NEUROCOM SMART Equi Test Balance Master® The Next Step In Rehab

Doug Brown can hardly keep the excitement out of his voice when talking about the SMART Equi Test Balance Master® machine. And why should he? He describes it as the "new Cadillac" of balance machines because it is capable of doing so much more than the regular Balance Master.

A physical therapist at Martin Memorial Health System in Stuart, Brown said the SMART Equi Test can do static and dynamic testing, but the SMART Equi Test takes it one step further: "It incorporates the ability to test motor control, adaptability and visual acuity," he said. "It allows you to hone in on what needs to be corrected and work on specific treatment."

He described the machine as looking like "an incredibly large phone booth. It's surrounded 270 degrees by walls of multi color—they're very bright, with patterns like clouds." The walls and floor can remain motionless, or they can be adjusted to determine how much sway is taking place during a test. Brown, who has 10 years of experience in physical therapy and has been with Martin Memorial for four years, said balance has three components: Sensation – the ability to sense your feet and extremities; vision – what you see; and the vestibular system (inner ear, brain etc.) – which analyzes everything. "All three have to work in conjunction," Brown concluded.

He went on to say that the SMART Equi Test can be utilized with "any type of balance dysfunction—whether from stroke, diabetes, spinal cord injuries, head injuries, or an orthopedic problem, for example, someone who develops a gait disturbance from having a bone fracture." He added that the machine is so versatile, it can be used to train athletes who are undergoing rehabilitation from an injury, or to train a 90-year-old adult who may be at risk for falling. "We can adjust it to work at 200 percent or 20 percent," he said.

Brown explained how one specific test works: A variety of conditions are simulated in the Sensory Organization Test (SOT) conducted with the SMART Balance Master. "During the tests, we introduce different stimuli. We do two or three trials of 15 seconds each, and we start with having the patient's eyes open and the floor firm. Then we run tests with eyes closed and the floor firm. Then eyes open and the walls responsive to patient sway. Then the walls are fixed, but the floor responds to patient sway."

He emphasized that the therapists do not actually move the walls, but rather the walls and floor can be adjusted so they are permitted to move if the patient is swaying—or off-balance—during the test. The walls and floors have sensors, and they help to measure the amount of sway, and how fast or hard it is. Brown said there is also a viewing monitor inside the machine walls, so when testing is completed and training begins, the patients get visual feedback on how they are performing.

If all of this sounds a little frightening to someone who is having problems with balance, Brown assures, "There's no chance of falling. The patient is strapped in, it's like a parachute harness that's tethered from a steel bar on top of the unit." He went on to say, "People don't have problems because we control what's happening. If they start to show signs of fatigue or other symptoms, then we adjust the training to patient tolerance." He added that the tests are performed within the standards of the individual's demographics. "There is an established base of norms," he pointed out. "If we're testing a female who is 73 years old and is 5'4", we know where she should be. If someone is 73 we don't test them like they're 20; the testing in that case is not as intense."

Brown said Martin Memorial's SMART Equi Test Balance Master is one of just a handful in South Florida, and the Health System got this one last June. "This has been a few years in coming," he admitted. "The clinic where I work sees a large number (of patients with balance problems), and we've developed a reputation for handling them well. Administration said this is something we need, and they put it in the budget for last year." He added that this one unit "goes all day long—if not for tests, then for training. It's an exceptional training tool."

The training consists of the patient being in the machine and being introduced to different stimuli that will address specific deficits. While surrounded by the stimuli, the patient tries to keep a digital icon in a small box or tries to hit specific targets, similar to playing a video game. "You learn to filter the information you're receiving," Brown said. "You realize when your center of gravity has been disrupted and how to correct it in a safe manner." He said that on average, rehab generally runs from eight to 12 visits, from 30 to 45 minutes per visit, over a period of four to six weeks.

The NEUROCOM SMART Equi Test Balance Master was designed by NeuroCom International, Inc., a world leader in the development of computerized tools for the assessment and rehabilitation of balance and mobility disorders. It was developed with grants from NASA to evaluate the effects of weightlessness in astronauts.