Derek: Core Strengthening and Trunk Control Rehabilitation

Derek has way better core/trunk control, and movement than he had before, as well as an increase in his sitting tolerance and faster reaction time.

— Andon, Derek’s Therapist

Derek is a patient with an Incomplete Spinal Cord Injury (SCI) at C4, 5, 6 who needed rehabilitation to improve strength in his weaker arm, increase core/trunk stability, build muscle strength, sit unassisted, and address generalized muscle weakness.

Derek first used REAL® Immersive System in August 2020 as an adjunct to conventional rehab sessions to help him reach his therapy goals. His therapist, Andon, initially customized Derek’s REAL sessions by selecting the lowest difficulty settings. However, within six weeks of using REAL, Andon had adjusted Derek’s settings to the highest levels.

Since incorporating REAL System into Derek’s therapy, Andon noticed:

  • Improved core trunk stability (Bumper Band activity encouraged slower, controlled movement)
  • Faster reaction time (Sports Park activities set at most challenging levels)
  • Increased usage of both arms


In Bird Forest activities, Derek held weights as he placed birds into their nests. These activities focus on functional movement patterns and Activities of Daily Living (ADL) training.



In one of the Hot Air Balloon activities called Bumper Band, Derek rescued three band members’ balloons in a record 54 seconds! For a bigger challenge, Derek tried to beat his own record while holding weights and stabilizing his core. This family of activities focus on trunk control and stability.



In Sports Park activities, Derek used weights and an Airex® pad to further challenge functional and reactive movement. Derek stabilized a weight by holding it at his core with one hand and used the other hand to isolate and block flying blue fish or move his body to dodge spiky red fish.

Derek has increased the use of both arms and continues to work towards his therapy goals using REAL System.

Engage a wide rehab-patient population from high-acuity to high-functioning

REAL System has you covered, whether you work with high-acuity patients who lack upper extremity (UE) stability or high-functioning patients who require new challenges like bimanual coordination and increased speed. Schedule a free demo to learn more about REAL System from our dedicated team of Care Specialists.

Image used with permission. Consents on file at Penumbra, Inc. Clinical results may vary. Procedural and operative techniques and considerations are illustrative examples from healthcare provider experience. Healthcare providers’ treatment and technique decisions will vary based on their medical judgment. The opinions and clinical experiences presented herein are for informational purposes only. The results may not be predictive for all patients. Individual results may vary depending on patient-specific attributes and other factors.

Caution: Federal (USA) law restricts this device to sale by or on the order of a healthcare provider. Prior to use, please refer to the Instructions for Use (IFU) for complete product indications, contraindications, warnings, precautions, potential adverse events, and detailed instructions for use. Please click here for the complete IFU. Please contact your local REAL Care Specialist for more information.

20928, Rev. A 05/21 USA

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Awards & News

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About Us

Penumbra, Inc., headquartered in Alameda, California, is a global healthcare company focused on innovative therapies. Penumbra designs, develops, manufactures and markets novel products and has a broad portfolio that addresses challenging medical conditions in markets with significant unmet need. Penumbra supports healthcare providers, hospitals and clinics in more than 100 countries.

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