Telerehabilitation Used Successfully as a Tool for the Handtutor Armtutor Legtutor and 3DTutor

Writing in Disability Rehabilitation. Aug 25,2011 Dr.I. Cikajlo, et al of the University Rehabilitation Institute Ljubljana, Slovenia reports on the objective of telerehabilitation as a follow up to the hospital or clinic rehabilitation process in the patient’s home. The study compares the balance training in a clinical environment with the telerehabilitation approach where the physiotherapists and physicians can follow the progress remotely. In this paper, the preliminary study of the pilot project with virtual reality(VR)-based tasks for dynamic standing frame supported balance training is presented. Six stroke patients participated in the study. The patients performed the balance training for 3 weeks, 2 weeks in the clinical setting and 1 week in the home environment, five times a week, and each time for up to 20 minutes. Objective effectiveness was demonstrated by parameters as track time, number of collisions and the clinical instruments Berg Balance Scale (BBS), Timed Up & Go (TUG), 10-m walk test and standing on the unaffected and affected extremity. The outcomes were compared to the balance training group without VR and telerehabilitation support. A 2-way ANOVA was used to explore the differences between both stroke groups.
Results: In patients who were subject to VR supported balance training, the BBS demonstrated improvement of 15%, the TUG of 29%, the 10-m walk of 26%, stance time on the affected and unaffected extremity for 200 and 67%, respectively. The follow-up demonstrated that the patients preserved the gained functional improvement. The VR task performance time and number of collisions decreased to 45 and 68%, respectively. In addition, no statistical differences were found between the telerehabilitation approach with VR supported balance training and conventional balance training in clinical settings either regarding the overall mean level or regarding the mean improvement.
Conclusions: The telerehabilitation approach in VR-supported-balance-training improved balance in stroke patients and had a similar effect on the patient’s postural functional improvement as conventional balance training in clinical settings. However, when balance training is continued in the patient’s home instead of the hospital, it eventually decreased the number of outpatient visits, reduced related costs and enabled treatment of a larger number of patients.
The HandTutor, ArmTutor, LegTutor and 3DTutor have been designed to be used both in hospitals, clinics and at the patient’s home through the use of telerehabilitaion. The dedicated software gives the therapist objective and quantitative information on the patient’s functional impairment. The information is recorded and documented and allows the therapist to fully customize the treatment session–all remotely via telerehabilitation. The Tutor system is used extensively and successfully for patients suffering from brain, head, spinal, Brachial Plexus, Radial and Ulnar nerve injuries , Parkinson’s, CP, MS, Development Coordination Disorders, and more. The Tutors are adaptable to children and adults.