Patient’s Efforts with the Tutor System Effective for TBI

Dr. Catherine Dalton etal of the Regional Neurological Rehabilitation Unit of the Homerton University Hospital, London, UK writing in CLINICAL REHABILITATION on Sept. 2011 conducted a study with an objective to investigate the effects of patient participation in multidisciplinary goal setting during early inpatient rehabilitation after acquired brain injury.
The study was conducted in the Regional Neurological Rehabilitation Unit. One hundred and five patients with acquired brain injury participated. The main measures incorporated were the following: Numbers of goals set and achieved per patient before and after intervention; Barthel Index and Functional Independence Measure.
The results of the intervention resulted in a significant increase in the number of goals set per patient (340 versus 411 total goals, mean per patient 6.3 pre versus 8.05 post, P = 0.008). More patients had multiple goals set within each domain (P = 0.023). There was an increase in the number of patients with sleeping (0 pre, 9 post), continence (3 pre, 17 post) and leisure (15 pre, 35 post) goals set, and leisure goals achieved (60% pre and 68% post, P < 0.001). Correlations between goal achievement and change in activity-related outcome measures (Barthel Index and Functional Independence Measure) also improved with the new goal setting process. The proportion of goals achieved remained similar (60% pre and 63% post intervention), suggesting there was no evidence of inappropriate or unachievable goals set when the patient and family were included.
The conclusions reached were that real-time engagement of brain-injured patients in the goal setting process during early inpatient rehabilitation is achievable, but requires a structured multidisciplinary assessment of need. We found it increases the number of domains in which goals are set and includes functional areas not rated by commonly used global measures of outcome during inpatient rehabilitation.
When the Tutor (HandTutor, ArmTutor, LegTutor and 3DTutor) system is used in an inpatient rehabilitation environment for brain injury patients the main aspect is that the patient’s own efforts and participation are what affords improvement in range of motion and movement. The system uses set goals that are created by the patient himself through the use of dedicated and customized software. The Tutor system consists of ergonomic wearable devices together with powerful dedicated rehabilitation software. It is designed for those who have head, trunk, upper and lower extremity movement dysfunction. The Tutor system consists of motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises. Controlled exercise practice helps to prevent the development of compensatory movement patterns. The dedicated software allows the therapist to fully customize the exercises to the patient’s movement ability. In addition the therapist can objectively and quantitatively evaluate and report on the treatment progress. The rehabilitation system optimizes the patient’s motor, sensory and cognitive performance and allows the patients to better perform everyday functional tasks to improve their quality of life. Telerehabilitation allows the patients to use the system in an outpatient clinic or at home as well. The Tutor system is FDA and CE certified.