After 3 years of COVID-19 measures, it was a great night for the AVORA family to attend a baseball game with the Asheville Tourists! A bit of fun goes a long way in having all of us harmonize together! Additionally, masks are now optional and we support each person's right to choose what they feel comfortable doing to protect themselves. If you happen to be sick, we would still encourage you to quarantine and take a little time away from others to keep our family, friends, and neighbors safe. It continues to be a good health practice to wash your hands regularly and avoid spreading illness.

On August 10th, 2021, the FDA completed an extensive review process and designated GyroStim as a Breakthrough Medical Device, stating GyroStim has: “a reasonable expectation for providing more effective treatment relative to the current standard of care for balance disorders and vestibular dysfunction.” 
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The Breakthrough Device designation is a monumental accomplishment and a significant distinction that sets GyroStim apart from all other devices in its category: GyroStim is the first and only device for the treatment of balance disorders and vestibular dysfunction the FDA has designated as a Breakthrough Medical Device.

​A big thank you going out to Dr. Keith Sales and his family for getting involved in heartswithhands.org. Hearts with Hands provides support to families who are in need. The recent flooding in WNC from hurricane Ida displaced and disrupted the lives of numerous families.

​Dr. Sales volunteered AVORA to be a donation drop-off site and has received over 3 barrels of goods from donors.

Who would have thought this would be the new normal? We were really on the fence whether to write a blog post on the COVID-19 Pandemic or not. I'm glad we waited to avoid adding more hype to the situation.  With 6 months of the pandemic now behind us, it seems appropriate to address the issue more concretely. AVORA has been fortunate to avoid any positive tests so far (knock on wood) and we hope that it stays that way.

As a healthcare  service provider, we feel especially committed to avoid cross contamination. Many of our patients are vulnerable, especially our elder population. So, our precautions may seem overly rigorous to some, but it helps us sleep better at night knowing that we have been doing all that we can to help prevent the spread. All patients are required to wear masks and we take temperatures and ask them to wash their hands before and after leaving our clinics. We also screen for potential cases before allowing admittance into our facilities. Additionally, we have more stringent cleaning procedures and have closed our waiting rooms and ask patients to call us when they arrive so we can bring them in one at a time.

We may not know if we are being overly cautious, but we will know if we are not doing the best job we can. I hope everyone in need of our services can appreciate the situation we are in and so far, I'm pleased to say that our patients have not only been supportive of our measures, but also appreciative that we care enough to take things seriously. We wish you the best of staying healthy and look forward to assisting you any way we can. 

Dr. Kim Fox, DPT and Dr. Courtney Hall, PT, PhD behind their research presentation poster.

Dr. Courtney Hall, PT, PhD presented their research findings at the APTA CMS on February 13, 2020 in Denver, Colorado.

Presentation 1326
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Abstract
The use of sensorimotor, multi-axis, rotational (SMART) training to treat Mal de Debarquement Syndrome

Purpose/Hypothesis: Mal de Debarquement Syndrome (MdDS) is a rare condition in which those afflicted perceive a chronic rocking or swaying sensation, often relieved when in motion and symptomatic when still. Etiology is uncertain; therefore, treatment options are limited. While there is reported success with medication, optokinetic stimulation or transcutaneous magnetic stimulation, there is no single treatment that works for all patients. This retrospective chart review investigated rehabilitation outcomes following sensorimotor, multi-axis, rotational (SMART) training to address MdDS symptoms.

Number of Subjects: Forty-nine

Materials and Methods: Forty-nine patients participated in 10-20 sessions of SMART training, with integrated use of a visual targeting system and physical therapy. Between sessions, patients were instructed to perform mindfulness breathing, relaxation and grounding techniques. Pre- and post-training Dizziness Handicap Inventory (DHI), 4-item Dynamic Gait Index (DGI), and computerized posturography including Sensory Organization Test (SOT) were assessed. Subjective change following rehabilitation was tracked at discharge, 5 weeks, 3 months, 6 months and 1 year post-training.

Results: Mean age (SD) of patients was 52.9 (12.6) years with the majority (n=47) being female. Mean time from onset of symptoms (SD) was 50.8 (87.8) months suggesting chronic symptoms. At discharge, 42 of 49 patients reported improvements, with nearly half (n=24, 48.9%) of all patients reporting marked or moderate improvement in symptoms; whereas, 14 (28.6%) reported minimal improvement in symptoms. Based on paired t-tests, all outcome measures – DHI, MdDS severity Visual Analog Scale (VAS), Motion VAS, 4-item DGI, and SOT - improved significantly (p < 0.001) from initial evaluation to discharge. Several personal factors were associated with rehabilitation outcomes based on bivariate correlations. With some variation, patients sustaining improvements at 1 week post-discharge, generally continued to sustain at 5 weeks, 3 months, 6 months and 1 year.

Conclusions: SMART training plus physical therapy resulted in improved performance outcomes and in significant reduction or resolution in MdDS symptoms. This study provides early evidence that this method of training has promising potential to aid in the management or recovery of MdDS.

Clinical Relevance: MdDS is disorder with no specific cure. Treatment is limited. SMART training may serve as an effective outcome to reduce or resolve symptoms associated with MdDS.

See  Research Gate Kim Fox and Courtney Hall publication of research for more details
https://www.researchgate.net/publication/333669306_The_use_of_sensorimotor_multi-axis_rotational_SMART_training_to_treat_Mal_de_Debarquement_Syndrome_MdDS

The GyroStim room makes a great place to watch black bears, wild turkeys, and other wildlife. These photos were taken on April 25, 2019.

Jackson Gannon's mom says he said his first 2 words since his accident which was 1-2 days following his last GyroStim training session at AVORA Health.
https://www.wbrc.com/video/2019/03/20/jackson-gannon-speaks-first-time-nearly-years/  He also, on his own free will, walked over to the sink and started washing dishes, with an awareness that they needed to be done and the desire to do something about it. We are so happy for Jackson and his family!

Note: The news report indicated that "(Dr. Fox) believed it could help Jackson learn to speak again." This was only a portion of Dr. Fox's statement during the interview regarding speech. It is important to know that while we have seen evidence of speech improvement with Jackson as well as other patients, we do not claim in any capacity to treat speech related issues.

Dr. Fox's official stance on GyroStim and speech improvement is "We have seen patient speech improvements through the use of GyroStim, but do not specifically treat speech and do not claim to be Speech Therapists. The results are anecdotal to the underlying conditions (such as concussions) that we treat as vestibular rehabilitation experts."