NeuroMobility Symposium: “We can only master the topic of spasticity on an interdisciplinary basis.”

Sina Wiedemeier (centre) and Kerstin Rathgeb (right) offered the patient perspective during the "Everyday Spasticity Management" panel discussion with Dr Jennifer Ernst (left).
Sina Wiedemeier (centre) and Kerstin Rathgeb (right) offered the patient perspective during the Everyday Spasticity Management panel discussion with Dr Jennifer Ernst (left).

Thursday, 23 November 2023

  • The second NeuroMobility Symposium was held in Berlin in mid-November under the motto Mastering neurological challenges together.

  • At the invitation of Ottobock and under the scientific leadership of Dr. Jennifer Ernst, experts from the fields of medicine, orthopaedic technology and physiotherapy, as well as two affected individuals, discussed the topic of spasticity management through neuromodulation.

  • The aim of the interdisciplinary exchange is to raise awareness of treatment failures, recognise new potential and improve the situation of patients with spastic paresis caused by multiple sclerosis, cerebral palsy or stroke.

On 15 and 16 November, Ottobock organised the second NeuroMobility Symposium in Berlin under the motto Mastering neurological challenges together. The event was scientifically led by Dr. Jennifer Ernst, surgeon and senior physician at Hannover Medical School.It brought users, doctors, physiotherapists and O&P professionals together at the podium and highlighted the obstacles and potentials of spasticity management using neuromodulation from various perspectives. “The only way we can master the topic of spasticity is through an interdisciplinary approach,” Dr Ernst explained.

Neuromodulation Today: Taking stock of the healthcare situation

Dr Jennifer Ernst outlined the scope of the symposium at the outset with Neuromodulation: the Scientific Foundation. “The language of our nerves is an electrical signal. This makes neuromodulation a useful instrument with few side effects when the electrical activity of the muscle has become disordered due to spasticity,” says Dr Ernst. “But we don’t just need clinical objectification, we also need functional objectification.”

Dr Andreas Hahn, Corporate Vice President Clinical Research & Services at Ottobock, developed this theme further and focused on movement deficits caused by infantile cerebral palsy, multiple sclerosis or stroke. The first broad studies and post-marketing surveillance studies showed, for example based on the Berg Balance Scale, a reduced risk of falling, less pain and improved quality of life – both short and long-term – thanks to the Exopulse Mollii neuromodulation suit. “But we have to ask ourselves again and again the fundamental question: How do we look? Where? And with which instruments? It’s not just about the fastest possible tests, but also meaningful functional objectification,” recalled Dr. Hahn.

Prof. Dr. Bernd Brüggenjürgen, Head of the Institute for Health Care Research and Orthopaedic Technology at MHH Hannover/Diakovere Annastift, focused his presentation Health Care Research and Spastic Movement Disorders on the questions: How does technology reach the patients and how can failures of care be overcome?Dr. Brüggenjürgen pleaded: “Above all, we need to integrate patient needs and we need integrated, regional on-site care rather than silo care. This would allow us to create meaningful transitions between the treatment areas instead of simply managing interfaces.”

In their presentation, Dr. Dörthe Lison and Dr. Andreas Lison from the Centre for Sports Medicine of the German Armed Forces looked at Spasticity Management in Rehabilitation – an Interprofessional Process, at what is meant by the concepts disability and rehabilitation and how this affects the measures taken: “Rehabilitation is working in an interdisciplinary team. Above all, that means working together with the patient. Barriers can only be overcome and disability avoided when hindrances to participation – in line with a modern concept of disability – are comprehensively recognised.”

Physiotherapist Renata Horst, specialising in orthopaedic manual therapy, neurological rehabilitation and motor learning, gave a lecture on Neuromodulation – Guidelines in Physiotherapy.She used various case studies to demonstrate the extent to which motor learning influences the success of treatment and why the concept spastic paresis is more precise than spasticity. The aim of the respective rehabilitation therapy should be to empower patients to act with the appropriate input instead of merely treating them.

As part of the Everyday Spasticity Management panel, Sina Wiedemeier and Kerstin Rathgeb discussed the perspectives of patients who are actively using neurostimulation using the Exopulse Mollii Suit. Their experiences clearly demonstrate the life-changing effects of the suit, which is unique in the world:

Kerstin Rathgeb received a diagnosis of multiple sclerosis 25 years ago at the age of 17. The mother of two was close to care level 5 when she found out about the Exopulse Mollii Suit on Instagram. “My life was defined by falling, falling, falling. I had pain all day and total insomnia. It was exhausting,” says the trained nursery school teacher. “The Suit saved my life.” Since she started using the Suit – every day at first, but now every two or three days in the evening – Kerstin Rathgeb has had no pain or sleepless nights any, and she has been able to participate in life again. She was also able to reduce her medication, almost doing away with it completely. Her goal for the future: to become even more autonomous in order to be less dependent on the help of others.

After a sports accident, Sina Wiedemeier became incompletely paraplegic and relies on a combination of devices to enable her to walk and cope with her everyday life. The young teacher also had to take various medications that made her feel light-headed and drowsy. Due to a sudden spasticity she happened to kick the inventor of the Exopulse Mollii Suit – Fredrik Lundqvist – at a trade show. They started talking and Sina Wiedemeier was able to test the suit that same evening. Since then, the device has helped her manage spasticity with less pain, fewer sleepless nights, fewer medications, and she has been able to cover longer distances safely. “I now have the ability to be there for my primary school students. This was unthinkable before,” Sina Wiedemeier sums up.

Dr Jürgen Kohler, a practising neurologist at the Zollhalle Neuro- and Physiotherapy Centre in Freiburg im Breisgau, reported on his day-to-day practice in his presentation Spasticity Management: Integrating Neuromodulation Using the Example of Multiple Sclerosis. Obstacles in relation to prescribers and doctors are mainly due to insufficient knowledge of orthotic treatment options and a lack of cooperation with medical supply companies and O&P professionals. “We have to bring neurologists on board and also overcome boundary anxieties between medicine and orthopaedic technology on a professional level,” says Kohler.

Finally, Günter Bieschinski, an O&P professional, and Dennis Koch, a physiotherapist at rahm (Centre for Health & Mobility), offered an insight into a screening with the Exopulse Mollii Suit in their presentation Neuromodulation: Case study from the field of orthopaedic technology. Various case studies from their day-to-day work illustrated how patients use the neuromodulation suit and how they experience the effect of electrical stimulation. “The Exopulse Mollii Suit can prove very effective especially when used over an extended period of time and is a great concept to complement therapy for use at home in particular,” Günter Bieschinski summarises.

Conclusion: Improving treatment today

The interdisciplinary symposium highlighted which aspects are really relevant for spasticity management using neuromodulation. ”Sensible transitions have to be created between medicine, orthopaedic technology, therapists and patient. In addition, individual treatment plans are required that take a holistic view and actively involve those affected – and whose results are objectified and documented on a functional level. So that therapies, devices and technologies like the Exopulse Mollii Suit get to and are used where they're needed: the patients. None of this can be implemented without interdisciplinary exchange,” says Dr Ernst, summarising the day.

New perspectives for more mobility: The symposium was part of Ottobock’s NeuroMobility concept for integrated patient care. In addition to innovating more powerful devices, this interdisciplinary transfer of knowledge is the decisive factor in improving the mobility and quality of life of hundreds of thousands of people - as positive developments in patient care and an active life for those affected by neurological disorders can only be achieved by taking a holistic and realistic approach to user needs.

A video clip of the event can be watched here Link. The recordings of the individual lectures will be available here Link from the beginning of December 2023.