Novel use of optokinetic chart stimulation to restore muscle strength and mobility in patients with subdural haemorrhage: Two case studies

Abstract

With optokinetic chart stimulation leading to reversal of knee flexor contractures in one case and restoration of independent mobility in both cases, more research is needed to investigate use of optokinetic chart stimulation in patients with severe subdural haemorrhages and other traumatic brain injuries.

Does use of the optokinetic chart stimulation based OKCSIB protocol improve recovery of upper and lower limb movements, function and quality of life at 3 year follow up in dense strokes? A retrospective case control series

“…In ataxic patients who have suffered from posterior circulatory strokes, optokinetic chart stimulation has been reported to lead to improved postural control and function (Chitambira & Smithard, 2009). The optokinetic chart stimulation based OKCSIB protocol (Chitambira, 2011) has also been found to restore voluntary movements in other neurological conditions such as dense subdural haemorrhages (Chitambira, 2013), post critical care myopathy (Chitambira, 2012) and post critical care poly neuropathy (Chitambira, 2011). The OKCSIB protocol is aimed at recovery of the balance and anti-gravity extensor systems.…”

Novel Use of Optokinetic Chart Stimulation to Restore Muscle Strength and Function in a Bed Bound Traumatic Brain Injury Patient that was in a Vegetative State of Unconsciousness: A Case Study

“…Although preliminary beneficial use of OKCS has been reported in severe TBI with subdural haemorrhages [12] and dense strokes [13], this is the first time OKCS has been reported to benefit severe TBI in a vegetative state that progressed to a minimally conscious state and then full consciousness within weeks of commencement of OKCS. Without the use of OKCS, the patient's treatment would have been limited to respiratory intervention only.…”

“…This enhances recovery of balance which is a pre-requisite for function [12], whereas conventional neurophysiotherapy is based on practising specific tasks and functional activities [6]. The range of functional activities and task-specific activities that vegetative and minimally conscious patients with TBI can carry out is limited.…”

“…The range of functional activities and task-specific activities that vegetative and minimally conscious patients with TBI can carry out is limited. This may then leave these patients at the mercy of natural recovery which may not be guaranteed to occur [12] The fact that OKCS can be carried out in lying in bed as well as its being low intensity makes it more useful to vegetative and minimally conscious severe TBI when compared to conventional neuro rehabilitation approaches. This is in sharp contrast to the high intensities currently used in conventional neuro therapies.…”

“…The patient's eyes were manually held open by the first author while an optokinetic chart [13] was moved in front of the patient's face for 3 minutes to and fro laterally, 3 minutes to and fro vertically and 3 minutes to and fro forwards and backwards. In each of the planes, the chart was moved manually at a frequency of one cycle per second as per OKCSIB protocol previously used in dense acute strokes [13] and SDH [12]. This treatment regime has been successfully used in completely paralysed strokes and was developed using a time intensity of 3 minutes widely used in vestibular rehabilitation.…”