Motor learning and training of co-ordinated joint movements with the HandTutor and LegTutor systems

In the January edition of Journal of NeuroEngineering and Rehabilitation http://bit.ly/gYcxHf Dr. Sun Jong Choi and his team from the Department of Orthopedic Surgery, Synergy Hospital and Seoul National University report on the validity of gait parameters for hip flexor contracture in patients with cerebral palsy.
Hi group compared the kinematic data during the gait analysis of twenty-four patients with cerebral palsy (mean age 6.9 years) and 28 normal children (mean age 7.6 years). They found that the maximum pelvic tilt, maximum psoas length, hip flexor index, and minimum hip flexion in stance were found to be clinically relevant parameters in evaluating hip flexor contracture.
As we know children with CP and other patients with other neurological injury and disease will exhibit a central neurological problem that will lead to a flexor pattern either or both upper and lower extremities. The main problem that causes this problem is the lack of interjoint co-ordination. Normal physiological movement and the ability to do functional movement e.g. walking needs not only the joint range of motion but chief in importance is interjoint co-ordination.
The HandTutor, ArmTutor and LegTutor systems incorporate the concept of virtual functional tasks. These tasks allow the patient to be given intensive active exercise practice and targeted movement feedback on the position of one, two or more joints and instructions on how to move the joint in association with another joint. Therefore the LegTutor system works on isolated and combined movements of the hip and knee and the HandTutor system works on isolated and combined movements of the shoulder, elbow, wrist and fingers. This allows the patient to do intensive task practice that will teach them how to do coordinated movements of two or more joints. Motor learning that teaches the patient how to move more than two joints in a coordinated pattern will improve functional movement ability and the performance of the everyday tasks e.g. walking.