Stroke Treatment and Stroke Rehabilitation Center NYC

Stroke Treatment and Stroke Rehabilitation Center NYC Neurorehab
At our rehabilitation center we use multimodal comprehensive and individual patient approaches. Our unique technology allows us to diagnose deficits in neuromuscular control as well as cognitive control and their interaction in stroke victims. We use gait analysis and C.A.R.E.N’s unique balance assessment to evaluate patients. The most unique ability of C.A.R.E.N is being able to display motor behavior of the whole system rather than its constituents. Whole body movement behavior and interaction with the environment is an important characteristic of C.A.R.E.N’s scientific progress. Virtual environment allows patients to understand their movement deficits and make connections with the therapeutic process. At our center we are not only are technologically advanced. We are the only clinic in NYC providing Vojta therapy. Vojta therapy has been one of the most standard treatments for patients with neurological damage in Europe and only now making its way to US. Dr. Kalika has been performing Vojta therapy since 2000. We also use conventional methods for stroke treatment such as NDT approach. The Stroke treatment and rehabilitation here is one of most advanced treatments you will find in NYC. In our center we feel like we have the missing link to stroke treatment and stroke rehabilitation in NYC.

Rehabilitation of Stroke

Stroke Treatment and Stroke Rehabilitation Center NYC Neurorehab
Stroke is a cerebrovascular accident (CVA) leading to interruption of blood supply to the brain tissue resulting in damage to the nerve cells in the brain. There are two types of stroke: ischemic and hemorrhagic. The ischemic CVA is due to a blood clot and hemorrhagic CVA is due to the leakage of the blood in to the brain tissue. A CVA can occur at any age; however 75 percent of people affected by it are over sixty five. CVA is a third leading cause of death in United States and a leading cause of serious long term disability. There are about 800,000 people suffering from it every year. The number one risk factor for stroke is high blood pressure, followed by atrial fibrillation, and then smoking. The signs can range depending on location of the ischemic or hemorrhagic and severity.  Some of the main signs are inability to smile, inability to move one side of the body such as arms or legs, loss of balance or speech, and inability to understand speech.  These are just some of the symptoms.

VR (Virtual Reality) Center for Rehabilitation

It is very critical to get a diagnosis early on.  The earlier the patient starts receiving treatment the better their recovery will be.  Usually used in diagnosis are blood tests, MRIs, and several other neurological tests.  Again the sooner a patient gets to a hospital the sooner they can be diagnosed and start receiving treatment. The most important characteristic of the human brain is its ability to adapt to changes required to accommodate new movement conditions. This function is called neuroplasticity.  The long existing theory in the science of neurology is that the brain is a system divided to different parts; each of them responsible for particular constant function; is only partly true. The brain is not a constant organ made of distinct functional units, which have specific function in control of human movement. On the contrary, the brain is a dynamic organ with different parts responsible for specific regulatory function, however, only as long as environmental condition for movement is such that they are familiar to the person. In the instance of drastic change in the environmental conditions for movement, the parts of the brain normally only responsible for particular function can change their function in order for the whole brain to adapt to new movement conditions or challenges.

There has been significant progress in the treatment and rehabilitation of neurological diseases in the last ten years. With the advancement of technology we are able to understand brain plasticity better than ever before. In fact, neuro rehab has had great improvement with integrating technology into the rehabilitation practice. At Dynamic Neuromuscular Rehabilitation we are proud to be leaders in rehabilitation of neurological disease in the US. Our Center for Virtual Reality is the first private VR neurorehab center in the country.  We proudly have the first VR (Virtual Reality) rehabilitation center in NYC. Our C.A.R.E.N (Computer Assisted Rehabilitation Environment) system is the first private unit in NYC and one of few in the country.  C.A.R.E.N has been used for 8 years in military rehabilitation centers as well as research universities conducting studies in finding new and more effective ways to help patients recover from brain damage. VR rehabilitation has been the forefront of neurorehabilitation in the last five years and is now finally reaching patients affected by neurological

When people suffer brain injuries, it can be a traumatic experience to enter the real world upon the path of recovery – a world that is moving, a world with uneven surfaces, physical obstacles, and unseen but immense psychological and emotional pressures. The immersiveness of VR allows people to be treated in a fully controlled environment.
The immersive, multi-sensory environment created by C.A.R.E.N allows patient to perform complex motor activities under the supervision and guidance of our neurological experts, safely taking the first steps in their recovery, from virtual to reality.

C.A.R.E.N is made of a moving platform and a high-tech motion capture system that can be used for diagnosis and rehabilitation of balance and movement control. Gait (walking) training is one of the most unique features of C.A.R.E.N system. Due to the combination of the movement of the platform and virtual reality multisensory immersive environment it provides real life challenges in a controlled and safe environment. The patient is surrounded by a 180 degree hemispherical screen within which an active virtual environment can be projected. This allows the patient to be completely immersed in a versatile, multi-sensory, real-time virtual environment. C.A.R.E.N simply accomplishes results in the area of rehabilitation of walking, weight bearing, and balance beyond what was possible before. Furthermore the latest scientific literature established that rehabilitation of upper extremity in VR is most effective and is now considered evidence based.

Treatment is based on the following extraordinary features:

  • Immersive  Environment. Immersive Environment techniques are used to manipulate interaction of a patient with new virtual conditions therefore facilitating the learning process in both virtual and real environments. Immersive environment enables the development of new movement strategies and unlearning the poor movement habits that arise due to  damage  of brain function
  • Dynamic Effect. Directing the patient’s attention to the effects of the movement (external focus), in contrast to the attention to the movement itself (internal focus), contributes to rapid recovery;
  • Motor imagery. Motor imagery provides access to brain pathways responsible for stored memory of movement patterns in the brain prior to the injury;
  • Walking and Movement Parameters. All gait and other movement parameters are on display in real time for monitoring and intervention. This feature that has been available only in research labs is now offered in C.A.R.E.N;
  • Dynamic control of Center of Mass (COM). For example steering external objects using COM – while inside the Immersive Environment;
  • Dynamic balance training; Training of spatial awareness;

In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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