activity, Maintain muscle mass, Cardiovascular exercise

This technology allows for a gradual progression from the patient being passively moved through a normal gait pattern to a therapy that allows the patient to do active therapy as they gain strength and coordination.

Research

  • Burnfield JM, Shu Y, Buster TW, Taylor A, Nelson CA (2011). Impact of elliptical trainer ergonomic modifications on perceptions of safety, comfort, workout and usability by individuals with physical disabilities and chronic conditions. Physical Therapy, 91(11)1604-1617.
  • Nelson CA, Burnfield JM, Shu Y, Buster TW, Taylor A, Graham A (2011). Modified elliptical machine motor-drive design for assistive gait rehabilitation. Transactions of the ASME Journal of Medical Devices, 5:021001.1-021001.7.
  • Burnfield JM, Taylor AP, Buster TW, Shu Y, Goldman AJ, Nelson CA (2011). Use of Intelligently Controlled Assistive Rehabilitation Elliptical Trainer to Improve Walking and Fitness during Acute Stroke Rehabilitation. Stroke, 42(3), pg. e326.
  • Burnfield JM, Goulet C, Buster TW, Cassel AJ, Mills J, Seow CM (2011). Comparison of velocity, muscle demands and perceived exertion during elliptical training and treadmill walking in individuals with and without multiple sclerosis. 2011 Annual Combined Sections Meeting of the American Physical Therapy Association.
  • Burnfield JM, Shu Y, Buster TW, Taylor AP, Merriman L, Nelson CA (2010). Comparison of lower extremity electromyographic (EMG) demands during ICARE training and walking. American Society of Biomechanics 2010 Annual Meeting. (PDF Download).
  • Burnfield JM (2010). ICARE: An Affordable Technology Designed to Promote Walking and Cardiovascular Fitness During Rehabilitation and Following Discharge. 8th Annual Medical Rehabilitation Providers Association Educational Conference.
  • Burnfield JM, Buster TW, Taylor A, Keenan S, Shu Y, Nelson CA (2010). Intelligently Controlled Assistive Rehabilitation Elliptical (ICARE) Training: An Analysis of Lower Extremity Electromyographic (EMG) Demands with Varying Levels of Motor Assistance. Online Proceedings, Rehabilitation Engineering and Assistive Technology Society of North America’s 2010 Annual Conference (PDF Download).
  • Shu Y, Buster TW, Taylor A, Keenan S, Nelson CA, Burnfield JM (2010). Ergonomic redesign of elliptical trainer to promote greater safety, comfort and usability. Online Proceedings, Rehabilitation Engineering and Assistive Technology Society of North America’s 2010 Annual Conference (PDF Download).
  • Burnfield JM. Development of the ICARE Trainer to Promote Gait and Cardiovascular Fitness in Individuals with Physical Disabilities (2010). Presented at Rancho Los Amigos National Rehabilitation Center. Downey, CA. May 27, 2010.
  • Taylor AP, Buster TW, Barber BR, Burnfield JM (2009). Comparison of Forefoot and Heel Pressures Across Fast Walking and Four Elliptical Trainer Conditions. Supplement to Medicine and Science in Sports and Exercise, Volume 41(5), pg. S242.
  • Burnfield JM, Barber BR, Buster TW, Taylor AP (2009). Plantar Pressures Vary Across Elliptical Trainers and Compared to Walking. Proceedings, Gait and Clinical Movement Analysis Society 14th Annual Meeting, pgs. 116-117.
  • Buster TW, Goldman AJ, Corbridge LM, Shu Y, Burnfield JM (2009). Partial Body Weight Support Treadmill Training: Clinician’s Upper Extremity Muscle Activation During Facilitation of Hemiparetic Limb Movement. Proceedings, Gait and Clinical Movement Analysis Society 14th Annual Meeting, pgs 258-259.
  • Burnfield JM, Buster TR (2009). Neuroplasticity: Applying Guiding Principles to Help People Relearn to Walk Following an Injury. Presented at Osher Lifelong Learning Institute (OLLI), College of Education and Human Sciences, University of Nebraska – Lincoln. Lincoln, NE. April 8, 2009.
  • Kulig K, Burnfield JM (2008). The role of biomechanics in orthopedic and neurological rehabilitation. Acta of Bioengineering and Biomechanics, 10:1-14.
  • Burnfield JM, Buster TW, Provorse A, Takahashi S (2007). Muscular demands during elliptical training compared to overground walking. Physiotherapy, 93(Supplement 1), pg. S179.
  • Takahashi S, Burnfield JM, Buster TW, Provorse AR (2007). Comparison of Gluteal Muscle Electromyographic Activity across Five Cardiovascular Exercises in Healthy Young Adults. Medicine and Science in Sports and Exercise, Volume 39(5), pg. S255.