Moody
Neurorehabilitation
Institute Space Center

brain injury clients in fulfilling their goals related to their physical activity and motor control. Physical Therapists and Physical Therapist Assistants evaluate and address physical limitations and functional movements (i.e., walking) by focusing on muscle strength, flexibility and balance. The physical therapy department helps to train survivors of acquired brain injury (ABI) and their families in exercise programs, gait training, mobility and balance training, safe transferring techniques and the use of assistive devices or adapative equipment that may be necessary for the client’s independent and functional living.

In other words, all of the daily activities that are a part of “the job of living.” When people are unable to perform these activities, they need help in order to succeed, either from other human beings, mechanical devices, or both. At Moody, our Occupational Therapy Department works closely with individuals and their families to achieve optimal independence. Under the direction of licensed occupational therapists, clients will participate in programs designed to increase basic motor and cognitive skills, upper body strength, mobility, and the ability to safely perform activities of daily living. In addition, individual compensatory strategies are developed to match client and family needs. Clients receive specialized training and equipment to promote independence with activities of daily living. The focus of the services is to train upper extremity function, self-care skills (e.g., showering, dressing, grooming), and advanced living skills (cooking, housekeeping, money management, mobility). The OT Department uses both simulated (i.e., virtual reality) and real-life experiences for training purposes.

Therefore, it is important that throughout the rehabilitation process, compensatory strategies and alternative methods of communication that utilize a patient’s existing capabilities are maximized and expanded upon. Our Speech and Language Pathology (SLP) Department evaluates and treats individuals with communication disorders including the ability to comprehend and express language. In addition to speech evaluations and treatment, speech language pathologists conduct swallowing evaluations and provide recommendations for meal preparation and food texture. The SLP department provides comprehensive augmentative and alternative communication (AAC) evaluations and conducts necessary treatment for individuals with persistent communication disorders.

This means more than a return to doing what they loved to do before the illness or injury. It involves the ability to live in the way the patient chooses to live without barriers. Moody Neuro fosters a patient’s growth in their new life in the community as opposed to the nuances of the medical facility where they achieved medical recovery. Therapists at Moody Neuro work with patients to develop safe, productive leisure activities to improve quality of life. New activities are learned and old activities are re-evaluated to determine the need for assistance and/or adaptive equipment. Apartment trials are provided for patients who have demonstrated independent and safe behaviors on campus. While in the apartment, these patients are expected to engage in real-life scenarios (e.g., meal preparation and clean-up) with guidance from licensed therapists.

The field of neuropsychology seeks to understand how these modifications are correlated with the brain injury, providing an informed pathway toward progress, and a most effective rehabilitation regimen. At Moody Neuro, our Neuropsychology Department contributes to client care in three important ways: (1) comprehensive neuropsychological assessment, (2) cognitive rehabilitation and (3) management of emotional and behavioral problems. Upon admission, every client participates in a detailed assessment of his/her cognitive and emotional status. This comprehensive evaluation assesses all aspects of an individual’s cognitive skills: attention, planning and organization, language, visual processing skills, motor and sensory functioning, and memory. Patient mood and personality are also assessed. The results of this evaluation provide information about the client’s cognitive strengths, which allows the interdisciplinary treatment team to develop maximally-effective treatment plans and prioritize interventions. In addition, the neuropsychology team assists the client in adjusting to his/her disability, manages undesirable behaviors, provide individual and group therapy to survivors, and conducts family therapy when necessary.

Numerous studies have demonstrated the benefit of both multidisciplinary and single service out-patient treatment for moderate to severe acquired brain injury. Results of these studies showed significant improvement in motor performance (i.e., balance, endurance, ambulation), cognition (attention, memory, information processing speed), and activities of daily living (ADL’s) following intensive outpatient therapy. Improvements in motor, cognitive, and daily living skills were shown to significantly decrease function dependence and promote community integration. Patients receiving out-patient services meet the same admission criteria as those receiving comprehensive residential treatment. Those criteria include: primary diagnosis of acquired brain injury (i.e., traumatic brain injury, stroke, anoxic and other encephalopathies, brain tumor, etc.); 16 years of age or older (younger adolescents are considered on a case by case basis); ability to participate in and benefit from up to 5-6 hours of skilled therapy per day; the patient is medically stable (i.e., the patient does not require 24-hour skilled nursing care); the patient is self-preserving (i.e., not a danger to self or others); and the patient has been free from chemical substances (i.e., “clean & sober”) for 30 consecutive days. Generally, patients must be 16 years of age or older to participate in the out-patient programs. Moody Neuro PABI programs typically serve 1-2 adolescents per year. 2. Occasionally, Moody Neuro will provide outpatient services to patients that have co-occurring limb loss, spinal cord injury (SCI) or have a SCI without acquired brain injury. In order to participate in rehabilitation programming, it is necessary for brain injury patients with co-occurring SCI or SCI only to have some use of their hands for mobility, ADL’s performance and bowel and bladder care. Patients with incomplete spinal cord injuries at the C 5-6 level, who have sensory and motor function preserved below the neurological level of injury with more than half of key muscles having a grade of 3 (active movement against gravity), and the potential for recovery of function, are appropriate for admission. Patients with complete spinal cord injuries at or below the T-1 level are appropriate for admission. 3. During the 2018-19 fiscal year, Moody Neuro Galveston did not serve any SCI patients in the out-patient setting. Moody Neuro Lubbock program served three (3) patients with SCI in the out-patient setting. 4. Additionally, Moody Neuro out-patient programs will consider accepting patients with portable nasal cannula oxygen on a case-by-case basis. A patient may transition from the Residential PABI program to the Outpatient program if the patient has made progress enough to live supported in their own home environment, the clinical teams deems it appropriate and if the funding source permits.

During their time at Moody Neuro, we strive to provide the highest-quality patient experience to the patient as well as peace of mind for their loved ones. Residential therapies encompass a wide array of activities each aimed a maintaining the comfort of patients while encouraging continued progress. Our Residential Department provides a full range of residential services for survivors of brain injury. They offer: round-the-clock supervision; observation and documentation of behaviors; assisting with activities of daily living (ADLs); ensuring the safety and security of clients; implementing treatment techniques; following therapist recommendations related to cognitive, behavioral, and physical limitations; assisting with toileting, feeding, and personal hygiene; providing feedback on the application of recommendations; aiding clients in attending scheduled therapy sessions and appointments; and assisting with the adjustment to a residential rehabilitation treatment setting.

Assistive technology includes any device utilized by an individual with a disability to maximize independence and allow for maximum community reintegration. For brain injury survivors, assistive technology can be as simple and low-tech as a spiral notebook to help with organization and memory, or as sophisticated as a computer-powered vocal assistant to aid with communication. The following innovative technologies complement the talents of our human staff, furthering our rehabilitation capabilities and value to the patient. LOCOMAT® The world’s leading robotic medical device, the Locomat provides highly intensive rehabilitation to increase the strength of muscles and the range of motion of joints in order to improve walking. BIONIK INMOTION ROBOTIC ARM InMotion Interactive Therapy enables clinicians to efficiently deliver intensive motor therapy to help patients regain motor function following a neurological condition or injury. This new generation InMotion ARM is an evidence-based neurorehabilitation technology that provides patients with real-time Assistance-as-Needed™. The InMotion ARM quietly monitors the patient’s movements during therapy while it gently assists where needed to help them complete various motor therapy activities. MOVEO XP The Moveo XP is a weight bearing exercise platform for patients who need full body weight support in order to be able to exercise and participate in the rehabilitation process. It is ideal for patients with conditions such as: lower extremity weaknesses, poor postural control, poor muscle control, and decreased lower extremity range of motion.MYRO BY TYRMOTION The Myro is a touch and pressure sensitive screen that provides bio feedback to therapist and patient alike. Utilizing a variety of attachments to target different grips and movements while also using interactive screen activities to test cognition and visual acuity. DRIVING SIMULATOR Our driving simulator allows patients to test the necessary skills to drive without risking safety. With multiple settings including traffic, day vs night and rural vs urban driving it is possible to simulate a variety of real world situations. We also have adaptions to allow those without use of lower extremities to use hand control for acceleration and break BIONESS L300GO AND H200 The L300 go utilizes FES (functional electrical stimulation) to improve thigh weakness and foot drop to allow patients improved independence and functional mobility. It can be worn throughout the day allowing movement withoutwires. The H200 Wireless Hand Rehabilitation System is an easy-tooperate system that helps the patient achieve recovery goals. Reaching, grasping, opening and closing the hand are all possible in a functional capacity using this device ZeroG The ZeroG Gait and Balance system is a robotic body-weight support system attached to a motorized trolley that rides along a ceiling-mounted track to help patients regain the ability to walk and maintain balance. When patients use ZeroG, they are safe and cannot fall, yet can be challenged as they progress. Activities such as walking up steps, getting off the floor, or navigating rough terrain are real-life demands that patients can practice with the ZeroG.