HandTutor Increases Joint Movement of Post Stroke Patients

In an article entitled “Neurophysiological and Behavioral Effects of tDCS Combined With Constraint-Induced Movement Therapy in Poststroke Patients” published in ” Neurorehabilitation & neural repair” (2011). , LUIGI TESIO writes that
recovery of motor function after stroke may depend on a balance of activity in the neural network involving the affected and the unaffected motor cortices. Objective. To assess whether transcranial direct current stimulation (tDCS) can increase the training-induced recovery of motor functions. Methods. In an exploratory study, 14 patients with chronic stroke and mean Fugl-Meyer Upper Extremity Motor Assessment of 29 (range = 8-50) entered a double-blind shamcontrolled study, aimed to investigate neurophysiological and behavioral effects of bihemispheric tDCS (cathodal stimulation of the unaffected motor cortex and anodal stimulation of the affected motor cortex), combined with constraint-induced movement therapy (CIMT). Results. Patients in both groups demonstrated gains on primary outcome measures, that is, Jebsen Taylor Hand Function Test, Handgrip Strength, Motor Activity Log Scale, and Fugl-Meyer Motor Score. Gains were larger in the active tDCS group. Neurophysiological measurements showed a reduction in transcallosal inhibition from the intact to the affected hemisphere and increased corticospinal excitability in the affected hemisphere only in the active tDCS/CIMT group. Such neurophysiological changes correlated with the magnitude of the behavioral gains. Both groups showed a reduction in corticospinal excitability of the unaffected hemisphere. Conclusions. CIMT alone appears effective in modulating local excitability but not in removing the imbalance in transcallosal inhibition. Bihemispheric tDCS may achieve this goal and foster greater functional recovery.
The HandTutor and its sister devices (ArmTutor, LegTutor and 3DTutor) have shown that they are effective in increasing hand and wrist movement for post stroke patients through the use of stimulating and challenging software games. The HandTutor is a unique ergonomic glove that is easy to put on even for patients with neuromuscular problems. The HandTutor glove is designed to detect finger and wrist motion and the dedicated software then records the information that the therapist uses to customize the treatment session to the patient‘s ability. The Tutors are now being successfully used in leading U.S. and foreign hospitals and clinics. Children as well as adults can even use the devices at home through telerehabilitation.