“Show me your best model walk,” my friend Lizzie calls out as we saunter down Amsterdam Ave, walking off a particularly delectable Italian dinner in the Upper West Side of Manhattan. I strut ahead of her and then turn around to strike a pose. “Gorgeous! She’s a natural,” Lizzie laughs.

On September 9, 2024, I will embark on one of my more frightening endeavors to date: walking the runway for New York Fashion Week. I am thrilled to represent the disability community and walk for Runway of Dreams, a nonprofit dedicated to empowering people with disabilities to engage in self-expression through beauty and fashion, often through the use of adaptive clothing. The organization’s strong commitment to disability inclusion is what attracted me to the opportunity. Representation in the industry is important, and I hope to play my own small part by modeling during NYFW, to show that people with disabilities are beautiful and deserve representation. We want to see more models that look like us, celebrating all abilities, races, ages, and genders. The future is inclusive.

While modeling in a big fashion show certainly feels like a dream come true, it is no less daunting. As a fashion-conscious stroke survivor with foot drop myself, I’m always looking for ways to express myself through the clothes I wear, and that includes how I style my mobility devices. In preparation to walk the runway, I decided to consult our CIONIC community for the best tips on how everyone wears and styles their Neural Sleeves.

Blanca:

Blanca is a member of the CIONIC community in Colorado living with MS. She wears the Neural Sleeve on her left side due to severe weakness in her leg and hip. The Sleeve enables her to ambulate short distances and climb the stairs in her home. “Even though I’m disabled I still want my style to remain and improve,” she tells me. Blanca will often match her sapphire-blue Neural Sleeve with the color of her clothes, cane, or handbag. “My style is my way of being, my way of expressing myself. I love art in all its forms,” Blanca says.

She loves wearing her Sleeve with dresses or shorts to stand out, and will often plan her outfits to match her Neural Sleeve before getting dressed in the morning. “Put the Sleeve on the bed with clothes you want to wear to see how it looks first, with your accessories,” she advises. “It’s easier to visualize how it will look, a certain outfit.”

Bridget:

“I used to be an athlete and this (diagnosis) has been hard, but with CIONIC it’s so much better,” CIONIC community member Bridget tells me. Bridget has PPMS and the Neural Sleeve helps her foot drop and enables her to exercise on the Peloton. She loves cycling and tends to dress in comfortable athleticwear with her Sleeve. She even took her leggings to Lululemon, where they hemmed them to fit around her Neural Sleeve, free of cost. “What’s great is it totally fits snugly enough over the top of the sleeve that it keeps it in place,” she says.

Rose:

Rose has MS and foot drop, and has been wearing the Neural Sleeve since October 2023. She loves that she no longer has to wear her AFO, and feels that she has more energy when wearing the Neural Sleeve.”Put on the Sleeve first and calibrate it before getting fully dressed,” is her biggest piece of advice. Once the Sleeve is on and the settings are dialed in, Rose continues getting dressed, usually in skorts or wide leg pants which are both fashionable and functional.

Amy:

Amy is a retired kindergarten teacher living between Akron and Columbus, Ohio. She has been diagnosed with MS for the past twelve years and since she started wearing the Neural Sleeve she has seen dramatic improvements in her mobility. She wears her Sleeve to help her carry out the activities of daily living, like walking, shopping, and doing physical therapy exercises.

“For me it’s all about coolness and comfort,” Amy tells me. Cooling tanks and shorts are a staple in her wardrobe, and she wears them with her Sleeve on all day long. “Be patient with your body and with the Sleeve,” she advises. “It’s an aid, not a cure, so (that) we can keep living life on our terms.” Amy shares that she sometimes switches the placement of the Sleeve on her leg 3–4 times per day. But when she gets it right, the Sleeve greatly enables her to live her life, mitigating the fall risk. As a matter of fact, Amy will be wearing her Neural Sleeve to walk down the aisle when she marries the love of her life in October. Congratulations Amy and we can’t wait to see you rock your Neural Sleeve on your big day!

How do YOU wear your Neural Sleeve?

Which brands — adaptive clothing brands or otherwise — are your favorite? How do you like to style your Neural Sleeve? We love getting inspired by our community, so please send us all of your styling tips!

Function Meets Fashion: From Bionic Clothing to Adaptive Clothing on the Runway and in Real Life was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.

Christine Gregory is a teacher, a deacon, a mother of four, and a grandmother of 15. She is passionate about her life and work, and an active member of her community. In December 2022, just after Christmas, Christine’s world was turned upside down. While running errands in her car, she was struck by a drunk driver. The impact was severe, causing significant injuries to her spinal cord, particularly around the sacral spine nerves. Despite there being no bone injuries, the extensive swelling caused a devastating spinal cord injury, leaving her unable to feel or move from the waist down and in need of intensive spinal cord injury rehab.

The Road to Recovery: A Story of Hope

The initial days after the accident were incredibly challenging. She couldn’t feel or move her legs, and the prognosis was uncertain. After a month, she began to regain sensation and movement in her right leg, but her left leg wasn’t responding in the same way. However, Christine wasn’t one to give up.

She spent the spring of 2023 undergoing extensive physical therapy, where she engaged in passive exercises to encourage movement in her left leg. For months, Christine’s left leg remained unresponsive, with only minimal muscle contraction, not enough to stand or walk independently. The leg would often give out, or she would lose control of it entirely.

Her spinal cord injury rehab journey was long and arduous, taking her out of teaching for the entire spring semester of 2023. Slowly, she began to make progress, driven by personal determination, and aided by the skilled hands of her doctors and therapists. She feels that the combination of modern medicine integrated with recent advances in technology is nothing short of a miracle.

A Miraculous Return to the Classroom

In July of 2023, Christine was ready to return to teaching, but this time, in a wheelchair. It was a significant adjustment, but her love for teaching and her students propelled her forward, in spite of some of the challenges she experienced.

The summer of 2024 brought about a remarkable transformation. Christine had spent the break working tirelessly on her rehabilitation and learning to walk again, a period she refers to as her “Jaime Sommers Summer,” inspired by the fictional bionic woman known for overcoming great physical challenges. When she returned to the faculty gathering before school started, there were tears of joy as she shared her progress, walking at the event in front of some of her colleagues for the first time since the accident.

Now, school is back in session for the 2024–2025 school year, and Christine Christine no longer uses her wheelchair for all mobility. Instead, she leaves her wheelchair at the school and walks in and out herself every day. It’s a large campus and the distance from her classroom to the office is a half-mile, so she switches between walking and using her wheelchair for mobility. She can also now stand up in front of the classroom, write on the board independently, and greet her students at the door.

The Game-Changer: Cionic Neural Sleeve

Christine’s progress has been incredible, and the tool she used to return to walking during her “Jaime Sommers Summer” is the Cionic Neural Sleeve. She first heard about it from one of the physical therapists she worked with during spinal cord injury rehab, who thought it might be beneficial. Christine did some research and saw that the Neural Sleeve provided functional electrical stimulation for foot drop, which could be effective at restoring mobility for individuals with spinal cord injuries, such as herself. Christine was willing to try anything that might help her walk again, and her neurologist agreed that it was worth a try.

The Neural Sleeve proved to be a game-changer for Christine. From the moment she began using it, Christine noticed a significant improvement in her ability to lift her foot and bend her knee — movements that had eluded her for over a year and a half. The device’s stimulation helped bring all the mechanical pieces back together, enabling her to walk independently with a crutch for balance.

During her initial onboarding with Alex, her Mobility Specialist, she saw the transformation in her gait immediately. They worked together to build up an exercise program as she started moving and standing again. After a year and a half without walking, Christine had experienced muscle atrophy, so she ramped up, increasing use over time as she rebuilt the muscles.

Building Strength and Independence

CIONIC technology offers a range of programs to support different mobility needs. Christine’s current walking program is known as “Step To,” which supports a gait pattern where the foot that swings forward first is then met by the other foot, unlike a “step through” gait pattern where one foot goes in front of the other. Christine’s ultimate goal is to progress to a program designed for a “step through” gait pattern, which includes algorithms and stimulation for climbing stairs.

In addition to her walking program, Christine engages in in-app exercises that are part of the Neural Sleeve’s comprehensive rehabilitation approach. Her favorites include Toe Raises and Knee Extension, both of which help strengthen her muscles and improve her walking ability. She’s noticed that when she’s not wearing the Neural Sleeve, her calf muscles have become more defined, counteracting the disuse atrophy she had been battling.

An Ongoing Journey of Faith and Resilience

Christine’s story is one of incredible resilience and faith. From the difficult moments after her accident to the joy of walking again, she has shown that with determination, support, and the right tools, recovery is possible. Her students, colleagues, and family have rallied around her to support her journey, rooting for her every step of the way. In the classroom, at home, and in her community, Christine stands as a beacon of hope, a reminder that even in the face of overwhelming challenges, the human spirit is capable of remarkable resilience.

From Wheelchair to Walking: Christine’s Inspiring Spinal Cord Injury Rehab was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.

There is quite possibly nothing more alarming and disorienting than waking up in the ICU after an emergency surgery with absolutely no idea where you are and what happened. Unfortunately for me, this was my reality upon waking up from a brain surgery following an AVM rupture in late May of 2017. Put simply, this is suboptimal, I remember thinking. I went for a run the other day and now suddenly I can’t move at all — where do we go from here?

Bouncing back from the devastating stroke that nearly took my life has been no walk in the park. Throughout my own journey with recovery, community has been everything. Connecting with others has helped me to better understand that we are not alone nor do we have to go through a traumatic experience in isolation. It wasn’t until I opened myself up to connecting with other survivors that I realized the power and impact a bond with others who understand can have.

I am thrilled to continue connecting with others by joining the CIONIC team as Community Engagement and Advocacy Manager! Previously I worked as a reinsurance underwriter and most recently as a client relations specialist in the luxury fashion industry. I authored a book on my stroke recovery journey, and have spent the past five years building community through my Instagram, @maddistrokeofluck. I enjoy sharing my journey on the power of mindset and turning obstacles into opportunities, and have spoken at various schools to physical and occupational therapy students, support groups, and even at the World Health Organization in Geneva last year!

One of my greatest joys pre and post-stroke is travel, and in May of 2024, I hosted a trip to Bali for my community. I brought together a group of survivors to experience the beautiful temples, Monkey Forests, and pristine beaches. This trip to Southeast Asia was a fantastic opportunity to further build and connect with my stroke community.

As a hemiplegic stroke survivor, I suffer from foot drop, and I actually wear the Neural Sleeve myself on my daily journey to hit 10,000 steps!

I am eager to build on my advocacy experience by joining the CIONIC team. I can’t wait to meet everyone and share the joy of mobility with our community. Step by step, it keeps getting better. Onward!

It Just Keeps Getting Better was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.

We recently observed Stroke Awareness Month, so here at CIONIC, we wanted to discuss a relevant topic: walking after surviving a stroke. As you might imagine, we feel very passionately about one’s ability to walk — especially for individuals with a mobility difference precipitated by a diagnosis like a stroke. Mobility is important not only for maintaining independence, but also for empowering us all to show up for our communities, families, and friends. While walking after a stroke will likely look different than it did before, it doesn’t mean that one can’t show up with intention and attention to the world around them with maximized mobility.

Walking after a stroke: the role of rehab

If you or someone you know suffered a stroke, treatment will begin with rehabilitation. Fortunately, we live in an age where information and resources are at our fingertips, making rehabilitation more accessible than ever before. Rehabilitation is crucial to maximizing mobility following a stroke and is the gateway for other benefits like assistive devices (walkers, ankle-foot orthoses and other braces, FES devices like the Cionic Neural Sleeve, etc.), home modifications, support groups, and list goes on!

During rehabilitation, as many as three different types of therapies may be included — physical therapy, occupational therapy, and speech therapy. While gait (or walking) training typically occurs in physical therapy, therapeutic techniques implemented in occupational therapy and speech therapy help to facilitate walking as well.

For example, playing games or performing activities in occupational or speech therapy that encourage engagement with both hemispheres of the brain can be very meaningful to one’s coordination (see this research article for a bit more information!).

Activities of daily living performed with an occupational therapist help to promote balance and core strength, both of which are necessary building blocks for walking. Bottom line, we do many things every day that can help promote walking, and all of the therapies received can be considered precursors to increased mobility.

Pre-gait activities in the early stages of stroke rehabilitation

Physical Therapists will help to initiate “pre-gait activities” which include strengthening of the legs, transfer training (how you get from one place to another), balance exercises, coordination activities, core strengthening, spasticity management, prosthetics and brace fittings, and assistive device selection and fitting.

See below for a few examples of pre-gait exercises that should be conducted under the supervision of a therapist or trainer. Once these tasks are completed or underway, gait training can begin.

Sit to Stands:

Sit to Stands are an essential functional exercise that helps with getting out of a chair, transferring, and so much more. If you have a Neural Sleeve, you can perform Sit to Stands in the CIONIC App with the support of the stimulation.

• Seated in a stable, firm-backed chair with arms, scoot to the edge of the seat
• Place hand(s) on the armrest
• Lean forward
• Push through the legs and arm(s) to stand
• Transfer hand(s) to assistive device

Romberg (test and exercise!):

This is a dynamic and highly modifiable exercise designed to assess challenges with balance and proprioception.

• Stand in a corner with arms down at the side or crossed over the chest
• Stand with your feet together, or slightly apart depending on balance
• The eyes can remain open or closed depending on balancing ability
• Hold the position for a predetermined amount of time or as long as possible, depending on the goal (test vs exercise)

Balloon Volleyball:

This exercise is used in therapy to challenge balance and coordination — both of which are important for walking safely!

• With a gait belt and additional helper to provide stability and assistance as needed, stand in front of a stable chair
• If relevant, your assistive device should be positioned in front, within reach
• As the therapist taps the balloon toward their patient, the patient will reach out of their base of support to challenge their balance and tap the balloon back with one or both hands
• Sit down or reach for your assistive device as needed to recover balance

Standing Marches:

This exercise helps to re-train the hemispheres of your brain by mimicking the reciprocal movement executed during walking while helping to strengthen the muscles in your legs!

Variation 1

• While holding an assistive device, shift weight toward involved/weaker side and lift opposite leg
• Repeat to focus on weight shifting, with assistance stabilizing the weight-bearing side as needed
• A low box can be included to place the lifted foot on to mimic a “step-up” — if you have a Neural Sleeve and can safely perform standing exercises, the new Step Ups functional exercise protocol will help with this!

Variation 2

• While holding an assistive device, shift weight toward involved/weaker side and lift opposite leg
• Alternate and shift weight toward uninvolved/stronger side, lift opposite leg
• Even if the foot is not lifted very high, this is a great activity to focus on and can be done with assistance lifting the leg and foot as needed

Gait training to promote walking after a stroke

Gait training is actually much less complex — though still challenging — than pre-gait training because the main activity is walking! Tasks, distance, assistive devices (popular assistive devices following a stroke are hemi-walkers and quad canes), and assist level will vary greatly from person to person.

Depending on the severity, not everyone will be able to walk again after having a stroke. In these cases, therapists will work with their patients to maximize mobility and increase independence.

The goal of gait training is to enable someone to walk as much as possible, with the least cumbersome assistive device and braces possible, while still being safe. A question we often receive at CIONIC is: “Will I be able to stop using my walker/cane?” And the answer is always, “That is up to you and your therapist because we want you to be safe”.

A therapist will most likely place a belt around their patient to hold onto to help provide stability and security, and may decide to schedule therapy during a time when another therapist or aide is available to assist in keeping the patient safe by following with a wheelchair, helping to advance a foot, stabilizing an arm on an assistive device, or — with patients with higher levels of mobility — challenging their balance while they are walking.

The therapists will set short-term and long-term goals for each patient and create a treatment plan to reach those goals — a patient’s input is very valuable here as the entire team wants to focus on what is important to each patient and what their goals are.

Challenges of relearning how to walk

Relearning how to walk after a stroke is not easy. It requires patience, determination, and resilience. There may be moments of frustration and setbacks along the way, but it’s essential to stay focused on the ultimate goal of maximizing mobility.

Challenges individuals may face during walking rehabilitation include:

• Muscle weakness and stiffness: Weakness in the affected limbs and stiffness in the muscles can make it difficult to initiate and sustain movement.
• Balance and coordination deficits: Impaired balance and coordination increase the risk of falls and may require intensive training to address.
• Fear of falling: A fear of falling can hinder progress and lead to decreased confidence in walking independently.
• Fatigue: Stroke survivors often experience fatigue, which can impact their ability to participate fully in rehabilitation activities.
• Cognitive impairments: Some individuals may struggle with attention, memory, or problem-solving skills, which can affect their ability to follow instructions and engage in therapy.

Despite these challenges, significant progress is possible. With the support of rehabilitation professionals, family members, and friends, individuals can overcome obstacles and make significant strides in their recovery journey.

Additional treatment options and assistive devices for stroke survivors

Treatment plans for someone who has had a stroke might also include modalities like functional electrical stimulation to help activate and educate the muscles weakened by a stroke, alongside strength, balance, and gait training.

The Cionic Neural Sleeve is an assist device for individuals who have had a stroke. It uses functional electrical stimulation during the gait cycle to promote strength, neuroplasticity, neuromuscular re-education, sequencing of muscle contractions, and cueing for the brain all while the user is walking. This technology is particularly beneficial for those who have incurred foot drop from a stroke or other lower extremity weakness that impacts their walking ability.

If you are interested in learning more about the Cionic Neural Sleeve and seeing if it could be a fit for you and your mobility, head to cionic.com/assessment to answer a few questions. Please be ready with an assistant and a tape measure to provide some measurements and don’t hesitate to reach out to us at support@cionic.com with any questions you might have! Our team is full of highly qualified mobility experts waiting to assist you.

Written by:

Raina Adkins, MPH, PT-A

CIONIC Mobility Specialist

Walking After Stroke: The Role of Rehab, Gait Training, & Assistive Devices was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.

Meet Blanca. Originally from Venezuela, she’s called the United States home for the last eight years. In May of 2018, her life took an unexpected turn. She was diagnosed with multiple sclerosis. This blog is a heartfelt account of her experiences — from the initial shock of her diagnosis to the challenges of living with a disability, chronic pain, and the triumphs along the way. Here is her story.

How it all started: denial

“I first noticed something was wrong while at work. My right eye hurt when I moved it in various directions, but I brushed it off as stress or a headache. Ignoring the symptoms, my husband and I went on vacation to Miami, immersing ourselves in the festive atmosphere. However, my blurry vision persisted, culminating in a clumsy incident at a mall. Concerned, my husband urged me to see a doctor upon our return to Colorado.

The eye doctor mentioned multiple sclerosis, which was unfamiliar to me. A series of tests followed, leaving me anxious and frustrated. Eventually, an MRI confirmed the diagnosis. I was in denial, clinging to the hope that it was just a passing issue. Yet, reality hit hard when the neurologist confirmed the diagnosis and prescribed medication. My husband’s unwavering support was my anchor during this tumultuous time.

Desperation, anger, and depression: navigating the unknown

Receiving the medication — steroids for inflammation — marked the beginning of a challenging phase. Daily intravenous injections, coupled with the emotional toll, tested my resilience. Chronic pain became a constant companion, and confusion set in as my life took unexpected turns.

Steroids brought some relief, but not everything returned to normal. Despite physical therapy, I faced lingering pain, mobility issues, and a relentless quest for answers. The journey involved missteps, multiple doctor visits, and the introduction of mobility aids like canes, wheelchairs, and bionic clothing.

Amid desperation and anger, a pain doctor diagnosed “foot drop,” a common symptom of MS. Custom braces, PRP injections, and the disruptions caused by the pandemic added layers to the struggle. The relentless pursuit of normalcy, fueled by external opinions and expectations, only intensified the pain.

The new me: inspiration, acceptance, and self-love

Amid the chaos, a turning point came when I stumbled upon the inspiring stories of other young women embracing their disabilities. Observing them sparked my journey towards acceptance, self-love, and a passion for adaptive fashion, which has become a powerful tool in boosting my confidence and embracing my body.

Discovering clothing that accommodates my needs without sacrificing style has empowered me, transforming how I perceive my disability. This newfound confidence has led me to explore modeling, showcasing the beauty and strength that come with embracing one’s unique self.

Through my experiences, I aim to inspire other young people with disabilities, encouraging them to see adaptive fashion not just as a necessity but also as a way to express their individuality and feel empowered in their skin.

My new goal isn’t to revert to who I was before MS but to find peace amidst the pain and disability. Embracing self-love, listening to my body, and moving mindfully are now my priorities.

This journey, though challenging, has revealed a stronger, more resilient version of myself.

Finding what works for me: The Cionic Neural Sleeve

Though I have found acceptance and embraced self-love in my MS journey, it is not without walking difficulties and pain. In addition to improving my mental outlook with my diagnosis, I was also researching devices and aids to improve my overall quality of life with MS.

My new doctor recommended the Cionic Neural Sleeve. Intrigued by its concept and purpose, I decided to apply for one to assist my left leg. Enrolling was very straightforward — my doctor provided a prescription, and CIONIC sent me the sleeve. The setup was conducted online, and the entire process was efficient and convenient. When I tried it, I noticed a remarkable improvement in my walking pace and the movement of my left leg, significantly different from other devices I had used.

The sleeve stimulates the weak muscles in my left quad, hamstring, shin, and calf, enabling them to move naturally. I can adjust the intensity based on how my leg feels each day. This has allowed me to walk more steps than before, enhancing my independence both at home and outdoors.

Additionally, my gait appears more natural, which has reduced the strain on my lower back muscles and bones. Overall, my daily lower back pain has significantly decreased thanks to the Neural Sleeve.

Join me on this journey

Through sharing my journey, I aim to connect with individuals facing similar challenges, offering inspiration, acceptance, and self-love to our wonderful disabled and MS communities. Let’s share our stories, support one another, and celebrate the strength that comes from embracing our unique journeys. Together, we can find beauty in resilience and redefine what it means to thrive with grace.

Join me as I continue to navigate life with MS, chronic pain, and a newfound appreciation for the strength within us all.”

Thank you, Blanca, for sharing your story. Use code QQNN for $50 off your Neural Sleeve.

Individual results and experiences may vary. Consult with your doctor on treatment decisions.

CIONIC Stories: Blanca on Multiple Sclerosis, Disability, and Self-Love was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.

At CIONIC, we are committed to helping our customers improve their mobility. In addition to creating a range of protocols that target activities like walking and stationary cycling, we have developed a library of exercises targeting the major muscle groups of the leg, designed to improve strength and conditioning for the muscles and movement patterns essential to gait.

With the latest software release 1.16, we are excited to release four new functional exercises: Squats, Sit-to-Stand, Step Ups, Swing Ups. These new exercises have been some of the most frequently requested by the community!

What is functional exercise?

The Mayo Clinic defines functional exercises as exercises that “train your muscles to work together and prepare them for daily tasks by simulating common movements you might do at home, at work or in sports…By training your muscles to work the way they do in everyday tasks, you prepare your body to move efficiently in a variety of common situations,” [cit].

While traditional exercise focuses primarily on improving strength or endurance, functional exercise emphasizes movements and tasks that mimic real-life activities, such as walking, reaching, or standing up from a chair. Functional exercise is crucial for people with neurologic conditions, in particular, because it directly targets the activities of daily living (ADLs) that may be compromised due to the diagnosis.

What are some benefits of functional exercise?

Research has demonstrated numerous benefits to a fitness regimen that incorporates functional exercises. Functional exercise can:

• Improve Independence: Functional exercises are designed to enhance the specific movements needed for daily tasks. By practicing these movements, individuals with neurological conditions can regain or maintain their ability to perform activities such as dressing, cooking, or using the bathroom independently, thereby improving their quality of life and reducing reliance on caregivers.
• Enhance Mobility and Balance: Many neurological conditions affect mobility and balance, making simple tasks like walking or standing challenging. Functional exercises target these areas, improving muscle strength, coordination, and proprioception (awareness of body position), which are essential for maintaining balance and mobility.
• Promote Neuroplasticity: Functional exercises engage multiple muscle groups and stimulate various sensory inputs, which can promote neuroplasticity — the brain’s ability to reorganize and form new neural connections. This is particularly important for individuals with neurological conditions, as it can help compensate for damaged or impaired areas of the brain and improve motor function.
• Reduce Fall Risk: Falls are a significant concern for individuals with neurological conditions due to balance and gait impairments. Functional exercises that target balance, coordination, and reaction time can help reduce the risk of falls by improving stability and confidence in movement.
• Be Tailored to Individual Needs: Functional exercises can be tailored to each individual’s specific abilities and goals, making them accessible and effective for people at all levels of ability.

How do I get the exercises?

The first step in getting the new exercises is confirming you have the latest version of the CIONIC App. If you haven’t already, visit the Apple App Store or Google Play Store to confirm you have the latest software for your Neural Sleeve. Once you have the latest app, upgrade the firmware as well.

We’ll host a live Q&A where we’ll talk in greater depth about the new features of 1.16, including a demo of these new exercises, on May 8. Once that training session is complete, the exercises will get rolled out to all active CIONIC subscribers with an assigned gait protocol. Note that if you are an exercise-only customer and you would like to enable these exercises, just contact your Mobility Specialist or support@cionic.com.

If you are unfamiliar with any clinical terms referenced in this article, you can read our glossary of terms found at the bottom of this article. Otherwise, here’s a guide to our new exercises.

Sit-to-Stand

This exercise addresses a movement that is essential to so many aspects of our lives. Transitioning from a seated to standing position, as well as the reverse, is an integral part of many different ADLs. Activities including bathing, dressing, and getting out of bed all involve this movement, as well as activities that may feel more obvious like getting out of a chair.

Before performing this exercise, be sure that you are in a stable chair on a firm surface with armrests. Also be sure that you have any assistive devices nearby, as they can and should be used as part of this protocol — or any exercise protocol that involves standing — if you use an assistive device for your mobility.

Sit-to-stands not only strengthen the quadriceps and gluteal muscles, but they also contribute to core stability.

Setting up Sit-to-Stand

Stimulation for this exercise focuses on the quadricep muscles. Use similar settings to the Knee Extension exercise protocol so you have a comfortable contraction if desired.

How to perform Sit-to-Stand

As always, we recommend watching the tutorial video accompanying the exercise program to view a live recording and description of the motion of this exercise.

• Begin seated on a firm, stable chair with armrests with your feet on the ground
• Place your hands on the armrests. Lean forward and come to a standing position
• To return to the seated position, while leaning slightly forward, reach your arms back to the armrests, and sit back down in a careful, controlled motion

Step Ups

Step Ups is a new protocol that helps practice stepping up with your more impacted leg — your Neural Sleeve leg — as the lead and stepping back down with the less impacted leg.

Setting Up Step Ups

You’ll enter settings for two muscle groups in order to perform Step Ups in the Timer Activated mode:

• Shin: use settings similar to your preferred gait protocol, or during Toe Raises, to get adequate dorsiflexion
• Quadriceps: for this muscle group, use similar settings to the Knee Extension exercise protocol so you have a comfortable contraction

Key Differences in Timer Activated vs. Biofeedback Exercise Protocol for Step Ups

• While the Timer Activated Step Ups stimulate both the shin and quadriceps, Biofeedback displays the muscle activity for the quadriceps only, though it is still important to focus on dorsiflexion during Biofeedback.

How to perform Step Ups

As always, we recommend watching the tutorial video accompanying the exercise program to view a live recording and description of the motion of this exercise.

• Stand at the bottom of a staircase with your hand on the railing
• While holding the railing, place the foot of the most impacted side on the first step focusing on maintaining your ankle dorsiflexed and toes up (Shin stimulation)
• Step up focusing on your quadricep muscles to straighten your knee and propel up (Quad stimulation)
• Bring the other, less impacted side to meet the first foot on the first step
• Step down with the less impacted side while maintaining active quadricep muscles to slowly lower yourself downward (Quad stimulation)
• Bring the more impacted side down to meet it while focusing on maintaining your ankle dorsiflexed and toes upward (Shin stimulation)

Swing Ups

Swing Ups practice stepping up with your less impacted leg — in other words, the leg without the Neural Sleeve — as the lead, and stepping down with the more impacted leg.

Setting up Swing Ups

You’ll enter settings for two muscle groups in order to perform Swing Ups:

• Shin: use settings similar to your preferred gait protocol, or during Toe Raises, to get adequate dorsiflexion
• Hamstrings: for this muscle group, use similar settings to the Knee Flexion exercise protocol so you have a comfortable contraction

Key Differences in Timer Activated vs. Biofeedback Protocol for Swing Ups

• While the Timer Activated Swing Ups stimulate both the shin and hamstrings, Biofeedback is focused entirely on the shin. During Biofeedback, only the muscle activity for the shin is displayed; however, it’s still important to focus on using the hamstrings to bend the knee when stepping up and back down.

How to Perform Swing Ups

As always, we recommend watching the tutorial video accompanying the exercise program to view a live recording and description of the motion of this exercise.

• Stand at the bottom of a staircase with your hand on the railing
• While holding the railing, place the foot of the less impacted side on the first step and step up
• Bring the other, more impacted side to meet the first foot on the first step while focusing on bending the knee to initiate the step and maintaining the ankle dorsiflexed and toes up (Hamstring and Shin stimulation)
• While holding the railing, carefully step down with the most impacted side, focusing on bending the knee to initiate the step and maintaining the ankle dorsiflexed and toes up (Hamstring and Shin stimulation)
• Bring the less impacted side down to meet it

Squats

Unlike the Sit-to-Stand exercise protocol which is primarily a functional exercise, the standing squat in the Squats protocol is a more traditional strengthening exercise, like you may do at the gym.

Setting up Squats

For Squats, you’ll want to have an active contraction in the quadriceps.

How to perform Squats

As always, we recommend watching the tutorial video accompanying the exercise program to view a live recording and description of the motion of this exercise.

• While standing next to a stable surface, place both hands firmly on the surface, keeping your feet at least shoulder-width apart
• Slowly bend your knees and press your hips back, only going back as far as you are comfortable, balanced, and safe doing so. By slowly bending your knees in the standing position, you are using your quadricep muscles to control your descent (Quadricep stimulation)
• Return to a standing position using your quadricep muscles to straighten your knees (Quadricep stimulation)

In Conclusion

The system gets smarter every time we release software and new features will always be driven by our customers. Customer feedback and suggestions have been crucial in the development of our latest updates, and we want to thank you for your continued support.

As always, if you have any feedback, suggestions, or questions, please do not hesitate to reach out to our support team by emailing support@cionic.com. Here’s to more mobility milestones!

Glossary of Terms

Muscle Contraction:
Muscle contraction refers to the activation of muscle fibers. When a muscle contracts, it generates tension, resulting in movement or the ability to resist forces. There are different types of muscle contractions, including concentric (muscle shortens), eccentric (muscle lengthens), and isometric (muscle remains the same length). Muscle contractions are responsible for various voluntary and involuntary movements in the body.

Knee Extension:
Knee extension refers to straightening or extending the knee joint, moving the lower leg away from the thigh, and increasing the angle between the two. It is the opposite movement of knee flexion. Knee extension is essential for activities such as walking, running, and standing upright.

Knee Flexion: Knee flexion refers to bending or flexing the knee joint, moving the lower leg toward the thigh, and decreasing the angle between the two. It is the opposite movement of knee extension. Knee flexion is essential for activities such as walking, running, and getting in and out of a chair.

Dorsiflexion:
Dorsiflexion is the movement of the ankle joint that brings the top of the foot closer to the shin. It involves lifting the toes and flexing the foot upward. Dorsiflexion is necessary for activities such as walking, running, and maintaining balance. It is the opposite movement of plantarflexion.

A Guide to Functional Training Exercises for Mobility in 1.16 was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.

A stroke can be a life-altering event, impacting not only physical health but also mental and emotional well-being. Survivors often face challenges in regaining strength, mobility, and independence. However, through targeted exercises and rehabilitation, many stroke patients can make significant progress in their recovery journey. In this comprehensive guide, we’ll explore a range of exercises for stroke patients to enhance overall physical and mental health.

Understanding stroke rehabilitation:

Before diving into specific exercises, it’s important to understand the principles of stroke rehabilitation. Stroke rehabilitation aims to address the physical, cognitive, and emotional impairments resulting from a stroke. It typically involves a multidisciplinary approach, including physical therapy, occupational therapy, speech therapy, and psychological support.

The rehabilitation process begins shortly after the stroke occurs, in the acute care setting. As the patient’s condition stabilizes, therapy intensifies, focusing on restoring lost functions and improving overall quality of life. Exercise plays a central role in this process, promoting neuroplasticity, muscle strength, coordination, and cardiovascular health.

Types of stroke:

It’s important to note that strokes vary in type and severity, and rehabilitation approaches may differ accordingly. Ischemic strokes, caused by a blockage in a blood vessel supplying the brain, are the most common type and often result in hemiparesis or hemiplegia (weakness or paralysis on one side of the body). Hemorrhagic strokes, caused by bleeding in the brain, pose different challenges and may require specialized rehabilitation strategies depending on the region of the brain impacted.

Always consult with your healthcare providers before performing any exercises to ensure you are able to do them safely and effectively.

Types of exercises for stroke patients:

1. Passive range of motion (ROM) exercises:

Passive ROM exercises involve gently moving the affected limbs through their full range of motion. These exercises help prevent contractures (permanent tightening of muscles, tendons, or other joint structures) and maintain joint flexibility. Caregivers or therapists typically perform passive ROM exercises in the early stages of stroke recovery.

2. Active assisted exercises:

Active assisted exercises involve the patient actively participating in moving the affected limbs with assistance from a therapist or caregivers. These exercises promote muscle activation, coordination, and motor control. Examples include assisted shoulder flexion, assisted hip and knee flexion.

3. Resistance exercises:

Resistance exercises focus on building muscle strength and endurance in the affected limbs. Initially, low-resistance exercises utilizing a resistance band or dumbbell, or even the individual’s own body weight may be prescribed.

As the patient progresses, resistance can be increased gradually to challenge the muscles further. Common strengthening exercises include bicep curls, leg presses, squats, step-ups, and push-ups.

4. Balance and coordination exercises:

Balance and coordination are often impaired after a stroke, increasing the risk of falls and injuries. Balance exercises such as standing on one leg or using a balance board help improve stability and proprioception.

Coordination exercises, such as lateral stepping or throwing and catching a ball, aim to enhance motor control and spatial awareness.

5. Cardiovascular exercises:

Cardiovascular health is essential for overall well-being and functional independence. Stroke survivors may engage in aerobic exercises such as propelling a wheelchair, walking, cycling, or swimming to improve cardiovascular fitness.

These exercises also promote circulation, which is crucial for brain healing and recovery. And with consistency, you can start to build more endurance.

6. Functional training:

Functional training involves practicing everyday activities or tasks to improve independence and quality of life. This could include activities like dressing, cooking, or stair climbing, tailored to the individual’s abilities and goals.

Functional training not only enhances physical abilities but also boosts confidence and self-esteem. As improvements are made with these types of activities, stroke survivors may feel more independent and like more active participants in their lives.

7. Mind-body exercises:

Mind-body exercises, such as yoga, tai chi, or qigong, combine physical movement with mindfulness and breathing techniques. These gentle exercises can help reduce stress, improve mood, and enhance overall well-being for stroke survivors.

Additionally, they may improve flexibility, balance, and coordination if practiced consistently.

8. Speech and swallowing exercises:

For stroke survivors with speech (dysphasia) or swallowing difficulties (dysphagia), speech therapy exercises are essential. These exercises may include tongue exercises, lip exercises, and swallowing maneuvers to strengthen muscles involved in speech and swallowing.

9. Cognitive rehabilitation:

Cognitive rehabilitation focuses on improving cognitive functions such as memory, attention, and problem-solving skills. Activities such as puzzles, memory games, and math and word exercises help stimulate neural pathways and promote cognitive recovery.

10. Psychological support:

In addition to physical exercises, stroke recovery often requires psychological support to address emotional challenges such as depression, anxiety, or frustration. Counseling, support groups, and relaxation techniques can be valuable components of stroke rehabilitation.

Conclusion:

Recovering from a stroke is a complex and often challenging journey, but with determination, a strong support system, and appropriate exercises, many stroke survivors can achieve remarkable improvements in their physical and emotional well-being.

From more passive range of motion exercises to cognitive rehabilitation and psychological support, a comprehensive approach to stroke rehabilitation addresses the diverse needs of survivors, empowering them to reclaim their strength and independence one step at a time.

Additional support for stroke survivors: FES to improve walking and range of motion

Even with a dedicated effort and consistency in completing the exercises mentioned above, many stroke survivors can still benefit from additional support to improve their walking. The Cionic Neural Sleeve is an FDA-cleared mobility device for individuals with upper motor neuron disorders, including stroke, multiple sclerosis, cerebral palsy, and incomplete spinal cord injuries.

The Cionic Neural Sleeve delivers functional electrical stimulation (FES) to not only increase strength and improve range of motion but also to promote muscle re-education.

It is the only system that:

- Target the four major muscle groups of the leg (quad, hamstring, dorsiflexors, plantar flexors)

- Combines sensing, analysis, and stimulation in a wearable garment that can be worn visibly under shorts, skirts, or dresses, or discreetly under pants

- Features software-steered current goes directly to the muscles rather than to a nerve

- Knows whether you are sitting, standing, or walking, and adjusts stimulation accordingly so you only get stimulation when you need it

- Automatically updates with every step you take, constantly adapting to your timing

- Is controlled by The Cionic App, allowing you to customize your settings and access a library of exercises

If you are interested in seeing if the Cionic Neural Sleeve is a fit for you, please take the 30-second assessment. If it is, you can place your order directly online!

The Path to Progress: A Guide to Exercises for Stroke Patients was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.

If you are part of the CIONIC community, undoubtedly you have met Jan. Her incredible story was first featured on CBS Bay Area while she was part of our original home trial, and she has been a shining light in our community ever since we first met her almost two years ago. Jan has a diagnosis of cerebral palsy, and as we think about some of the incredible individuals who have inspired the work we are doing at CIONIC, and as we acknowledge Cerebral Palsy Awareness Month this March, we had a chance to talk to Jan. As always, she was an inspiration!

It’s CP Awareness Month — what does that mean to you?

Well, it’s interesting, because the entire concept of a month to honor CP is so new to me. I’ve had this condition since birth — we’re talking 1951 — and I didn’t even know there was a month or a day until maybe last year when I first heard about it on social media.

But I do know how impactful awareness is. For example, [prominent disability rights activist] Judy Heumann was such a trailblazer, and her story is very close to mine. She was able to go to regular ed schools, and she had to fight to do that. She really worked to make a difference in such a visible, vocal way, and a political way. I know my condition also exposed a lot of kids and families to otherness. And I often had special needs kids placed in my classroom [when I was teaching], because the school district knew that I knew something of the road that those families were walking.

So what does it mean to me? I think the awareness around mobility differences has changed so dramatically in my lifetime. When I think of the way children treated me — were permitted to treat me — in elementary school, and the way that would be unconscionable and just simply not allowed today. I’m so grateful for that.

Having a month to have people focus and be aware of different conditions is a really good thing. It means that society has evolved to be so much more inclusive than it was 60, 65 years ago. You know, the children in my classroom never saw my condition. On the first day of school, sure, they might have had questions. But once they got their questions about “Mrs. G’s legs” answered, they didn’t see CP, they saw me. All it takes is getting to know a person. That’s what awareness can do — having a month to spotlight conditions represents societal evolution, to me.

As we think about awareness, what’s one thing you wish people understood or knew about having mobility differences?

I’m a whole lot more than walking differently. Every person with a difference or disability is so much more than what the world sees. Give me — the person — a minute and look past “it” — the CP. Yes, it takes me time to get to a chair and sit down. And yes, it takes me time to stand up, and it may look awkward and uncomfortable, but this is how I do it. It’s how I move, but it’s not me.

Another thing is how you offer help out in the world. In my family, everyone knows to ask ‘Can I help you?’ My husband does it all the time. I think his most used phrase to me is, “Can I help you?” and my most used phrase to him is, “Thank you.” I don’t always need help, so if I say no, then I’m grateful for the offer, but I mean it when I say no.

What are some of your guiding principles when it comes to movement?

My mother lived by four things after my dad died. She really needed to pull herself up and pull herself together. They were in their mid-fifties, and it was really hard. She’d expected to live with him for a long time. There was a lot of anguish for her. I knew she’d reached a turning point when she called me one day, and said, “I figured out, I have four rules I need to live by. I have to do four things every day: I have to do something for myself, something for someone else, something that has to get done, and something fun.”

My mother was an athlete, and she really thrived on physical exercise. So her fun was usually tennis or golf, until she was 86! After that, her ‘something fun’ became playing bridge.

I was thinking about that today, and exercise fits all four of my mother’s rules. When you have a neurological condition like mine, decades of daily exercise is a lot! But the exercise has to happen, because that’s something I can control. So I’ve decided, I need to frame it just the way my mother did: it’s something that has to happen — it just has to get done every day.

It’s also something for somebody else, because the more mobile I am, the better it is for my family and the people around me. Exercise is also something for myself, because it’s really important to me to stay as mobile as possible. And, luckily, some of the exercises I do are fun!

Looking back, would you have any words for your younger self about exercise habits?

You know what I would say to my younger self? Do something about exercise every day. Even if you phone it in a little bit, you know, and do 20 minutes instead of an hour, or half an hour instead of more than an hour. If you do something every day — even a little something — it’s so much better.

You have been using a Neural Sleeve for almost two years now, and recently transitioned from a single sleeve to two sleeves. How is that going?

With two Sleeves, there’s definitely a learning curve. What I’ve learned is that my right leg needs more support than I expected. So that was a big mental shift for me. It’s training me to walk in a whole new way. I do feel more balanced wearing two sleeves. It’s easier and it’s challenging.

For me, mobility requires work. It’s not automatic — nothing is automatic — but [with the sleeve] it’s MORE automatic. There’s a bigger carryover for me. That has been the biggest breakthrough. I’m noticing my sleeveless gait is better than it’s been for a very long time, and my gait with my sleeves on is good.

Wearing Neural Sleeves makes my gait easier, more natural, and less labored. I feel supported.

Are there any recent moments or milestones with the Sleeve?

Yes! I recently went to a museum with my husband. The experience of being able to stand up and appreciate art — to see the exhibit at eye-level rather than being in a wheelchair — is wonderful.

I also spent several hours recently at a very large shopping mall, walking with my husband. Being able to look around and navigate crowds of people in all kinds of situations still amazes me. Wearing Neural Sleeves has all but eliminated my foot drop. Not having to manage fatigue and the constant cognitive load that foot drop requires — watching every step — remains a gift!

Finally, we talk a lot about the importance of movement. What motivates you to move?

It’s really easy. I don’t want to miss anything! I think the younger generation calls it “FOMO” or the fear of missing out. I don’t want to be sidelined, to be the person who can’t go because it’s too hard. That includes attending activities for our grandchildren — navigating school gym floors for basketball games or performances, large venues for concerts, or seeing art exhibits. Walking places where I previously haven’t had the stamina to enjoy my surroundings is key.

So that’s why — that’s what motivates me to move — I want to stay engaged with family and friends. And that’s that.

Jan’s Story: Movement, Motivation, and Cerebral Palsy Awareness Month was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.

Earlier today, CIONIC announced three new Centers of Excellence, as well as the appointment of Enrique Alvarez, MD, PhD, associate professor of neuroimmunology at University of Colorado School of Medicine and the vice chair of clinical research for the department of neurology, to CIONIC’s Scientific Advisory Board. I had an opportunity to sit down with Dr. Alvarez to discuss his work at the forefront of multiple sclerosis (MS) care, as well as why he is excited to join the CIONIC SAB.

Dr. Alvarez is a neuroimmunologist and sees patients with autoimmune conditions affecting the brain and spinal cord, including MS. Neuroimmunology is a discipline within neurology and addresses complex medical conditions like multiple sclerosis which present so differently on an individual level. Neuroimmunology investigates the interactions between the nervous system and the immune system. It focuses on understanding how immune responses impact neurological health and vice versa.

Neuroimmunologists study conditions where the immune system mistakenly attacks the nervous system, such as MS. They explore the underlying mechanisms driving these diseases, identify potential targets for treatment, and develop strategies to modulate immune responses to preserve neurological function.

It is this deep specialization that allows neuroimmunologists to gain a more comprehensive understanding of complex medical conditions and adjust treatment to improve outcomes for their patients.

From Medical School to MS Neuroimmunologist

Dr. Alvarez always knew he wanted to go to medical school. In his words, “I always joked that I didn’t have much of an option — I knew I was going to medical school. The only option was which specialty in medicine I would choose. I like science and medicine, and have always been interested in balancing patient care and research.”

He attended medical school at the University of Colorado and spent a year interning there before moving to St. Louis to do his neurology residency at Wash U, which was followed by a three-year fellowship through the National MS Society at Wash U before he ultimately returned to University of Colorado School of Medicine.

When asked how he chose neurology, he said, “I was fascinated by the thinking process for the field. While other fields are more concrete–where something like a blood test can demonstrate a clear diagnosis–neurology involves talking to patients, understanding how symptoms develop, and connecting the dots. It is an interesting puzzle, and there is always more to learn.”

When asked about his interest in MS specifically, it was a calling. “MS neuroimmunology was interesting to me because it’s such a unique disease. It is a younger patient population with fewer additional diseases but it presents so individually. Because of this, it’s a condition that must be studied deeply. In doing so, there was a lot we could do, both regarding treatment options as well as symptomatic interventions to improve quality of life.”

“Being a neuroimmunologist is a way to be highly focused on one thing. For patients with conditions under [a neuroimmunologist’s] care, we can really get good at managing a lot of the symptoms that a generalist may not recognize. In neurology, and specifically with MS, there are a lot of symptoms that are unclear. When you’re focused you have more comfort in understanding what is and is not part of MS,” he went on.

Current Areas of Focus

“As my career has progressed, the percentage of time spent on patient work and research has changed. When I started my career, my focus was primarily patient work, but today I spend more time on research. I love research, but I am always interested in clinical questions, specifically what kinds of questions patients have and how we answer them,” he says. “As faculty, I can stay close to the clinical side of the field which I love, while also progressing research.”

Dr. Alvarez is currently leading research on many different topics to advance understanding and efficacy of multiple sclerosis treatment. His research on biomarkers began when he was a fellow and continues today.

Biomarkers research assists with understanding many aspects of multiple sclerosis, from early detection to disease progression and management. This work investigates what proteins might be available to evaluate in spinal fluid (learn more in this recent conversation with Dr. Alvarez following ECTRIMS last year). As part of this ongoing work, Dr. Alvarez works “in collaboration with others to provide samples, think through the types of patient populations to evaluate, and conduct ongoing analysis.”

Dr. Alvarez is also investigating the comparative effectiveness of different disease-modifying therapies (DMTs) used to treat MS over time, and evaluating the benefits and risks for how and when to use high-efficacy drugs in the course of an individual’s MS treatment [cit].

“I’m very interested in treatment paradigms and de-escalation. The key is preventing the advancement of disability earlier, so this often means starting with high-efficacy drugs. As we age, our immune systems become less effective, so it becomes less likely for individuals living with MS to have a relapse,” he said. “What we are looking at is how do we adjust care over time to account for this change and provide optimal patient care.”

Dr. Alvarez also collaborates closely with other neurologists and, in particular, neuroimmunologists specializing in MS care. In his words, “There are a small number of MS neuroimmunologists. We all know each other. We specialize in different things: disease-modifying therapies, how to diagnose MS (MRIs, blood-based biomarkers), rare things that might point to bigger trends, etc. Because there are different areas of specialization, we conduct research and educate each other as we advance the collective understanding of multiple sclerosis.”

The Importance of Mobility and MS Care

Dr. Alvarez talks a lot about preventing disability progression as early as possible. One critical piece of the puzzle is prescribing the right DMTs and other therapeutics at the right time during an individual’s disease progression. Another piece is the symptomatic interventions that individuals can do over time to manage symptoms and maintain mobility.

As Dr. Alvarez thinks about mobility, he shared some advice for individuals early in their MS journey. “Do everything you can to prevent disability. During the first 6–12 months it’s easy to crawl into denial, but the younger you are, the faster you bounce back. Keep compensating — stay active. Emphasize wellness in whatever way is right for you — diet, exercise, etc. Most importantly, stay active physically and mentally — all the things that general medicine recommends for everyone, but that we’re never good at doing. It’s easy when we’re busy to deprioritize exercise and physical activity, and it gets hard to become active the older we are.”

Promising New Technology

As part of CIONIC’s Centers of Excellence initiative, UCHealth University of Colorado Hospital is now a facility where experts in neurologic care, including Dr. Alvarez, will be able to integrate the Neural Sleeve into treatment for patients.

He first learned of the Neural Sleeve when he saw it on a patient. This individual had been using functional electrical stimulation (FES) for mobility, but it wasn’t providing ankle support or correcting inversion during gait, which was resulting in an uncomfortable slapping effect for the patient.

“He was able to get better control of his gait with the Neural Sleeve. Between the app access where we could make real-time adjustments, as well as increased stability with the additional control points, the Neural Sleeve corrected his issues. Not only did it get rid of the slap, it also fixed the inversion and increased ankle stability.”

“When I first saw the Neural Sleeve, it was fairly new, but it looked like it was a different type of product and a few patients had told me they were using it and found it was really helping. Through being part of the SAB, especially since we’re on the first version of the Neural Sleeve, I’m also excited to see how can we use it from a research perspective, as well as collaborate with CIONIC to improve the overall product experience,” Dr. Alvarez said.

“At times, it feels like people can lose hope about how much they can do to positively impact their disability levels. By staying active and continuing exercise, for example with the Neural Sleeve, you can slow down the delay or progression associated with MS, as well as regain the confidence to get out and about,” he added.

One of the things the CIONIC team is most excited to collaborate on is progress over time and measuring outcomes. As Dr. Alvarez says, “You can send people to movement labs, but what is the right measure in a clinical environment? The 25-foot walk test is important, but only a moment in time. Because the Neural Sleeve is used longer-term, there will be better measures that will be more reflective of the real benefits of exercise for individuals living with MS.”

“When things are working it all works,” he concluded.

Our work at CIONIC is in many ways just getting started. In collaboration with leading medical experts like Dr. Alvarez, we look forward to a future where the millions of people living with mobility differences have access to better care, and where advances in technology are deployed to help people with disabilities live more freely and independently.

New Scientific Advisory Board Member Dr. Enrique Alvarez on DMTs, Mobility, and MS Progression was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.

Suffering a stroke is a life-altering event that can disrupt not only physical abilities but also cognitive functions and overall quality of life. While rehabilitation often focuses on physical therapy and exercises that improve mobility, engaging in brain exercises for stroke recovery can be equally important.

These exercises not only aid in improving cognitive function but may also promote neuroplasticity, the brain’s ability to reorganize and form new neural connections. Here, we’ll explore ten brain exercises that can aid in rebuilding cognitive abilities and enhancing overall quality of life for stroke survivors.

Brain exercises for stroke recovery

1. Sudoku and Crossword Puzzles:

Sudoku and crossword puzzles are classic brain exercises that stimulate critical thinking, memory, and problem-solving skills. These puzzles challenge the brain to recognize patterns and recall information, making them excellent tools for stroke survivors seeking cognitive rehabilitation. Integrating these puzzles into daily routines can help improve concentration and mental agility, crucial elements in the recovery process.

2. Memory Games:

Memory games, such as matching cards or recall exercises, may be valuable for enhancing short-term memory. These activities encourage the brain to practice information retrieval and retention, essential skills for regaining cognitive function post-stroke. Whether played digitally or using physical cards, memory games offer a fun and engaging way to exercise the brain and promote cognitive recovery.

3. Mental Math Exercises:

Engaging in mental math exercises can help stroke survivors improve numeracy skills while stimulating various areas of the brain. Simple calculations, such as addition, subtraction, multiplication, and division, challenge cognitive processes like attention, problem-solving, and working memory. Incorporating mental math into daily routines, such as calculating expenses or tip percentages, provides practical application and cognitive stimulation simultaneously.

4. Word Association:

Word association games involve connecting words based on semantic relationships or similarities. This promotes linguistic abilities, semantic memory, and cognitive flexibility, all of which are crucial for stroke recovery. Stroke survivors can play word association games independently or with a partner, fostering social interaction while exercising cognitive skills.

5. Visualization and Imagery:

Visualization exercises involve mentally picturing scenes, objects, or concepts in vivid detail. This technique can enhance memory, attention, and spatial reasoning abilities, making it beneficial for stroke survivors aiming to regain cognitive function. Practicing visualization exercises, such as imagining a familiar place or visualizing a specific sequence of events, can strengthen neural pathways associated with perception and memory.

6. Jigsaw Puzzles:

Jigsaw puzzles offer both cognitive and tactile stimulation, making them ideal for stroke recovery. Assembling pieces requires visual-spatial skills, problem-solving, and attention to detail, all of which contribute to cognitive rehabilitation. Start with simpler puzzles and gradually increase the complexity as cognitive abilities improve.

7. Reading and Writing:

Reading and writing are fundamental activities that promote language comprehension, communication skills, and cognitive processing. Stroke survivors can engage in reading books, articles, or short stories to improve comprehension and expand vocabulary. Similarly, practicing writing, whether through journaling, letter composition, or creative writing exercises, helps strengthen cognitive functions associated with language and expression.

8. Music Therapy:

Music therapy harnesses the therapeutic power of music to facilitate cognitive, emotional, and physical rehabilitation. Listening to music, playing instruments, or participating in singing and dancing exercises can stimulate multiple areas of the brain involved in memory, attention, and motor coordination. Incorporating music therapy into stroke recovery regimens offers a holistic approach to rehabilitation, promoting overall well-being and cognitive function.

9. Meditation and Mindfulness:

Mindfulness practices, such as meditation and deep breathing exercises, promote relaxation, stress reduction, and mental clarity. These techniques can benefit stroke survivors by improving attention, emotional regulation, and overall cognitive function. Incorporating mindfulness into daily routines fosters a sense of calmness and resilience, essential for navigating the challenges of stroke recovery.

10. Brain Training Apps:

Advancements in technology have led to the development of various brain training apps designed to enhance cognitive function. These apps offer a wide range of activities, including memory games, puzzles, and attention exercises, tailored to individual needs and abilities. Stroke survivors can conveniently access these apps on smartphones or tablets, allowing for personalized and engaging brain exercise routines.

Beyond brain exercises: other ways to improve recovery

Incorporating brain exercises into stroke recovery regimens is a great way to promote cognitive rehabilitation and enhance overall quality of life. From classic puzzles to innovative technology-driven solutions, there are numerous ways to stimulate the brain and facilitate neuroplasticity post-stroke.

By engaging in targeted brain exercises consistently, stroke survivors can rebuild cognitive abilities. To rebuild physical abilities, physical therapy will be an essential component of rehabilitation. In addition to physical therapy, there are technologies and devices that can further support improved mobility.

The Cionic Neural Sleeve is a new, FDA-cleared assistive device designed to address leg weakness and foot drop due to stroke. Take the assessment to see if it’s a fit for you and your mobility.

10 Brain Exercises for Stroke Recovery was originally published in CIONIC Blog on Medium, where people are continuing the conversation by highlighting and responding to this story.