Go back to blogIn this DIH Success Story, we talk with Hans Roesems, Paramedical Head of VITAZ, about rehabilitation, innovation and the implementation of technologies in rehabilitation. Following a merger between AZ Nikolaas and AZ Lokeren (2022), VITAZ now consists of six campuses in the Waasland region. VITAZ offers a comprehensive range of healthcare services, with a vision and mission to continuously expand this range through innovation and thorough specialization.
Within TREV., the rehabilitation center operating within the VITAZ campuses in Beveren, Sint-Niklaas and (recently) Lokeren, high-quality rehabilitation is offered to a very wide range of pathology groups (including neurological, geriatric and orthopaedic patients). Within TREV, this quality is offered through multidisciplinary collaboration between the various (para)medical disciplines, with approximately 450 patients being treated daily (outpatient and hospitalized).
In addition, VITAZ strives to guide the patient through the entire process, from admission to the end of the rehabilitation process. In the process, VITAZ is continuously open to innovative developments in the field of rehabilitation.
Hans Roesems, Paramedical Head of VITAZ
Since 2023, you have been using the LokomatPro and the C-Mill VR+ at VITAZ. Do these products fit in with the vision of innovative developments in the field of rehabilitation?
Hans: Absolutely. Our Head of Medical Services, Dr Hofman, became acquainted with these products during a conference in Switzerland. After this conference, Dr Hofman informed me and I contacted DIH, in the person of Mark Van De Ven. He came to present both devices to the department, and it became clear that the innovative possibilities these devices offer our patients and therapists would be an added value within VITAZ.
Was the combination of LokomatPro and C-Mill VR+ a conscious decision?
Hans: We did indeed consciously choose to combine Lokomat and C-Mill, as they are compatible in terms of “level”. Thanks to its robotic support options, Lokomat provides support for standing, walking and moving in the acute phase, after which C-Mill can be used in a later phase of rehabilitation.
The seed had been planted; what steps were then taken to actually realize the purchase?
Hans: After these initial steps, intensive discussions were held about the purchase procedure and subsequent implementation, both internally within VITAZ and with DIH (Hocoma / Motek) in the person of Mark. It was a challenging process in which the financial aspects, substantive working methods, spatial planning and subsequent training of therapists were all weighed up, with a satisfactory result: since the summer of 2023, patients have been able to enjoy the benefits of the Lokomat Pro and the C-Mill VR+.
How was the purchase then completed?
Hans: In addition to the regular investment budget for the C-Mills, we submitted an internal request to our hospital’s MIF (Medical Investment Fund) for the Lokomat Pro. This is a fund that provides resources for purchasing medically innovative equipment. In order to submit a well-founded dossier and have it approved by the MIF, we worked closely with DIH (Hocoma / Motek) and Mark.
And what does this mean for the patient? Will they now have to pay extra to use the latest technology?
Hans: No, absolutely not. As a hospital, we strive to offer accessible care, so we have decided not to charge any additional pseudocodes on top of their standard personal contribution for their rehabilitation treatment. Lokomat or C-mill is part of their rehabilitation treatment, and it is our vision that patients don’t come to the rehabilitation centre solely for these devices.
The procurement process was therefore extensive and intensive. How did VITAZ / TREV. and DIH (Hocoma / Motek) deal with this?
Hans: Clear agreements were made with DIH (Hocoma / Motek) for the delivery/installation of the three devices. The aim was to minimise disruption to the rehabilitation setting during installation while ensuring that delivery could proceed smoothly. This plan was more than successful, with some parts even being brought in through the window in Beveren! The training of the therapists was coordinated so that both campuses received training on the same days. There was a split between morning and afternoon, so that we could train as many therapists as possible per campus and disrupt operations as little as possible. Of course, a partial closure of the outpatient setting was unavoidable. After a number of months, there was also a follow-up training course to ensure that the implementation went as smoothly as possible.
The efficient use of the equipment after installation is obviously very important; what has been your approach in this regard?
Hans: We obviously thought carefully in advance about which devices and which combination would best suit and fit in with our patient population. As a result, the Lokomat was installed at our rehabilitation campus in Beveren. There, we have a large number of potential patients who, after their stay in the acute care department in campus Sint-Niklaas, undergo a longer period of rehabilitation during their hospitalization, followed by a possible outpatient program. This department treats a mix of orthopedic and neurological patients. We also have a C-mill VR+ on the same campus. This means we have both devices that can be used in the rehabilitation process. It gives us the option of using the appropriate device depending on the patient’s progress, ensuring that the use of the devices is optimal and fully integrated. The training prior to use, as well as the follow-up training and consultations, have also made an important contribution to this.
Do you use the devices on a one-to-one basis, or also during group therapy sessions?
Hans: In Sint-Niklaas, we don’t have an inpatient rehabilitation department, so we only have an outpatient center where the C-Mill VR+ is used. Here, we see that mainly neurological patients are being trained on it individually. In addition, we also have a large number of group therapies on this campus that use it. For example, our Parkinson’s group makes extensive use of it. But patients undergoing metabolic rehabilitation and oncological rehabilitation can also use it in a safe and motivating way.
Last but not least: how do your therapists and their patients experience the use of this technology in rehabilitation?
Hans: Therapists see the safety aspect offered by both the Lokomat Pro and the C-Mill VR+ as a hugely positive feature. The Body Weight Support system ensures that patients can start standing, balance and walking training at an earlier stage and that therapists do not have to worry about patients falling. Virtual reality/gaming motivates patients on both the Lokomat and the C-Mill.
Feedback I have received indicates that the Lokomat has a positive mental effect on many patients, with the feeling of being able to walk safely having a very positive impact. Once the patient is set up, they can repeat many more steps than with the traditional method. In addition to the safety aspect, the C-Mill VR+ also offers a huge “fun factor” compared to the traditional treadmill. Patients can be challenged to perform tasks similar to ADL situations, allowing training to take place at an optimal level tailored to the patient. Both the Lokomat Pro and the C-Mill VR+ also offer many tools for measurable and transparent working (reports, measurements, etc.), adding value within both campuses. All in all, we are very satisfied with the use and implementation of the Lokomat Pro and the C-Mill VR+ in Beveren and Sint-Niklaas, and we are proud to be able to offer this form of technological and innovative rehabilitation.
On behalf of DIH, we sincerely thank Hans for giving this amazing insight into the role technology, with the Lokomat and the C-Mill VR+, plays in the treatment and training of the VITAZ’ population.
