Patient’s gross motor skills improved significantly, exhibited by knee and hip flexion with full range of motion. However, ankle flexion was possible in only the patient’s right foot. Improvement was also observed in knee extension (kicking out), with the patient’s right leg extending better than the left leg, but without full range in either leg. Patient is able to push both legs outwards and demonstrates fair trunk control while sitting.

Patient has fair static sitting balance with no back support needed and is able to sit up straight. Patient also demonstrates dynamic sitting balance, but loses balance when reaching out at an extended distance. Patient does not have static standing balance, and requires maximum assistance when changing position from sitting to standing, requiring a hoist for support.
Patient is able to stand with the support of a hoist, and requires assistance in locking knees and hips in both legs while standing. Patient has no trunk control while standing and is able to support only 50-70% of his weight on his legs when upright. Overall improvements in standing are very mild, but more feedback will be collected in 6 months time to see if any further improvements in standing have been made.

Due to the inability to stand effectively, stepping exercises were not conducted with this patient in his immediate post-surgery rehabilitation. However, a stepping program has been created so that patient is able to practice stepping during his physical therapy sessions back home.

Muscle mass and endurance were improved upon discharge.

1 Year Post-Treatment

One year after the initial treatment period with Verita Neuro, patient is performing 10 hours of physical therapy per week.

Gross motor functions have improved moderately. Patient is still able to flex and extend his right ankle, hips, and knees. The programs provided by Verita Neuro for gross motor function are still working very well. Patient feels stronger and is able to carry out more repetitions of kicking out his legs. From a scale of 1-to-5 with “1” being worse than before surgery and “5” being significantly improved from the surgery, the patient rates his gross motor functions somewhere between 3-4.

Patient is still practicing standing exercises and is able to stand without switching on the epidural stimulation device (with support). When the stimulator is switched on, the patient is able to stand bearing weight equally on either leg. He reports that he does not use the stimulator often. The patient is still not able to take steps or conduct gait training. Mild improvement was seen in patient’s static and dynamic sitting balance.

Patient reports that he has observed a decrease in his muscle mass, but has experienced a slight reduction in fatigue. We recommend this patient to come back for more mapping sessions to improve his stepping exercises. The patient should also increase the amount of physical therapy he conducts per week, and switch on the epidural stimulation device more often in order to gain muscle mass and improve more.