Balance and Vestibular Rehabilitation with Computer Assisted Rehabilitation Environment (CAREN)

Normal balance requires the integration of three sensory systems; visual, vestibular (inner ear), and somatosensory (skin, muscle, tendon, and joint sensations). Balance is maintained through a complex process involving sensory detection of body movement, integration of sensorimotor information within the central nervous system (CNS), and execution of appropriate musculoskeletal responses.
When one or more of these systems is not functioning well, individuals may experience the symptoms of balance disorders.
Common symptoms may include:

  • Episodes of spinning or dizziness (vertigo)
  • Periods of lightheadedness
  • Feelings of faintness (syncope)
  • Problems with eye-head coordination
  • Poor balance (disequilibrium); difficulty in sitting, standing, bending, and walking.

The way in which normal individuals weigh or use each system is dependent upon the environment in which they are functioning. To maintain upright balance, patient populations with sensory deficits rely on sensory systems differently than normal individuals.

At DNR we specialize in treatment of balance and vestibular disorders with the help of CAREN ( Computer Assisted Rehabilitation Environment), the most advanced technology for treatment of balance and vestibular disorders ,available for the first time in NYC.

All therapies are conducted within CAREN’s immersive environment. Specialized objective testing is conducted to define treatment protocols

The results achieved with CAREN are not achievable by conventional physical therapy.
CAREN treatment combines sensory motor training, visual exercises and habituation treatment.
We are proudly the first private facility in US providing MOTION BASED EQUILIBRIUM REPROCESSING THERAPY which has been successfully used in military for pilots suffering from motion sickness.

Motion Based Equilibrium Reprocessing Therapy(MERT)

Vestibular disease can handicap people physically, emotionally and socially.
Unilateral peripheral vestibular loss results in gait and balance impairment , dizziness and oscillopsia.
Conventional treatment with betahistine, carbamazepine and oral steroids as well as head rotation exercises by Cawthorne and Cooksey have limited indication and varying response rates.
Patients affected with peripheral vestibulopathies are usually frustrated with inability to find the right treatment.

Virtual reality rehabilitation is a new method which has shown results superior to conventional treatment options.
MERT ( motion based equilibrium reprocessing therapy) – is a novel treatment method for chronic peripheral vestibulopathies.
A woman during Caren's balance and vestibular rehabilitation session

Treatment Method

MERT is based on military desensitization principles within Virtual Environment.
The 6 DoF ( degrees of freedom) virtual reality motion base CAREN is used to expose patient to sinusoidal vertical passive whole body motion in gradually increasing intensity while fixating the eye site on rolldome and/or optokinetic drum through virtual reality 180 degrees screen.

Treatment Frequency

3-5 times a week during two consecutive weeks

CAREN Stable Suit

CAREN (Computer Assisted Rehabilitation Environment) offers an integrated solution for stability and balance related disorders. CAREN supports the use of therapeutically constructed Virtual Reality (VR) applications using real-time feedback. Dedicated assessment applications are used for objective and quantitative measurements, while motivating exercise activities help to train impaired balance control and stability. Balance (or static postural stability) and dynamic stability are key features in many therapeutic programs. Many patients with neurological disorders experience difficulties in balance and stability control, potentially restricting a healthy active lifestyle. Impaired balance and stability is often also the cause of falls, with devastating consequences like extensive rehabilitation programs or even hospitalization. Caren can measure and improve postural stability and balance control. Assessment applications provide doctors and therapist with objective measures to define a base level, to monitor treatment progression and to set the level of personalized training applications. Immersing patients in a challenging environment with real time feedback is beneficial for balance restoration. The available exercise games for training are specifically developed for stability and balance enhancement in immersive and motivating therapy environment.

CAREN contains a carefully selected set of applications for both the assessment and subsequent training of balance and stability. Proven, precise therapeutic protocols are implemented in challenging VR (virtual reality) environment.

Assesment

Unambiguous and dedicated assessment applications are used to obtain quantitative and objective outcome measures, which helps the therapists to identify stability and balance related issues. The applications are used to define a base-level of the patient and monitor therapy progression.