In the December edition of stroke http://bit.ly/h21GuE Dr. Asplund from Riks-Stroke, Department of Medicine, University Hospital, Umeå, Sweden looks at Patient Dissatisfaction With Acute Stroke Care. The group highlight the potential for reducing patient dissatisfaction by structural measures, such as access to care in a stroke unit, patient involvement in discharge planning, and systematic follow-up after discharge.
However the strongest predictor of dissatisfaction with acute care was poor functional outcome. If the patient is dependent on caregivers for daily living this leads to a depressed mood state and poor self-perceived health.
Our experiences with the HandTutor system in the community setting show that providing the patient with an ergonomic glove and easy to use rehabilitation software motivates both the patient and their caregiver to do intensive exercise practice. The home care therapy sessions can be supported by physical and occupational therapists offering tele-rehabilitation which again gives the patient the feeling that the patient and care giver are not alone and there is still progress to be made in their physical rehabilitation.
Sunday 26 December 2010
HandTutor system provides intensive repetition exercises and is a clinical and economically proven tool
In the December edition of Topics in Stroke Rehabilitation Dr. Backus and her team from Shepherd Center, Atlanta, Georgia USA comment on Translating Research Into Clinical Practice: Integrating Robotics Into Neurorehabilitation for Stroke Survivors http://bit.ly/hZJJrP
The report states that robotic devices hold the promise of providing high doses of repetitive movement in a reliable and controllable manner and are causing both excitement and apprehension among therapists and rehabilitation clinic management.
The group concludes that the role that robotic devices play in the continuum of clinical care remains uncertain.
Are robotic devices a status symbol that says: “we are a top rehabilitation center”, “I am a top therapist”, “our clinic offer patients the most up to date treatment options”. Alternatively are they clinically and economically proven and more effective than traditional intensive therapy.
The HandTutor system offers therapists and clinic managers a cost effective tool that provides patients with intensive active exercise practice with proven hand movement rehabilitation outcome.
The report states that robotic devices hold the promise of providing high doses of repetitive movement in a reliable and controllable manner and are causing both excitement and apprehension among therapists and rehabilitation clinic management.
The group concludes that the role that robotic devices play in the continuum of clinical care remains uncertain.
Are robotic devices a status symbol that says: “we are a top rehabilitation center”, “I am a top therapist”, “our clinic offer patients the most up to date treatment options”. Alternatively are they clinically and economically proven and more effective than traditional intensive therapy.
The HandTutor system offers therapists and clinic managers a cost effective tool that provides patients with intensive active exercise practice with proven hand movement rehabilitation outcome.
Are retrospective studies powerful enough to draw conclusions on functional outcome in stroke
In a Retrospective study published in Circulation and the Journal of the American Heart Association Dr. Kurth from INSERM in Paris France show that migraines are associated with increased risk of ischemic stroke however these strokes are typically associated with good functional outcomes. See more details: http://bit.ly/eYu0KI
Passing thought: Is a retrospective study powerful enough to draw conclusions on functional outcome in stroke when there are so many independent variables including treatment protocols, assessment tools to name just two?
Passing thought: Is a retrospective study powerful enough to draw conclusions on functional outcome in stroke when there are so many independent variables including treatment protocols, assessment tools to name just two?
Virtual functional tasks meet therapy goals of intensive exercise
In the December edition of study published in Topics in Stroke Rehabilitation Dr. Flynn and her group discuss the “Development of an Interactive Game-Based Rehabilitation Tool for Dynamic Balance”. The group tested commercially available gaming systems and found that current commercial games are not compatible with controlled, specific exercise required to meet therapy goals http://bit.ly/dYbkxH
Is this finding all so due to the sensors being used in commercially available games only testing to see that the end point of the movement has been reached and therefore do not prevent compensatory movement strategies?
MediTouch have developed the LegTutor system that allows for the implementation of virtual functional lower extremity tasks. The system incorporates 3D position information on the hip and allows the patient to practice intensive isolated knee and hip exercises. Using the LegTutor system in combination with traditional functional exercises promotes functional rehabilitation.
Is this finding all so due to the sensors being used in commercially available games only testing to see that the end point of the movement has been reached and therefore do not prevent compensatory movement strategies?
MediTouch have developed the LegTutor system that allows for the implementation of virtual functional lower extremity tasks. The system incorporates 3D position information on the hip and allows the patient to practice intensive isolated knee and hip exercises. Using the LegTutor system in combination with traditional functional exercises promotes functional rehabilitation.
Too much tone to do traditional task practice then start virtual functional practice with HandTutor
The Journal of Rehabilitation Medicine reports on an upcoming double-blind, prospective, randomized, European and Canadian study: Evaluating patient outcomes and costs of managing adults with post-stroke focal spasticity http://bit.ly/gOMxLq
The trial to be conducted by Division of Rehabilitation Medicine; Department of Clinical Sciences Karolinska Institutet; Sweden led by Dr. Borg is aiming to provide evidence for the extended use of botulinum toxin A in focal post-stroke upper and lower limb spasticity and to evaluate the impact of incorporating botulinum toxin treatment into the rehabilitation of patients with spasticity.
Occupational and Physical therapists can reduce the patient’s spasticity level during training. It is important that during this training the patient undertakes repetitive customized exercises that improve their sensory and motor movement ability. The HandTutor system provides virtual functional task practice exercises that motivates and allows the patient to exercise even if they have limited movement ability. This limited movement ability prevents the patient from doing traditional task practice exercises. Intensive repetitive exercises using the HandTutor, therefore improves the patients functional recovery.
The trial to be conducted by Division of Rehabilitation Medicine; Department of Clinical Sciences Karolinska Institutet; Sweden led by Dr. Borg is aiming to provide evidence for the extended use of botulinum toxin A in focal post-stroke upper and lower limb spasticity and to evaluate the impact of incorporating botulinum toxin treatment into the rehabilitation of patients with spasticity.
Occupational and Physical therapists can reduce the patient’s spasticity level during training. It is important that during this training the patient undertakes repetitive customized exercises that improve their sensory and motor movement ability. The HandTutor system provides virtual functional task practice exercises that motivates and allows the patient to exercise even if they have limited movement ability. This limited movement ability prevents the patient from doing traditional task practice exercises. Intensive repetitive exercises using the HandTutor, therefore improves the patients functional recovery.
HandTutor tele-rehabilitation system
In a recent article in Rehabilitation Engineering, Dr Colombo and his team from Rehabilitation Institute Veruno and Pavia Italy discuss the development of systems architecture for robot aided tele-rehabilitation http://bit.ly/gZ2AFQ
The group note that to date, previous tele-rehabilitation studies have NOT studied a modular combination of rehabilitation devices that can be used by patients with a wide range of different ages, education, technology background and level of movement ability. Because patient motivation is an important factor in rehabilitation outcome a tele-rehabilitation system needs to increases patient satisfaction and motivation above or equal to that gained with traditional clinic based rehabilitation services. In addition the system needs to increase intensity of patient exercise performance and reduce health care costs. They point out that the technology has to be very user friendly so that the patient and therapist will concentrate on the task and not on the technology. Tele-rehabilitation holds the promise of allowing for improved continuity of care, increased exercise time and continuity of treatment with a reduction in the rehabilitation resources required. Interaction between the therapist and the patient can be through real time concurrent monitoring of the patient doing the virtual rehabilitation task with the patient and therapist being online at the same time during the session. Alternatively, intermittent online therapy consists of the therapist going online to update the exercise task and monitor the patient’s adherence to exercise regimen.
The HandTutor and ArmTutor system consists of a comfortable ergonomic glove and elbow brace with 3D shoulder position feedback. The patient wears the HandTutor and ArmTutor and the system allows the patient to practice multi-joint virtual functional tasks. The tasks are formulated so that they mimic ADL tasks like hair brushing, hand reaching and grasping. Continuous and intermittent online therapy is possible with the HandTutor system as the virtual functional tasks motivate the patient to practice on their own and either the patient or the therapist updating the task. Additionally evaluations on the patient’s quality, accuracy, speed of movement are incorporated into the HandTutor system allowing the therapist to quantitatively monitor the patient’s progress.
The group note that to date, previous tele-rehabilitation studies have NOT studied a modular combination of rehabilitation devices that can be used by patients with a wide range of different ages, education, technology background and level of movement ability. Because patient motivation is an important factor in rehabilitation outcome a tele-rehabilitation system needs to increases patient satisfaction and motivation above or equal to that gained with traditional clinic based rehabilitation services. In addition the system needs to increase intensity of patient exercise performance and reduce health care costs. They point out that the technology has to be very user friendly so that the patient and therapist will concentrate on the task and not on the technology. Tele-rehabilitation holds the promise of allowing for improved continuity of care, increased exercise time and continuity of treatment with a reduction in the rehabilitation resources required. Interaction between the therapist and the patient can be through real time concurrent monitoring of the patient doing the virtual rehabilitation task with the patient and therapist being online at the same time during the session. Alternatively, intermittent online therapy consists of the therapist going online to update the exercise task and monitor the patient’s adherence to exercise regimen.
The HandTutor and ArmTutor system consists of a comfortable ergonomic glove and elbow brace with 3D shoulder position feedback. The patient wears the HandTutor and ArmTutor and the system allows the patient to practice multi-joint virtual functional tasks. The tasks are formulated so that they mimic ADL tasks like hair brushing, hand reaching and grasping. Continuous and intermittent online therapy is possible with the HandTutor system as the virtual functional tasks motivate the patient to practice on their own and either the patient or the therapist updating the task. Additionally evaluations on the patient’s quality, accuracy, speed of movement are incorporated into the HandTutor system allowing the therapist to quantitatively monitor the patient’s progress.
Motivating early mobilization improves functional ability
In the December edition of Stroke http://bit.ly/hYnXS6 Dr Cumming and his group from University; and School of Physiotherapy La Trobe University, Melbourne, Australia and Department of Medicine University of Melbourne report on a clinical trial to show the effectiveness of Very Early Mobilization After Stroke Fast-Tracks Return to Walking. The group show that very early and intensive mobilization allowed patients to return to walking significantly faster than did standard stroke unit care controls. The LegTutor is a Knee brace and 3D hip position system that allows the patient to perform virtual functional tasks. The LegTutor system allows the patient to practice virtual sitting to standing movement patterns without weight baring. The exercises can also be performed with the therapist assisting the patient to move his legs even if the patient does not have the required range of motion. The LegTutor system therefore allows the patient to perform motivating early mobilization exercises.
Thursday 16 December 2010
The Jury is still out on robotic rehabilitation devices
In the December edition of Topics in Stroke Rehabilitation Dr. Backus and her team from Shepherd Center, Atlanta, Georgia USA comment on Translating Research Into Clinical Practice: Integrating Robotics Into Neurorehabilitation for Stroke Survivors http://bit.ly/hZJJrP
The report states that robotic devices hold the promise of providing high doses of repetitive movement in a reliable and controllable manner and are causing both excitement and apprehension among therapists and rehabilitation clinic management. The group concludes that the role that robotic devices play in the continuum of clinical care remains uncertain.
Are robotic devices a status symbol that says: “we are a top rehabilitation center”, “I am a top therapist”, “our clinic offer patients the most up to date treatment options”. Alternatively is there use clinically proven to be more effective than traditional intensive therapy and also economically justified.
The HandTutor system offers therapists and clinic managers a cost effective tool that provides patients with intensive active exercise practice with proven hand movement rehabilitation outcome.
The report states that robotic devices hold the promise of providing high doses of repetitive movement in a reliable and controllable manner and are causing both excitement and apprehension among therapists and rehabilitation clinic management. The group concludes that the role that robotic devices play in the continuum of clinical care remains uncertain.
Are robotic devices a status symbol that says: “we are a top rehabilitation center”, “I am a top therapist”, “our clinic offer patients the most up to date treatment options”. Alternatively is there use clinically proven to be more effective than traditional intensive therapy and also economically justified.
The HandTutor system offers therapists and clinic managers a cost effective tool that provides patients with intensive active exercise practice with proven hand movement rehabilitation outcome.
Keeping the home care patient motivated to do intensive exercise practice
In the December edition of stroke http://bit.ly/h21GuE Dr. Asplund from Riks-Stroke, Department of Medicine, University Hospital, Umeå, Sweden looks at Patient Dissatisfaction With Acute Stroke Care. The group highlight the potential for reducing patient dissatisfaction by structural measures, such as access to care in a stroke unit, patient involvement in discharge planning, and systematic follow-up after discharge.
However the strongest predictor of dissatisfaction with acute care was poor functional outcome. IF the patient is dependent on caregivers for daily living this leads to a depressed mood state and poor self-perceived health.
Our experiences with the HandTutor system in the community setting show that providing the patient with an ergonomic glove and easy to use rehabilitation software motivates both the patient and their caregiver to do intensive exercise practice. The home care therapy sessions can be supported by physical and occupational therapists offering tele-rehabilitation which again gives the patient the feeling that the patient and care giver are not alone and there is still progress to be made in their physical rehabilitation.
However the strongest predictor of dissatisfaction with acute care was poor functional outcome. IF the patient is dependent on caregivers for daily living this leads to a depressed mood state and poor self-perceived health.
Our experiences with the HandTutor system in the community setting show that providing the patient with an ergonomic glove and easy to use rehabilitation software motivates both the patient and their caregiver to do intensive exercise practice. The home care therapy sessions can be supported by physical and occupational therapists offering tele-rehabilitation which again gives the patient the feeling that the patient and care giver are not alone and there is still progress to be made in their physical rehabilitation.
Wednesday 15 December 2010
Signs and symptoms to predict movement ability outcome
In the December edition of PM&R Dr. Ramasamya and his UK group from the Academic Department of Military Surgery and Trauma, Birmingham and colleagues from Royal National Orthopaedic Hospital, Stanmore, University Hospital, Middlesborough and Defence Medical Rehabilitation Centre discuss Peripheral nerve injury following combat extremity trauma—does plantar sensation return? The report can be found at http://bit.ly/hB7oHK.
They conclude that as 95% of salvaged limbs with a documented insensate foot at initial presentation showed a return of plantar sensation then initial plantar sensation is not prognostic of long-term plantar sensory status and should not be a component of a limb-salvage decision algorithm.
Therapists and doctors should focus on signs and symptoms rather than initial diagnosis as an outcome prediction. The HandTutor system can be used for all patients that have hand movement dysfunction regardless of diagnosis. The system focuses on the sign and symptoms which are the amount and quality of patient’s active movement ability. This information provides the therapist and patient with real time feedback on movement ability and improvement.
They conclude that as 95% of salvaged limbs with a documented insensate foot at initial presentation showed a return of plantar sensation then initial plantar sensation is not prognostic of long-term plantar sensory status and should not be a component of a limb-salvage decision algorithm.
Therapists and doctors should focus on signs and symptoms rather than initial diagnosis as an outcome prediction. The HandTutor system can be used for all patients that have hand movement dysfunction regardless of diagnosis. The system focuses on the sign and symptoms which are the amount and quality of patient’s active movement ability. This information provides the therapist and patient with real time feedback on movement ability and improvement.
Shortage of trained PT's projected
In the December edition of PM&R DR. Zimbelman and her team from Cleveland Medical Centre USA look at Physical Therapy Workforce in the United States: Forecasting Nationwide Shortages http://bit.ly/hTf5ax . The group reports that On the basis of current trends, demand for PT services will outpace the supply of PTs within the United States.
In regards to neuromuscular rehabilitation, industry has to further develop intense and engaging upper-extremity rehabilitation tools that motivate the patient to intensively practice therapy tasks with less dependence of the therapist. The increased use cost-effective systems that can be used by the patient alone or with caregiver support will reduce the demand on PT’s, the healthcare system and healthcare budget.
The HandTutor system is used by patients in the home care environment with quantitative exercise performance data being stored so that it can be reviewed by the therapist. In addition the therapist can take part in the patients treatment from a remote location by using readily available web based tools.
In regards to neuromuscular rehabilitation, industry has to further develop intense and engaging upper-extremity rehabilitation tools that motivate the patient to intensively practice therapy tasks with less dependence of the therapist. The increased use cost-effective systems that can be used by the patient alone or with caregiver support will reduce the demand on PT’s, the healthcare system and healthcare budget.
The HandTutor system is used by patients in the home care environment with quantitative exercise performance data being stored so that it can be reviewed by the therapist. In addition the therapist can take part in the patients treatment from a remote location by using readily available web based tools.
Tuesday 14 December 2010
An informative open access article that discusses poor motor skill ability and ADHD found at: http://bit.ly/fyjpAk
The paper quotes references to support:
1. Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders, affecting approximately 3-9% of all school-aged children.
2. ADHD is characterized by a chronic developmentally inappropriate pattern of hyperactivity, inattention and impulsivity, which impairs academic performance, social interaction, and family function.
3. A high percentage of children with ADHD (30-50%) continuing to experience symptoms into adulthood.
4. Poor motor performance skills, are prevalent in children with ADHD, characterized by: excessive overflow movements, poor timing, force control, balance leading to poor ADL ability; e.g. tying shoes, poor handwriting, etc.
5. 50% of children with ADHD display motor coordination problems consistent with developmental coordination disorder (DCD).
6. The typical feature of DCD involves a marked impairment in the performance of motor skills that is not due to general intellectual, sensory, or motor neurological impairment. www.HandTutor.com
The paper quotes references to support:
1. Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders, affecting approximately 3-9% of all school-aged children.
2. ADHD is characterized by a chronic developmentally inappropriate pattern of hyperactivity, inattention and impulsivity, which impairs academic performance, social interaction, and family function.
3. A high percentage of children with ADHD (30-50%) continuing to experience symptoms into adulthood.
4. Poor motor performance skills, are prevalent in children with ADHD, characterized by: excessive overflow movements, poor timing, force control, balance leading to poor ADL ability; e.g. tying shoes, poor handwriting, etc.
5. 50% of children with ADHD display motor coordination problems consistent with developmental coordination disorder (DCD).
6. The typical feature of DCD involves a marked impairment in the performance of motor skills that is not due to general intellectual, sensory, or motor neurological impairment. www.HandTutor.com
Wednesday 14 April 2010
Living life to the full around the world: 21st century treatment proves successful for adults living with cerebral palsy
The OT/ PT can use Neuromuscular stimulation and robot-assisted rehabiliation to improve finger/ wrist movement ability. Equally important is isolated and combined finger and wrist intensive exercises provided by the HandTutor in the form of customized rehabilitation games with biofeedback.
An important component in achieving optimal rehabilitation outcome is intensive active movement practice. Traditional Occupational and Physical therapy provides the patient task orientated training (TOT). TOT is intensive repetition of everyday functional tasks or Active daily living tasks. Intrinsic motor and sensory feedback from the result of the tasks will allow correction in the planning, initialization and performance of the task and assist in rehabilitation.
The MediTouch HandTutor is a rehabilitation glove and software which offers impairment oriented training and augmented feedback. The HandTutor provides repetitive customized isolated or inter joint coordinated finger and wrist hand exercises and rehabilitates fine movements of the hand and wrist. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and Orthopedic conditions.
Research with the HandTutor confirms that Task oriented training should be combined with Impairment oriented (IOT) training to achieve enhanced functional recovery. The HandTutor is used in hospitals and community hand therapy clinics as well as through tele rehabilitation. Examples of patients that are treated include Stroke, TBI, spinal cord injury CP, Orthopedic hand and arm surgery, development co-ordination disorders in children etc. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and orthopedic conditions.
An important component in achieving optimal rehabilitation outcome is intensive active movement practice. Traditional Occupational and Physical therapy provides the patient task orientated training (TOT). TOT is intensive repetition of everyday functional tasks or Active daily living tasks. Intrinsic motor and sensory feedback from the result of the tasks will allow correction in the planning, initialization and performance of the task and assist in rehabilitation.
The MediTouch HandTutor is a rehabilitation glove and software which offers impairment oriented training and augmented feedback. The HandTutor provides repetitive customized isolated or inter joint coordinated finger and wrist hand exercises and rehabilitates fine movements of the hand and wrist. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and Orthopedic conditions.
Research with the HandTutor confirms that Task oriented training should be combined with Impairment oriented (IOT) training to achieve enhanced functional recovery. The HandTutor is used in hospitals and community hand therapy clinics as well as through tele rehabilitation. Examples of patients that are treated include Stroke, TBI, spinal cord injury CP, Orthopedic hand and arm surgery, development co-ordination disorders in children etc. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and orthopedic conditions.
Sunday 11 April 2010
Tuesday 2 March 2010
Neuromuscular stimulation, robot-assisted rehabilitation task specific training and the HandTutor
The Occupational/ Physical therapist has in his hand therapy repertoire several techniques to maintain and improve the patient's finger and wrist movement ability including Neuromuscular stimulation and robot-assisted rehabilitation. Additionally an important component in achieving optimal rehabilitation outcome is intensive active movement practice together with task orientated training. It is widely accepted that a combination of impairment oriented training with task specific training is essential for enhancing functional recovery. The HandTutor is impairment oriented training and provides customized games and biofeedback to motivate and challenge the patient to do intensive active finger and wrist exercises and to achieve maximal functional recovery.
Thursday 25 February 2010
Hand Therapy for Complex Regional Pain Syndrome
Complex Regional Pain Syndrome is a chronic condition that causes intense burning or aching pain, swelling and hypersensitivity in usually the arm or leg. The diagnosis is based on the patient presenting with a set of symptoms rather than a physiological sign. The pain usually gets gradually worse and may spread to other parts of the body.
Because the patient experiences pain during movement of the limb the patient stops to use the limb. This causes atrophy, progressive weakness and degeneration of the limb. Therefore the underlying principles of treatment are mobilization of the limb.
Case studies using the HandTutor on patients suffering from CRPS have shown that the patient moves his fingers and wrist during the exercise task presented by the dedicated rehabilitation software. It is thought that the "rehabilitation" games distract the patient from the pain allowing mobilization of the affected limb and preventing disuse atrophy and aiding functional rehabilitation.
Because the patient experiences pain during movement of the limb the patient stops to use the limb. This causes atrophy, progressive weakness and degeneration of the limb. Therefore the underlying principles of treatment are mobilization of the limb.
Case studies using the HandTutor on patients suffering from CRPS have shown that the patient moves his fingers and wrist during the exercise task presented by the dedicated rehabilitation software. It is thought that the "rehabilitation" games distract the patient from the pain allowing mobilization of the affected limb and preventing disuse atrophy and aiding functional rehabilitation.
Wednesday 24 February 2010
Outcomes of musculoskeletal surgeries in adult patients with cerebral palsy
The above paper concludes that the goal of upper and lower extremity musculoskeletal surgery should be an improvement in patients' functional ability.
Surgery is performed in order to improve functional ability by correcting or improving the underlying anatomical musculskeletal problem. This will facilitate physiological movement and allow for the development of a normal movement pattern.
In upper or lower extremity/ limb rehabilitation following for example arm and leg surgery, Physical and Occupational therapy must be designed to ensure that as near a normal movement pattern will be achieved. In order to do this the PT/ OT has to customize the exercise task to the patients' movement impairment. HandTutor provides sensory motor impairment oriented training by giving the patient games that require isolated, co-ordinated and accurate finger and wrist movements. At the same time the HandTutor dedicated rehabilitation computer games motivate and improve concentration and allow for intensive practice. Optimal functional outcome is achieved by combining HandTutor with traditional task specific training. The LegTutor by MediTouch provides objective knee and ankle kinematic evaluations and customized active practice with augmented feedback/ biofeedback using the same customizable rehabilitation software as the HandTutor.
Surgery is performed in order to improve functional ability by correcting or improving the underlying anatomical musculskeletal problem. This will facilitate physiological movement and allow for the development of a normal movement pattern.
In upper or lower extremity/ limb rehabilitation following for example arm and leg surgery, Physical and Occupational therapy must be designed to ensure that as near a normal movement pattern will be achieved. In order to do this the PT/ OT has to customize the exercise task to the patients' movement impairment. HandTutor provides sensory motor impairment oriented training by giving the patient games that require isolated, co-ordinated and accurate finger and wrist movements. At the same time the HandTutor dedicated rehabilitation computer games motivate and improve concentration and allow for intensive practice. Optimal functional outcome is achieved by combining HandTutor with traditional task specific training. The LegTutor by MediTouch provides objective knee and ankle kinematic evaluations and customized active practice with augmented feedback/ biofeedback using the same customizable rehabilitation software as the HandTutor.
Monday 22 February 2010
Optimising home rehabilitation functional outcome
Falling Through the Cracks: A Literature Review to Understand the Reality of Mild Stroke Survivors
http://thomasland.metapress.com/content/j15g01377802u232/
The link discusses how mild stroke survivors may present impairments that do not interfere with basic activities of daily living but do affect performance of complex tasks. Home interventions were found to help patients maximize their functions and improve rehabilitation outcome. However the majority of mild stroke survivors are sent home without referral to rehabilitation services although they present functional deficits.
Home rehabilitation will give better outcome if the dedicated supervised therapy sessions are as regular and intensive as in an in patient environment. However early release may be based on a logistical and financial decision rather a health decision.
The article points out however that the majority of mild stroke survivors are sent home without referral to rehabilitation services and their handicap/ disability, if not addressed, can lead to immobility demotivation, depression and the lack of ability to do active daily living tasks (ADL). This will prevent their reintegration into the community.
In order to enhance functional recovery it is fundamental that a customized home based rehabilitation program ensures that traditional task and exerise based rehabilitation is undertaken intensively and regularly.
The MediTouch HandTutor is a rehabilitation glove and software which offers impairment orientated training (IOT) and augmented feedback. The HandTutor provides repetitive customized isolated or inter joint co-ordinated finger and wrist hand exercises and rehabilitates fine movements of the hand and wrist. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and Orthopedic conditions.
Research with the HandTutor confirms that task oriented training should be combined with Impairment oriented (IOT) training to achieve enhanced functional recovery. The HandTutor is used in hospitals and community hand therapy clinics and home care to give an intensive active isolated exercise program. In home care the HandTutor can be supported by out patient therapy sessions or PT/ OT home visits or by tele rehabilitation therapy.
Examples of patients that are treated include Stroke, TBI, spinal cord injury CP, Orthopedic hand and arm surgery, development co-ordination disorders in children etc.
http://thomasland.metapress.com/content/j15g01377802u232/
The link discusses how mild stroke survivors may present impairments that do not interfere with basic activities of daily living but do affect performance of complex tasks. Home interventions were found to help patients maximize their functions and improve rehabilitation outcome. However the majority of mild stroke survivors are sent home without referral to rehabilitation services although they present functional deficits.
Home rehabilitation will give better outcome if the dedicated supervised therapy sessions are as regular and intensive as in an in patient environment. However early release may be based on a logistical and financial decision rather a health decision.
The article points out however that the majority of mild stroke survivors are sent home without referral to rehabilitation services and their handicap/ disability, if not addressed, can lead to immobility demotivation, depression and the lack of ability to do active daily living tasks (ADL). This will prevent their reintegration into the community.
In order to enhance functional recovery it is fundamental that a customized home based rehabilitation program ensures that traditional task and exerise based rehabilitation is undertaken intensively and regularly.
The MediTouch HandTutor is a rehabilitation glove and software which offers impairment orientated training (IOT) and augmented feedback. The HandTutor provides repetitive customized isolated or inter joint co-ordinated finger and wrist hand exercises and rehabilitates fine movements of the hand and wrist. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and Orthopedic conditions.
Research with the HandTutor confirms that task oriented training should be combined with Impairment oriented (IOT) training to achieve enhanced functional recovery. The HandTutor is used in hospitals and community hand therapy clinics and home care to give an intensive active isolated exercise program. In home care the HandTutor can be supported by out patient therapy sessions or PT/ OT home visits or by tele rehabilitation therapy.
Examples of patients that are treated include Stroke, TBI, spinal cord injury CP, Orthopedic hand and arm surgery, development co-ordination disorders in children etc.
Comparing HandTutor dedicated rehabilitation to the Wii general exercise system
http://www.usatoday.com/news/health/painter/2010-02-22-yourhealth22_ST_N.htm
The article from the USA today details so-called "Wiiitis" described as sore wrists and shoulders from overuse of the Nintendo Wii game's motion-sensitive remote even in healthy exercising individuals. These soft tissue injuries such as tendonitis are probably caused by overuse of gross motor movement and general exercise.
This can be compared to the MediTouch HandTutor dedicated rehabilitation software. the HandTutor works on the concept of repetitive fine motor, finger and wrist, isolated and combined exercises. The dedicated rehabilitation software allows the therapist to customize the games to the patients. All aspects of the exercise task can be customized such as difficulty and time to play for the game. This prevents overuse injuries however at the same time the physiotherapy and occupational therapy designed games are motivating and challenging for the patient.
The article from the USA today details so-called "Wiiitis" described as sore wrists and shoulders from overuse of the Nintendo Wii game's motion-sensitive remote even in healthy exercising individuals. These soft tissue injuries such as tendonitis are probably caused by overuse of gross motor movement and general exercise.
This can be compared to the MediTouch HandTutor dedicated rehabilitation software. the HandTutor works on the concept of repetitive fine motor, finger and wrist, isolated and combined exercises. The dedicated rehabilitation software allows the therapist to customize the games to the patients. All aspects of the exercise task can be customized such as difficulty and time to play for the game. This prevents overuse injuries however at the same time the physiotherapy and occupational therapy designed games are motivating and challenging for the patient.
Thursday 18 February 2010
Combined task oriented training and C.I with handTutor therapy
The above link discusses Constraint Induced Therapy.
An important component in achieving optimal rehabilitation outcome is intensive active movement practice. Traditional Occupational and Physical therapy provides the patient task orientated training (TOT). TOT is intensive repetition of everyday functional tasks or Active daily living tasks.
C.I or CIMT is Constraint Induced Movement therapy. By constraining the healthy hand C.I forces the patient to use only the affected hand with out relying on the healthy hand to eprform ADL. C.I therefore ensures that the patient performs intensive and repetitive functional ADL or exercise tasks.
The MediTouch HandTutor is a rehabilitation glove and software which offers impairment oriented training and augmented feedback or biofeedback. Impairment oriented training (IOT) relies firstly on an objective evaluation of the patients sensory motor and cognitive ability. A deficit in the sensory motor and cognitive ability is known as an impairment. Secondly IOT provides customized exercises for each impairment or exercises that group of impairments together.
The HandTutor provides repetitive customized isolated or inter joint co-ordinated finger and wrist hand exercises and rehabilitates fine movements of the hand and wrist. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and Orthopedic conditions. Research with the HandTutor confirms that Task oriented training should be combined with Impairment oriented (IOT) training to achieve enhanced functional recovery. The HandTutor is used in hospitals and community clinics as well as through tele rehabilitation. Examples of patients that are treated include Stroke, TBI, spinal cord injury CP, Orthopedic hand and arm surgery, development co-ordination disorders in children etc. The HandTutor is available worldwide from clinically trained local representatives and in the US from
David Garber P.T.
Englewood Cliffs Physical Therapy & Sports Medicine
701 Palisade Avenue
Englewood Cliffs, NJ
07632
Phone: 201 816 8925
Fax: 201 816 8926
therapysport.com
www.meditouch.co.il
Wednesday 17 February 2010
HandTutor IOT used together with an occupational adaptation approach to hand therapy
The Evidence Is Coming In on ADVANCE for Occupational Therapy Practitioners
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The above link discusses how hand therapy shifts from Biomechanical to Occupational Adaptation. In view of this I discuss how HandTutor IOT with augmented movement feedback compliments a OA approach. The handTutor exercise tasks work on improving finger and wrist movement parameters. Functional tasks do not work on the limit of these movement parameters. For example when gripping a cup the hand impaired patient does not work on the full range of his finger motion and does not reach maximum finger extension or flexion. Doing intensive exercises that challenge the patient to reach their full potential extension and flexion and speed of operning and closing of the fingers will ensure that the functional task is easier to perform. At the same time working on intensive isolated finger or co-ordinated finger flexion and extension will ensure that the elbow and shoulder are strengthened to support these movements. This will mean that the patient is less likely to incorporate a compensatory movement pattern during the functional task.
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The above link discusses how hand therapy shifts from Biomechanical to Occupational Adaptation. In view of this I discuss how HandTutor IOT with augmented movement feedback compliments a OA approach. The handTutor exercise tasks work on improving finger and wrist movement parameters. Functional tasks do not work on the limit of these movement parameters. For example when gripping a cup the hand impaired patient does not work on the full range of his finger motion and does not reach maximum finger extension or flexion. Doing intensive exercises that challenge the patient to reach their full potential extension and flexion and speed of operning and closing of the fingers will ensure that the functional task is easier to perform. At the same time working on intensive isolated finger or co-ordinated finger flexion and extension will ensure that the elbow and shoulder are strengthened to support these movements. This will mean that the patient is less likely to incorporate a compensatory movement pattern during the functional task.
Tuesday 16 February 2010
HandTutor treats children with ADHD and ADD
HandTutor is being used to treat children who have fine motor skill problems characterized by poor handwriting, cutting and painting skills and other functional tasks. These children have been diagnosed as having ADHD or ADD.
It has been found that fine motor training will improve the brain function of children with ADHD and ADD and improve academic achievement. Children are required to successfully do progressively more difficult fine motor tasks during their pre school and school careers. Children are therefore taught firstly to cut and paint before being taught to write. Thus their is a progression in the complexity of the task and the fine motor skill ability required to carry out the task. At the same time their is a progression in the concentration and attention to small details required to successfully complete the task.
The HandTutor provides sensory motor impairment orientated training by giving the child games that require isolated, co-ordinated and accurate finger and wrist movements. At the same time the HandTutor computer games motivate and improve concentration and allow for intensive practice. This practice will lead to better eye-hand co-ordination, and improved fine motor skill ability. This will allow the child to better perform the required functional task and encourage them to continue functional activities as they will begin to achieve better results. The HandTutor is suitable for children from 5 years old and upwards.
It has been found that fine motor training will improve the brain function of children with ADHD and ADD and improve academic achievement. Children are required to successfully do progressively more difficult fine motor tasks during their pre school and school careers. Children are therefore taught firstly to cut and paint before being taught to write. Thus their is a progression in the complexity of the task and the fine motor skill ability required to carry out the task. At the same time their is a progression in the concentration and attention to small details required to successfully complete the task.
The HandTutor provides sensory motor impairment orientated training by giving the child games that require isolated, co-ordinated and accurate finger and wrist movements. At the same time the HandTutor computer games motivate and improve concentration and allow for intensive practice. This practice will lead to better eye-hand co-ordination, and improved fine motor skill ability. This will allow the child to better perform the required functional task and encourage them to continue functional activities as they will begin to achieve better results. The HandTutor is suitable for children from 5 years old and upwards.
Monday 15 February 2010
Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis
Sunday 14 February 2010
HandTutor used in tele-rehabilitation
The HandTutor is a rehabilitation glove and software which offers impairment orientated training and augmented feedback. The HandTutor rehabilitates fine movements of the hand and wrist by encouraging and motivating the patient to do active and intensive hand exercises. The device is used in hospitals and community clinics as well as through tele rehabilitation. Examples of patients that are treated include, TBI, stroke, spinal cord injury CP, Orthopedic hand and arm surgery, development co-ordination disorders in children etc.
The HandTutor is available worlwide from clinically trained local representatives www.meditouch.co.il
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