The Tutors and Coping with Chronic Neuropathic Pain after Spinal Cord Injury

Matagne Heutink etal of the Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands on November 2011 discusses a multidisciplinary cognitive behavioral program that might have beneficial effects on people with chronic neuropathic spinal cord injury pain.
Many people with spinal cord injury (SCI) rate chronic neuropathic pain as one of the most difficult problems to manage. The aim of the CONECSI (COping with NEuropathiC Spinal cord Injury pain) trial was to evaluate a multidisciplinary cognitive behavioral treatment program for persons with chronic neuropathic pain after SCI. The intervention consisted of educational, cognitive, and behavioral elements. The analyses showed significant changes over time on both primary (t1–t2), and 2 out of 4 secondary outcomes (both t1–t2 and t1–t3). Significant intervention effects (Time*Group interactions) were found for anxiety and participation in activities, but not for the primary outcomes. Subsequent paired t tests showed significant changes in the intervention group that were not seen in the control group: decrease of pain intensity, pain-related disability, anxiety, and increase of participation in activities. This study implies that a multidisciplinary cognitive behavioral program might have beneficial effects on people with chronic neuropathic SCI pain.
The Tutors (HandTutor, ArmTutor, LegTutor, 3DTutor) are being incorporated into physical therapy rehabilitation programs for Spinal Cord Injury patients.
Pain is caused by incorrect movement or the patient doing compensatory movements which puts the body under mechanical stress. The Tutors allow intensive practice of isolated movements with feedback from joints that are used in a set movement pattern in order to achieve the functional task. The Tutor system teaches the patient to do the correct movement without implementing a compensatory movement strategy that can lead to the onset of pain.
The Tutor system consists of ergonomic wearable devices together with powerful dedicated rehabilitation software. The devices are indicated for patients in rehabilitation centers, private clinics and the home where it can be supported by telerehabilitation. It is designed for those who have head, trunk, upper and lower extremity movement dysfunction.
The system consists of motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises. Controlled exercise practice will help 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 patient to better perform everyday functional tasks to improve their quality of life. The Tutor system is FDA and CE certified. See www.HandTutor.com for more information.