Technology

The AlterG Bionic Leg is a battery-powered lower extremity device that is used as a part of a comprehensive therapy program. The device is used with patients who have suffered a stroke or who have chronic, degenerative neurological gait impairments.
While wearing the Bionic Leg, patients can work on motions like sit-to-stand, walking and negotiating stairs.
Built in sensors detect weight shift and knee angle changes, applying assistive force in leg extension to help patients stand. Madonna’s expert clinicians control and adjust different settings in real-time for the patient to practice a normalized gait pattern

The ArmeoSpring is specifically suited for patients who are beginning to regain active movement of the arm and hand. It is an upper extremity exoskeleton designed to off-weight the affected arm so that a patient is able to move their arm around more freely without having to lift the entire weight of their arm against gravity. This allows for patients to use proper movement patterns versus using compensatory movement patterns. While using 2-D and 3-D games, it offers various self-initiated repetitive therapies to increase the patient’s range of motion and selective control, motivating the patient to exert intense levels of both concentration and coordination.

Body weight Supported Treadmill Training (BWSTT) systems are being used for rehabilitation in many practices all across the country for a variety of patient population, including those with neural impairments, orthopedic injuries and degenerative diseases.
It has been shown to be an effective way of retraining gait in patients with neurological injuries resulting from stroke, brain injury or spinal cord injury.
The system can provide stability during locomotion and help progress weight bearing according to the patient’s needs.
It involves fitting a patient into a harness, which is attached to an overhead suspension system positioned over the treadmill portion of the unit. This suspension system is used to support a percentage of the patient’s body weight as the patient walks on the treadmill at various speeds.  
Specially trained therapists provide manual assistance to improve the patient’s walking pattern, postural control, motor recovery, strength and endurance.

The Dynavision 2000 is a computerized board used by occupational therapists to improve peripheral vision, reaction time, arm coordination and the ability to find objects to one side or in the environment. Dynavision is a device designed to improve visual motor skills in patients whose visual and motor function has been compromised by injury or disease. It has been successfully used to improve function in adults with limitations from stroke, head injury, amputation, spinal cord injury and orthopedic injury.

The EksoGT is a powered robotic exoskeleton that is utilized as a part of a comprehensive therapy program. This device is used with patients who have suffered from many different types of neurologic injury and have resulting lower extremity weakness.
While wearing the device developed by Ekso Bionics, patients can stand up and walk over ground for comprehensive gait training.
Built-in sensors help the specialized motors provide assistance as needed while Madonna’s expert clinicians control and adjust different settings in real-time for the patient to practice a normalized gait pattern.

The RT300 FES cycle combines a rehabilitation technique called Functional Electrical Stimulation (FES) with a motorized ergometer machine that allows for repetitive activity. FES uses computer-generated, low-level electrical pulses, which cause coordinated contractions of the leg muscles while sensors provide constant feedback to a computer. The result is a smooth and natural pedaling with the patient’s leg muscles providing the power to move the bike.

The Fiberoptic Endoscopic Evaluation of Swallow, or FEES, is a procedure that tests the oropharyngeal phase of the swallow reflex.  The diagnostic test uses a flexible endoscope, which is inserted through the nose and connected to a video camera to allow the speech-language pathologist (SLP) to evaluate the pharyngeal and laryngeal mechanism. The SLP may also provide something to eat or drink during the procedure.

The Intelligently Controlled Assistive Rehabilitation Elliptical trainer was developed by Madonna under a grant from the National Institute on Disability and Rehabilitation Research to help physically challenged individuals and those with chronic conditions regain or retain their walking ability and levels of physical fitness.
Institute for Rehabilitation Science and Engineering: ICARE 
The technology and training system helps individuals build strength, mobility, control and endurance so that they can walk and move more easily.
The ICARE integrates a motor that can assist users to train in either the forward or reverse directions at variable speeds. Different levels of assistance means a user can override the motor by simply pushing at a faster speed than the device is set. The ICARE also features four different hand hold options that adjust to the user’s unique needs. The foot pedals include straps that can be used to anchor the user’s foot to the pedal, a useful feature that helps sustain a consistent position on the pedal.

The Indego is a powered, lower limb exoskeleton that enables people with neurological injuries to walk and participate in over-ground gait training.
According to developers of the slim and lightweight medical device from Parker Hannifin, the design consists of five snap-together components, including a hip component and upper leg components with two motors and embedded sensors and controllers that aid with many different types of movements, including sit-to and from-stand transitions, walking, turning and veering.
Using an iOS app, Madonna’s expert clinicians can control the patient’s stride length, step frequency and step height in a variety of different therapy settings while recording data to help track the individual’s rehabilitation progress.

Madonna features a simulated community called Independence Square where patients can engage in real-life skills, such as grocery shopping, cooking a meal, transferring in and out of a vehicle or getting in and out of bed.
Simulating real-life activities is not only critical to regaining the maximum level of independence but helps build confidence and help regain skills like reaching and grasping, making a list, memory, cognitive skills and communication. 

Our clinicians are committed to ensuring that our pediatric patients are able to return to play and recreational activities. Both of our campuses include both indoor and outdoor playground spaces to help patients stay engaged and have fun during therapy sessions.

The Interactive Driving Simulator is a software program that mimics characteristics of an actual vehicle including a steering wheel, accelerator and brake pedal. The software offers complex, unpredictable traffic situations to challenge patients.

The Interactive Rehabilitation and Exercise System (IREX) is a virtual reality therapy system that uses gesture control technology to place patients into simulated environments on a screen such as virtual sports or gaming.  It allows patients, regardless of their age, ability or condition, to have fun in an environment they would not otherwise be able to experience such as sky diving, scuba and race car driving. 
Capable of measuring range of motion and other data points from the human body, the IREX allows therapists to program specific therapy routines for their patients to help achieve maximal recovery, and to measure their progress along the way. For example, individuals with difficulties moving an arm may be assigned a gaming task that encourages them to move their arm within a range that is considered appropriate to advance their functioning.  Tasks can be used to improve a variety of skills including balance, trunk control, mobility, cognitive skills, processing speed, etc.   

The Lokomat is a robotic treadmill training system that uses a body weight support system to suspend individuals while their legs are attached to robotic legs that assist with basic walking functions. The Lokomat system allows the therapist to control how fast the patient walks, how much body weight the patient is able to support and how much assistance the robotic legs give the patient through range of motion.
Studies show that locomotion therapy supported by a robotic assisted device on a treadmill is an effective intervention for improving over-ground walking function caused by neurological diseases and injuries.
The customized support and limb guidance provided by the Lokomat allows patients who have a wide variety of walking impairments to use this device both in inpatient and outpatient settings.
It is used to improve mobility in individuals following stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, cerebral palsy and other neurological diseases and injuries.

The NESS H200 Bioness is a neuroprosthetic device used to improve hand function and voluntary movement in patients with upper extremity hemiparesis or paralysis due to stroke, spinal cord injury or brain injury. It consists of five surface electrodes within the device used to stimulate and activate the muscles of the hand. The device is used to assist patients with grasping and releasing objects and for activities of daily living (ADLs).

The NESS L300 Foot Drop System is a neuroprosthetic device used to prevent foot drop during gait for patients with hemiparesis due to stroke, incomplete spinal cord injury or brain injury. It consists of a small wireless gait sensor, a leg cuff and a hand-held control unit. The leg cuff sits just below the knee and contains a stimulation unit and electrodes. When the heel comes off the ground, wireless signals from the gait sensor are sent to the stimulation unit in the leg cuff which stimulates the muscles to contract and lift the patient’s foot while walking.

The NTrainer System is a medical device designed to assess and reinforce non-nutritive sucking skills (NNS) in newborns and infants. The device consists of a silicone pacifier with a computer-controlled air pump that pulsates the nipple and stimulates the patient’s lips and tongue to help train the infant’s brain to prepare for independent oral feeding.

The Passy-Muir Valve (PMV) is the standard of care for our pediatric and adult ventilator and tracheostomy tube patients. Passy-Muir, Inc. is committed in their efforts to offer these patients a step toward independence and dignity through speech and has designated Madonna the first of just twelve Centers of Excellence in the country. The PMV has a one-way valve that connects to the tracheostomy tube. Air is inhaled through the trach tube and exhaled through the mouth. The valve opens during inspiration to allow air to go into the lungs. The valve closes during expiration and directs air up through the vocal cords to allow speech. The use of the PMV by our interdisciplinary team has contributed significantly to the success of our ventilator and trach tube weaning outcomes.

The Proprio 4000 provides balance training through dynamic range of motion (D-ROM) technology, which provides a multidirectional, dynamic platform and motion analysis that evaluates actual performance. The movements of the patient and the platform work together to create real-life movements that provide safe, controlled exercise.
This equipment is a proven method in treating patients with lower extremity orthopedic injuries. It is also effective for treating patients with stroke, brain injury or other neurological conditions resulting in balance disturbance.

The ReoGo, a neuromuscular retraining device, is an upper extremity robotic arm with a motor to assist with some or all of the movement to help patients regain upper extremity function. It can range anywhere from total assist to no assist from the motor. The ReoGo is exercise-based and helps lay the groundwork for regaining arm function. With engaging, interactive stimuli, it exercises cognitive capabilities and motor skills.

The RT300 FES cycle combines a rehabilitation technique called Functional Electrical Stimulation (FES) with a motorized ergometer machine that allows for repetitive activity. FES uses computer-generated, low-level electrical pulses, which cause coordinated contractions of the leg muscles while sensors provide constant feedback to a computer. The result is a smooth and natural pedaling with the patient’s leg muscles providing the power to move the bike.

The Sanet Vision Integrator (SVI) looks like a large, touch-screen television and features a variety of programs to build vision skills in a wide range of patients.
It incorporates both auditory and visual stimuli, using numbers, letters and words. It is used to enhance hand-eye coordination, visual reaction time, central-peripheral integration

The SmartWheel, a computerized, blue disc that attaches to a wheel of a wheelchair, examines manual wheelchair use by analyzing each push on the handrim. The SmartWheel measures push force, push frequency, push length, push smoothness, speed and much more. It creates automated reports that allow therapists to optimize wheelchair set-up and push style to reduce repetitive stress, optimize equipment selection and insurance justification for reimbursement and improve client evaluations through comparisons with a national database.

Children who have sustained a traumatic brain injury recover differently from adults. The Snoezelen Sensory Room helps “wake up” the child’s injured brain with specially designed devices, such as lighted therapy toys, and other therapeutic items with special textures and sounds. 

Madonna uses Vapotherm as the highest standard of care to provide heated humidification to tracheostomy patients. Tracheostomy patients are typically unable to humidify on their own which often results in thick and retained secretions in the lower airway. Vapotherm’s heated humidification improves mucociliary function and mobilization of secretions, helping the patient breathe more easily and accelerating the ventilator and tracheostomy weaning process.
Madonna received the Vapotherm Center of Excellence designation in 2017 for using Vapotherm’s technology in ventilator and tracheostomy weaning protocols.

Who can benefit from aquatic therapy?
Aquatic therapy in a warm pool may benefit people with:
Abnormal tone
Impaired head and trunk control
Decreased strength
Postural strain
Sensory impairments
Arousal problems
Motor planning
Decreased tolerance to weight bearing
Post surgical deconditioning
Edema
Respiratory problems

Why the water?
Other than water being comforting and fun, it also facilitates mobility, decreases pain, improves flexibility, increases strength, controls weight bearing, improves cardiovascular endurance, promotes relaxation, provides calming pressure/input, and promotes activation of core muscles.
The unique effects of water can be used as a therapeutic tool for children:
The warmth of water promotes muscle relaxation, assists with decreasing muscle spasticity, and helps enhance muscle stretching and joint movement.
The pressure exerted by the water molecules on the immersed body stimulates movement, improves circulation, and helps reduce tactile defensiveness because of the generalized constant calming sensory input.
The thickness of water prevents the children from using momentum and speed for movement and promotes more slow, smooth, and controlled movements which require more muscle strength and control.
Water reduces the effects of gravity, which decreases weight bearing and its impact on the joints and spine, allowing for greater mobility.  Children who use wheelchairs or other assistive devices to walk on land can often swim or walk in the water with little assistance.   
About the Madonna Aquatic Therapy Program:
The aquatic therapist works with the interdisciplinary team at our facility to help patients reach their therapeutic goals, using buoyancy and the resistiveness of the water throughout treatment.
Depending on the diagnosis, and precautions, treatment sessions can last 30-, 45-, or 60- minutes.
In addition, the using water as a therapeutic tool, our therapist uses toys, balls, floating devices, noodles, and steps for treatment.
Goals are geared toward function to enhance activities of daily living.

The Wayne Saccadic Fixator is a wall-mounted instrument with a touch-sensitive surface containing 33 LED lights arranged in three concentric circles with one light at the center.
A built-in computer provides a nearly unlimited variety of activities for developing eye-hand coordination, accuracy, speed, sequencing, directionality, pattern recognition, visual memory, anticipation, reaction time, peripheral awareness and more. The user responds to the appearance of a light by pressing the surface surrounding it.