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Machine exercises patients who can't move on their own

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    Machine exercises patients who can't move on their own

    Idea in motion
    Machine exercises patients who can't move on their own

    Kristi L. Nelson

    January 14, 2002 - Larry Bohanan never imagined his invention would move so many people.

    And seeing them use it has moved him more than once.
    "Watch this!" he says excitedly, playing a video clip of a young girl with brain damage strapped into his machine, the Quadriciser. "Look at that!"

    And then, as the girl moves her once-paralyzed hand and onlookers applaud, he says, wistfully, "I wish you could have been there."

    Bohanan's Quadriciser looks simple enough. The user sits in a padded chair with feet in padded cradles, elbows on padded armrests and hands on small trapezes attached to bungee cords. When the machine is activated, a four-cylinder engine moves a flywheel to which cords and pulleys are attached, moving the user's arms, legs and feet in a gentle, continuous motion similar to pedaling a bicycle. Velcro gloves hold in place the hands of those who can't grip the gloves on their own.

    When he invented the forerunner to the Quadriciser in 1993, Bohanan envisioned it helping those who couldn't move on their own - paraplegics and quadriplegics, stroke victims, those who have neurological damage or are recovering from surgery or serious accidents. The original machine was an effort to help his father, who had suffered several strokes and was about to have his leg amputated because while he was lying in bed, not moving, gangrene had set in.

    "I went home to exercise him, really, and I realized I couldn't do enough," Bohanan says.

    So Bohanan, who was then a graphic artist illustrating patent applications at Oak Ridge National Laboratory, invented a motorized machine that would move his father's legs for him. It worked well enough that he refined it and developed a model with a seat for his cousin, Colin Bullen, who became paralyzed as the result of a motorcycle accident 11 years earlier.

    Eventually, Bohanan says, his cousin could move his arms again. Regular use of the Quadriciser also kept Bullen free of the pressure sores he got from sitting in his wheelchair, lowered his blood pressure and improved his breathing and bowel and bladder health.

    "Then I realized I had something," Bohanan says. He used it with his mother, who was in a wheelchair with sciatic nerve damage and facing senility. To his delight, the increased circulation and flow of oxygen to her brain seemed to ease both her pain and her dementia. He used it with the 19-year-old, brain-damaged son of an acquaintance to build up his once-atrophied limbs. The results were better than either expected.

    "It does a lot more than I ever dreamed," Bohanan says. "It seems to synchronize the brain."

    For a while after that, Bohanan's Quadriciser was hot property. He took early retirement, sold some property and sank his fortune into building the devices, calling his company Kinetech Inc. He demonstrated Quadricisers at exhibitions and got five Veterans Administration hospitals as well as several area hospitals and rehabilitation centers interested. (Baptist Hospital of East Tennessee still has the machine on its Senior Dynamics Unit, and Hines VA Hospital in Chicago has used one for more than six years.)

    He got media attention - and results - when he built a child's model of the machine to provide "patterning" therapy, which simulates walking and crawling, to a toddler who had a traumatic brain injury. After using the machine over time, the boy could crawl independently and walk with support, his mother said.

    And then the attention sort of dried up. Bohanan kept making the Quadricisers, improving on the design with each new model, but he was giving away as many as he sold. Clinical data collection on the machine's effectiveness was started but never finished. Efforts to get the Quadriciser in more local facilities didn't work out, even though several medical professionals acknowledged its worth. John Staley, health service line leader for rehabilitation services at St. Mary's Health System, used the machine in the late '90s when he was a "skeptical" physical therapist for HealthSouth.

    "It was an effective device," Staley says. "We used it primarily for folks that had difficulty using traditional equipment such as stationary bicycles or treadmills. ... Patients enjoyed it because it was something they were able to do independently and see benefits carry over during their normal day."

    Though HealthSouth no longer has a Quadriciser, Staley says he liked the Quadriciser because it works multiple joints. As far as he knows, he says, there's still nothing comparable on the market.

    "There's equipment out there that's similar, but it requires the patients' own muscle power, which many of those patients don't have," Staley says.

    But as professional and media attention - and Bohanan's bank account - continued to dwindle, patient interest in the Quadriciser only mounted. Judy Moyers, co-facilitator of Knoxville's multiple sclerosis self-help group, was so impressed with the Quadriciser in 1997 that she had Bohanan demonstrate it for the group. Several members went to HealthSouth regularly to use the machine; when Moyers had surgery a couple of years ago and couldn't make it to HealthSouth, Bohanan put the machine in her home. She says she still uses it almost every day, and her doctors want her to continue.

    "It works every joint in the body: the arms, hips, knees, ankles, hands and wrists," Moyers says. "I use it for 30 minutes (a day), and it wears you out, but it makes your circulation move, and you feel sort of rejuvenated."

    Using the Quadriciser before bed relaxes her for sleep, Moyers says, and using it daily improves how she feels emotionally.

    That was a big part of the machine's attraction for Teal Sherer, a former Lenoir City resident who's now a junior at Oglethorpe University in Atlanta. At age 14, Sherer broke her back in an automobile accident and became paralyzed. Her mother, who worked at ORNL, learned of Bohanan's Quadriciser through a co-worker. Sherer's results with the machine were so positive her mother leased-to-own a machine for her.

    Sherer said the machine kept her limbs stretched, preventing muscle spasms and blood clots. It also improved her muscle tone, which improved the way she felt about herself.

    "The machine's not going to bring back muscles that aren't going to be brought back," she said, "but it strengthened muscles I do have."

    She also thinks the machine helped her gain the confidence she needed to become fully independent, which she is today. Majoring in communications and theater, Sherer has done some acting and modeling and recently went skiing for the first time. She'd originally taken the machine with her to college but now keeps it at her mother's home because her Atlanta apartment is too small to hold it in addition to other therapeutic equipment she needs.

    "I still use it every day when I'm home," she says.

    Sherer says she hasn't been in a situation where a doctor could evaluate the effect the Quadriciser has had on her, "but I can tell," she says.

    Sherer's story is but one of dozens of testimonials Bohanan is constantly adding to his files. After seeing Bohanan demonstrate the Quadriciser at a traumatic brain injury conference in Boca Raton recently, a Florida doctor ordered three for his clinic, which works with brain-injured youth. And though Bohanan continues to show his Quadriciser to health-care facilities, his best advertising is word-of-mouth, which gets individuals interested.

    Staley of St. Mary's says he's not sure why the Quadriciser hasn't caught on more quickly, unless it's that the machine - at about $8,000 - costs considerably more than the $1,500-$2,000 facilities would pay for a stationary bike or treadmill. To be the best value, he said, the Quadriciser needs to be in a facility that sees a high population of patients with stroke, spinal cord injury or neurological disorders such as multiple sclerosis; those patients aren't that common in the outpatient sector.

    Bohanan knows the cost is prohibitive for most individuals; that's one reason he wants the Quadriciser in publicly accessible facilities. He's working to get his machine covered by Medicare and insurance, which will require more clinical trials.

    "We have all these testimonials, but we really need clinical data to validate what we're saying," he says.

    Bohanan says his wife, Pat, has been supportive of his venture - the Quadriciser that has delivered results but has not yet delivered a return on their substantial investment. An acquaintance helping with marketing starts to mention that Bohanan has been more focused on getting the Quadricisers to people who can benefit from it than on getting back what it's cost him to make them.

    "But you think about it," Bohanan interrupts, gesturing to his computer screen where the brain-damaged girl is frozen in a video clip, a tentative smile on her face. "You see these people. It's kind of hard not to."

    This article is misleading.

    This is a 'Patterning' machine, not physical exercise. Unless the user is powering the machine with their own muscles, they will not receive the cardiovascular workout that they need for a long healthy life.

    For anyone with an SCI, I question the machines ablity to restore tone and reverse muscle atrophy.



      The article is not misleading.

      I happen to know Larry Bohanan myself, and I can say that he sure is an honest guy.

      When a person is quadriplegic, obviously they cannot move. So this machine repatterns the brain signals to access to brain locations that have not been active before.

      This machine is a breakthrough.



        Originally posted by Lysimachus
        The article is not misleading.

        I happen to know Larry Bohanan myself, and I can say that he sure is an honest guy.

        When a person is quadriplegic, obviously they cannot move. So this machine repatterns the brain signals to access to brain locations that have not been active before.

        This machine is a breakthrough.

        While it may be as beneficial as Bohanan claims, it is not, technically, an "exercise machine".
        "The world will not perish for want of wonders but for want of wonder."


          How would someone get one of these ? My mother is a quad and it is almost impossible for the caregivers to move her enough to keep her limbs limber and keep her stretched out. We have found that with more movement, she has fewer muscle cramps.