Terhi Kanga


“ArmeoSpring is a great device!”

25-year-old Joona Jalasmäki and occupational therapist Mervi Rantala meet at the Tutoris Pirkanmaa Special Rehabilitation Centre in Tampere after the summer holidays.

Joona spent the summer in his hometown, Savonlinna, and they both have plenty to share about their holidays. Joona says he went for a record-long 4.5-kilometer walk and decided to participate in peer recovery support activities in the autumn.

“I’m so glad to hear about your decision! I am sure you will be excellent as a peer supporter. Your motivation and attitude are incomparable. You’ve never taken the attitude of giving up and said that this isn’t going to work, even though I’m sure there have been bad days”, occupational therapist Mervi rejoices.

The young man’s life, who graduated as a chef, will never be the same after his accident three years ago. But it is astonishingly close to what it used to be, considering the level he started at in the early stages of rehabilitation.

My feet and hands did not move at all.

Joona and his friends went swimming in Savonlinna in June 2019 when things took a shocking turn for the worst. The water of the familiar lake was more than a meter lower than in the previous summer, and the group of friends knew nothing about it. Joona dived headfirst into the bottom of the lake. He broke his neck.

“Fortunately, my friends were alert and immediately realized what had happened. One of them held my head while another called an ambulance”, Joona says.

He spent the first few months in the hospital: ten days in an intensive care unit in Kuopio, from where Joona was transferred to the Hatanpää rehabilitation unit in Tampere.

“For the first month and a half, I was in a wheelchair. My legs and arms didn’t move at all. However, technology-assisted rehabilitation began already at this stage, which was very important. From the wheelchair, I was able to use first a walker and then a rollator, which I was discharged with four months later”, Joona says as he recounts the events.

While lying in the intensive care unit, Joona went over what had happened, but he was also already thinking about further rehabilitation. He was recommended Pirkanmaa Tutoris. Moving from Savonlinna to Tampere did not seem impossible for a quadriplegic young man as he weighed the possibilities of progressive spinal rehabilitation.

The support of personal assistants and immediate family members helped make the decision.

Armeo provided support throughout all the phases

In addition to the motivation and attitude praised by the occupational therapist, rehabilitation technology and more traditional forms of rehabilitation have accelerated Joona’s rapid rehabilitation. Joona has made use of several devices.

The rehabilitation plan immediately included the upper limb rehabilitation device Armeo®Spring. Not all devices from Tutoris’ wide range of rehabilitation technologies will serve users to their full potential in the early stages. Still, due to its weight-reducing properties, Armeo is excellent for all phases of rehabilitation.

Although Joona’s development has been intense, Armeo still presents enough of a challenge, as so many exercises, games, and performance levels exist. This is one of the reasons why ArmeoSpring is exactly the device that Mervi would not give up at any price if she had to give up something at Tutoris. Joona is also fond of Armeo.

“From the very first time, I enjoyed working with the Armeo device because it was so easy to use. I didn’t have to try to hold my hand up, and neither did a therapist. It is easier to focus on the exercise when you can do everything with the support of the device itself”, says Joona.

Armeo is a rehabilitation device for the upper limbs, but correct trunk control is also emphasized. At first, Mervi held Joona so his trunk would not start pulling away. In other words, Armeo develops trunk control alongside other physiotherapy exercises, and quite soon, Mervi could step back to observe and guide.

In addition to strengthening the hand, trunk control and balance were also very useful for home activities, such as cooking, which Joona is passionate about. The former chef wanted cooking to be strongly incorporated into daily rehabilitation activities, which have been strengthened with the therapists. The upright-handle knife and other small appliances are still used in everyday life, but Joona is already managing well to cook independently.

The work of a chef is so physical and demanding that Joona no longer believes he can be rehabilitated to become a professional chef. Still, already the status of a home chef is a tremendous achievement.

“At the beginning, my left hand was completely spastic. My fine motor skills were practically non-existent. Now, even my fingers are starting to straighten. The worst symptoms of paralysis remain on the left side. Many have told me I am fortunate if they haven’t known that I’m left-handed”, Joona laughs.

Providing ease where necessary – quickly too

ArmeoSpring has particularly developed Joona’s coordination, hand strength, and mobility. It has also provided wrist positioning, which has facilitated practising finger movement. Joona’s grip strength has evolved tremendously, and this has led to the development of his overall endurance too. The main goal of rehabilitation has been to maintain the ability to grasp.

“Personally, I have realised that the Armeo has specifically developed muscular strength in the hand. In the beginning, the exercises felt very harsh physically, when the hands were weak after the accident. Nowadays, I don’t even have to tell Mervi that I can’t do it anymore.”

According to Mervi, one of the great things about Armeo is that if the exercise feels difficult for one reason or another, you can change the plan and ease the difficulty of the activity on the fly. Only a few changes need to be made to the device settings, and the exercise can continue.

In this way, the patient’s daily form can always be considered, and even on a less successful day, the practice does not have to be left entirely unfinished.

It is precisely at this point that the professionalism of a therapist is of great benefit in a way that technology cannot provide. The therapist is always involved in evaluating a conveniently challenging level for the patient at that moment but not too difficult.

If it had not been for Armeo, they would have tried to replace the same exercises manually, for example, by rolling a ball along a table.

“With Armeo, the range of motion can be much more versatile with the help of weight reduction. In the manual options, the therapist’s assisting movement always leaves a small uncertainty about the extent to which the patient is carrying out the exercise themself”, says Mervi.

ArmeoSpring doesn’t push at all. It does have the human reflex of helping if a person cannot withstand or cope with the exercise. The patient always does the movement himself.

Data indicates development

The feedback that Armeo has stored on the computer has also been motivating for both of us. Improving game scores and trajectories drawn as data sets prove the progress achieved. Armeo training is usually carried out for 20 minutes at a time.

“I have been quite amazed at how fast progress has been made and continues to be made. It is often said that in two years following an accident, the chances of improvement will slow down, ” Joona says.

Occupational therapist Mervi points out that Joona’s functional ability enables further progress, even though the accident occurred already some time ago. Rehabilitation is always a very individual path. The more you challenge yourself, the more your brain adapts.

“Rehabilitation is a long process that changes along the way. In Armeo training, messages are sent from the target muscle to the cerebral cortex. The goal is to strengthen the neural network and restore hand function. Joona’s efficient training is an example of how active training enables the restoration of skills.

The longtime occupational therapist adds that an accident also has a psychological impact. Still, Joona was fortunate to have a strong network of friends and close relatives always available.

Joona’s hunger for life and positive attitude drives him forward. The accident has not made him bitter, but he has always spoken openly about what happened. All this has undoubtedly accelerated rehabilitation.


Photos: Pasi Tiitola

Originally published on 29.11.2022

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