PoNS Therapy™ for Balance and Walking Deficit from mmTBI

At Propel Physiotherapy, we are using PoNS™ in conjunction with physiotherapy to treat balance and walking deficits with clients with mild to moderate traumatic brain injury.

PoNS™ (short for Portable Neuromodulation Stimulator) is an innovative, non-surgical medical device that gently stimulates the surface of the tongue, exciting the neural networks flowing to the brain. This neural activity is believed to enable neuroplasticity – the ability of the brain to make adaptive changes related to the structure and function of the nervous system – which may restore lost function.

We have a long history working with clients with traumatic brain injuries including, concussion, post-concussion syndrome, moderate and severe traumatic brain injury. We have access to many evidence-based treatment tools and techniques that we use with our clientele during their path to recovery – body weight support treadmill training (BWSTT), robotic assisted gait training (RAGT), Bobath normal movement, Brainfx neurofunctional screen and Functional Electrical Stimulation (FES).

Traumatic acquired brain injuries are caused by something that comes from outside the body, such as motor vehicle accidents, falls, assaults, gunshot wounds, domestic violence and sports injuries. It can result in temporary injury, or more serious, long-term damage to brain cells.

Approximately 1.5 million people in Canada are living with a brain injury.
Statistics indicate that 100,000 Canadians will experience a brain injury each year.
In Canada, the annual cost of ABI has been estimated at $3 billion, with $1 billion in Ontario alone. (Brain injury association of Canada)

How Does PoNS™ Work?

It is theorized that this treatment acts as “priming” of the nervous system for information to move or flow. After a traumatic brain injury there can be damage to parts of the brain that are difficult to image or see, particularly white matter tracts. These are pathways that transfer information between different areas of the brain. Used in conjunction with targeted therapy this can be a powerful tool to improve function including walking and balance.

In two clinical trials, 165 patients with chronic balance deficits due to mild-to-moderate traumatic brain injury (mmTBI, including concussion and post-concussive syndrome), used the PoNS™ device in conjunction with targeted physical therapy [1,2]. Patients showed meaningful improvements in their gait and walking endurance, which they maintained after the 12-week withdrawal of treatment [1,2].

Neurostimulation combined with physiotherapy can potentially affect rehabilitation outcomes [3,4,5] and non-invasive brain stimulation can affect neural excitability and may facilitate motor skill learning [6]. Cranial nerves V and VII in the tongue and associated neural projections in the brain can be stimulated through non-invasive translingual neurostimulation [7].

Authorized PoNS Therapy™ Clinic

At Propel Physiotherapy, we are an authorized PoNS Therapy™ clinic and are excited to use this cutting-edge technology along with our other methods for the treatment of mild to moderate traumatic brain injuries.

We have built our practice around the treatment of complex neurological injuries such as traumatic brain injury. Our skilled professionals have training and experience working with those who have suffered a brain injury and addressing the chronic conditions and complications that follow.

The PoNS Therapy™ is a comprehensive 14-week program that combines both in-clinic and in-home use of the device. After a comprehensive assessment and baseline measures the program is tailored to meet the goals of each client. Components include targeted balance exercises, movement control exercises, breathing awareness and gait training. The stimulation coupled with the intensive individualized program has been shown to significantly improve functional outcomes around balance and mobility.

Propel Physiotherapy is an industry leader in neurological disorder and brain injury treatment. If you are interested in learning more about our treatment of mild to moderate traumatic brain injury using the PoNS Therapy™ please call us at 416 621-2506 to book a complimentary consultation to address any questions you may have.

References

[1] Helius Medical Technologies. Data on File. 2019 Post Hoc Analysis – Long Term Treatment Trial – Responder rate – Pharma Data Associates

[2]Tyler, et al. Arch Res Rehabil Clin Transl. 2019; 1(3-4):10026.

[3] Bolognini, A. Pascual-Leone, F. Fregni, Using non-invasive brain stimulation to augment motor training-induced plasticity J Neuroeng Rehabil, 6 (2009), p. 8

[4] A. Kemler, et al. The effect of spinal cord stimulation in patients with chronic reflex sympathetic dystrophy: two years’ follow-up of the randomized controlled trial Ann Neurol, 55 (2004), pp. 13-18

[5] M. Vaziri, et al. Low frequency repetitive transcranial magnetic stimulation to improve motor function and grip force of upper limbs of patients with hemiplegia, Iran Red Crescent Med J, 16 (2014), p. e13579

[6] Li, A.L. Zaninotto, I.S. Neville, W.S. Paiva, D. Nunn, F. Fregni. Clinical utility of brain stimulation modalities following traumatic brain injury: current evidence. Neuropsychiatr Dis Treat, 11 (2015), pp. 1573-1586

[7] Danilov, D. Paltin. Translingual Neurostimulation (TLNS): a novel approach to neurorehabilitation. Phys Med Rehabil Int, 4 (2017), p. 1117

Written by

Kyle WhaleyRegistered Physiotherapist & Clinic Director

Kyle’s passion for helping people move forward with their recovery inspired him to launch Propel Physiotherapy. Kyle and his colleagues use a holistic approach that emphasizes client-centered treatment, research, education, community engagement.

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Please select an available time slot and complete the contact form to book a 15-minute consultation with registered physiotherapist Kyle Whaley. Find out if PoNS Therapy™ is right for you.