Tutors Effective in Constraint Induced Movement Therapy

Crystal Phend, Senior Staff Writer for MedPage Today on January 16, 2012 discusses a new theory that is being published media wide but really is a rehash of the well established CIMT method of limb rehabilitation. If one wears a cast or splint it will cause the brain to rapidly shift its resources to make righties function better as lefties. This according to recent studies by researchers. Nicolas Langer, MSc, of the University of Zurich in Switzerland reported that right-handed individuals whose dominant arm had to be immobilized after an injury had a drop in cortical thickness in the area that controls primary motor and sensory areas for the hand. During the same two-week period, gray and white matter increased in the areas that controlled the uninjured left hand, suggesting “skill transfer from the right to the left hand,” as reported in the Jan. 17 issue of Neurology. Performance on motor skill tests showed a big boost in scores for the left hand over the two weeks after injury presumably from compensating for the immobilized right hand in daily activities. Likewise, Constraint Induced Movement Therapy(CIMT) is a unique treatment approach used for rehabilitation of the upper limb (arm/hand) following neurological damage. After a neurological event such as a stroke it is common for people to develop a tendency not to use their weaker arm which can lead to learned non-use or in some cases neglect of the weaker arm. CIMT aims to increase the amount of use and quality of movement of the weaker arm by following a structured treatment program developed by researchers in the USA. The treatment program works by producing ‘rewiring’ of the brain; this means that a larger part of the brain becomes active when producing movement of the weaker arm. This program is underpinned by several research studies which have proven benefits, particularly for stroke patients. The program involves a number of components in particular the use of repetitive task-oriented training. This involves the person practicing a series of short tasks with the weaker arm for several hours a day over a two to three week period under supervision by a trained therapist. Whilst using the weaker arm the unaffected side is restrained, for example by wearing a mitt or glove to continually remind the person to use the weaker arm. The person is encouraged to use the weaker arm outside of the treatment program for functional tasks at home whilst wearing the glove or mitt and is provided with a series of home assignments to complete. Research has proven that such intensive and repetitive use of the weaker arm over this short period leads to increased use of the weaker arm as well as improved quality of movement . The ARMTUTOR and HANDTUTOR have been at the forefront of physical therapy rehabilitation for stroke victims as well as for a host of other physical disabilities using CIMT. The TUTOR system consists of ergonomic wearable devices together with powerful dedicated rehabilitation software. The system is 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 TUTOR 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.