Case Study: Restoring Function and Confidence After Complex Medical Complications

Patient Background

This patient experienced a stroke in 2019 that affected his right arm and leg. In 2022, he developed infected wounds on both lower extremities that failed to heal, ultimately resulting in bilateral below-knee amputations. His recovery was complicated by multiple medical setbacks, leading to a prolonged period of immobility and eventual bed-bound status.

By the time of his initial physical therapy evaluation, the patient demonstrated significant functional limitations. He was unable to sit without back or upper extremity support, required a Hoyer lift for transfers, and was unable to tolerate standing. These impairments created both physical and psychological barriers to meaningful participation in therapy.

Initial Therapy Challenges

Traditional mat table setups presented clear limitations for this patient. Due to insufficient postural support, the therapist was required to provide continuous stabilization during seated activities, often necessitating a second clinician to assist with therapeutic exercises. This restricted the scope of therapy and limited the patient’s ability to safely engage in progressive functional tasks.

In addition to physical weakness, the patient demonstrated significant anxiety, particularly when sitting at the edge of the mat, driven by a fear of falling. These factors further limited early progress and tolerance for therapy.

Intervention with the Barihab™ Treatment Platform

The introduction of the Barihab™ table marked a turning point in the patient’s rehabilitation. The integrated adjustable back support provided the postural stability needed for safe seated positioning, allowing the therapist to focus on therapeutic exercises rather than manual support.

This design eliminated the need for a second clinician during many sessions and enabled a broader range of interventions to be performed more efficiently and safely.

The Barihab’s allowed the physical therapist to objectively track changes in the patient’s core strength over time. Initially, the patient was unable to perform a sit-up without full support at a 90-degree backrest position. With consistent therapy, he progressed to performing multiple repetitions of sit-ups from a 60-degree angle, demonstrating measurable improvements in trunk control and strength.

As stability and confidence improved, the patient’s anxiety while sitting at the edge of the mat significantly decreased, allowing him to participate more fully in therapy sessions.

Standing Tolerance and Functional Progression

The standing frame feature of the Barihab table further supported the patient’s recovery. Prior to its use, the patient was unable to tolerate a traditional standing frame due to poor accommodation of his anatomy and lower-extremity alignment, which resulted in pain and limited standing tolerance.

With the Barihab system, the patient was able to achieve proper positioning and comfort in standing. Over time, he progressed to standing for up to one hour without pain, while completing therapeutic exercises aimed at improving core and upper extremity strength.

Functional Outcomes

When therapy began in November 2023, the patient was completely bed-bound. Since then, he has made meaningful functional gains, including:

• Independently performing scooting transfers between his power wheelchair and the Barihab
• Completing assisted sit-to-stand transfers using the standing frame and his power wheelchair with an elevating feature
• Achieving independent sitting balance with no remaining fear of falling
• Improving lower-body strength sufficiently to ambulate with assistance and a walker

Facility Impact

The care team reports that the Barihab™ has played a significant role in supporting this patient’s functional recovery while improving therapy efficiency and safety. The ability to provide appropriate postural support, track objective progress, and accommodate complex anatomical needs has made the Barihab a valuable asset within the facility.

 

“We are so thankful that we bought the Barihab for our facility, as it continues to significantly improve our patient’s function, health, and quality of life.” – Stephanie Cole, OTR/L, DOR, CTO | Montecito Post Acute Care and Rehabilitation