Virtual Reality Treadmill Rehabilitates Neurological Patients

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A new treadmill developed by Motek Medical uses virtual reality (VR) to safely challenge patients with neurological impairments. Called CAREN (Computer Assisted Rehabilitation Environment), the platform has been tested by the Cleveland Clinic to help evaluate and train individuals with Parkinson's disease, multiple sclerosis, and other neurological conditions. The Cleveland Clinic is the first nonmilitary site in North and South America to install the interactive virtual reality treadmill. 

Specifically, CAREN analyzes balance, locomotion, and coordination in affected patients by placing them in an immersive and interactive environment. While a patient walks on the treadmill, surrounding visual projection, the floor, and the sound system react to the patient's behavior in response to real-time motion-capture capabilities. 

Another characteristic of CAREN is labeled '6-Degrees-of-Freedom,' and refers to the treadmill's ability to move up, down, left, and right and gives the platform simulator-like qualities. Real-time feedback merges data from CAREN's hardware to constantly perform quantifiable evaluation.

Physical Applications Of Virtual Reality Rehabilitation  

  • Identifying balance compensation anomalies.
  • Measuring and correcting gait problems from inefficient muscle use.
  • Identifying neural substrates of task difficulty and cognitive effort.

In less scientific terms, this means that the virtual reality treadmill has the capability to help zero in on physical and mental effects of neourological diseases, which will hopefully lead to improvements for people with brain conditions. By catering to a patient's customized needs and preferences, CAREN offers researchers future opportunities to make medical advancements for people suffering from degenerative brain diseases or traumatic brain injuries. 

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Since brain injuries may occur anytime and anyplace, from playing professional football, getting into a car crash or motorcycle collision, or even due to the circumstances of being homeless, technological developments are all the more necessary to help improve the lives of people suffering from neurological impairments. A virtual reality treadmill is just the latest in modern advancements for the brain, and hopefully there are many more creative treatments to come.


CAREN could be the future for people suffering from neurological conditions or traumatic brain injuries. If you or someone you know has experienced a brain injury from a motor vehicle accident, contact The Michigan Law Firm, PLLC at 844.4MI.FIRM for a free consultation. 

Total Knee Replacements Common After Automobile Accidents

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Total knee replacements are one of the most common surgical procedures in the country. In fact, the Agency for Healthcare Research and Quality expects that by 2030, about 11 million Americans will have had either a hip or knee replacement. In 2010 alone, approximately 7 million people underwent joint replacement surgery. And while many people may associate knee replacements with the elderly, patients of all ages undergo the procedure. This is due in part to the fact that car accidents can result in damage to the joint of the knee, and car accidents don't care how old you are.

The knee is made up of three bones - the lower end of the thigh bone known as the femur, the upper end of the shin bone known as the tibia, and the knee cap, also called the patella. Where these bones all meet is covered by protective cartilage. When the cartilage starts to wear away (either over time with old age, or sped up by a traumatic injury such as an automobile accident), this results in knee pain, also known as arthritis. According to the American Academy of Orthopedic Surgeons (AAOS), “damaging a joint raises your chances of developing arthritis sevenfold.” When unbearable pain, deformities of the knee, and loss of mobility are not being effectively treated by medication and/or physical therapy, a total knee replacement surgery is the final option.

Victims of automobile accidents who undergo total knee replacements are likely suffering from post-traumatic arthritis. According to the Cleveland Clinic, post-traumatic arthritis occurs when an intense force hits the knee, such as the impact from a car collision. This results in fracturing of the bone and damage to the surrounding cartilage, which alter how the joint moves and wears out the cartilage more quickly.

During a knee replacement surgery, the surface of the bone as well as the cartilage are replaced with an implant, creating a joint that glides much more smoothly than an arthritic joint does. The implant can be made out of metal, ceramic material, or plastic. According to the AAOS, there are 4 basic steps of a total knee replacement operation.

Steps of a Total Knee Replacement Operation

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  1. Prepare the bone. The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone.
  2. Position the metal implants. The removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts are cemented onto the bone.
  3. Resurface the patella. The undersurface of the patella (kneecap) is cut and resurfaced with a plastic button. Some surgeons do not resurface the patella, depending upon the case.
  4. Insert a spacer. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.

Patients are likely to experience some pain and discomfort directly after surgery. This is managed through medication and physical therapy. Health Care providers encourage the use of over-the-counter pain medications as much as possible, as opioids can have severe side effects, namely addiction. Physical therapy is used to help strengthen the muscle surrounding the knee, and restore range of motion. In the long term, total knee replacement patients experience a dramatic reduction of pain, and can enjoy low impact activities such as walking, swimming, and biking.

While overall quality of life is greatly improved for the vast majority of patients, doctors at the Cleveland Clinic are working to minimize pain and improve patient satisfaction in both the short and long term.

Research on Improving TKR Experience:

  • Robotic Total Knee Replacement: Using robots can improve accuracy and precision during surgery. This leads to a more exact placement of the implant, resulting in better patient outcomes.
  • Press-fit Implant Technology: This type of implant does not require cement to adhere it to the bone. This allows the bone of the knee to regrow better, allowing implants to last longer. This is especially beneficial for younger patients, who need their implants to last 20+ years.
  • Customized 3D Implant Printing: Knee implants typically have one design that only varies in size, even though human anatomy varies tremendously. Custom printed 3D implants that more closely match the patient’s anatomy improve function and satisfaction.
  • Neuromuscular Electrical Stimulation: This utilizes a brace that sends electrical stimulation to the muscles surrounding the knee. This causes the muscle to contract, strengthening the joint. These braces can be used before surgery, to make sure the joint is strong enough, and after surgery during recovery.
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Accidents happen, so while there is no way to completely prevent needing a total knee replacement due to a car collision, there are other areas of your life in which you can take steps to minimize your risk. Maintaining a healthy weight so as not to put extra strain on the joint is what most doctors recommend. More so, be sure to wear the proper safety equipment, such as knee pads and shin guards, when playing high impact sports such as football or soccer. And who knows, since most car crashes are caused by human error, maybe with the future of autonomous vehicles we will be able to minimize the risk of knee injuries from automobile accidents. The good news is that total knee replacements are a relatively safe and effective procedure, should you find yourself needing one, and doctors and researchers are working to make the experience even better.


Knee injuries make the simplest things in life, such as anything involving walking or moving, difficult. The experienced attorneys at The Michigan Law Firm, PLLC understand that it is especially frustrating to have sustained a knee injury due to a motor vehicle accident, since medical treatment can be very expensive and auto insurance companies can be difficult to work with. If you have suffered any injury from a car accident, including a knee injury, call The Michigan Law Firm, PLLC at 844.4MI.FIRM for a free legal consultation. Let our attorneys handle your legal situation while you focus on recovery.