The HandTutor–a Rehabilitative Tool for Stroke Patients

Student researchers in Northeastern University have created a post-stroke rehabilitation glove designed to increase hand strength through the use of finger extension to improve cognitive ability and complete everyday tasks such as turning a doorknob, picking up a glass or unscrewing a light bulb.
The innovative device was supported by a three-year, $270,000 grant from the National Science Foundation.
The device was developed using 3-D additive manufacturing with embedded sensors and can be customized to fit a patient’s hand.
To improve cognitive function, users match colored LEDs (light-emitting diodes) on the device’s fingertips with those on external objects fashioned into household shapes, such as cups or doorknobs.
Pacella, a senior mechanical engineering major, praised his group’s final design. “No other device assists with opening the hand and has cognitive exercises like this,” he said. “Most commercial hand motion rehab devices don’t use sensors to measure range of motion and control of the fingers.”
The device still needs work to be done, though, according to its designers. It needs to become more user friendly, thinner and stronger.
While the work is impressive this technology already exists in other commercial devices such as the HANDTUTOR. With the HANDTUTOR the patient opens and closes his hand to activate sensors connected to dedicated software. The software includes challenging games that afford the patient the opportunity to be involved in extensive exercises that will bring him back to normal usage of his affected limb or joint. The HANDTUTOR together with its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) is one of the most cost effective rehabilitation tools around and is already being used in leading U.S. and European hospitals and clinics. It is also available for home use through the use of telerehabilitation and is designed for children from the age of 4 as well as adults
See WWW.HANDTUTOR.COM for more information.

The HandTutor as a Near-Natural Rehabilitative Tool

An old saying states that if you want to help a hungry person survive you should not give him a fish to eat but rather a fishing rod so he can fish for food himself. When an individual is recovering from a brain or spinal cord injury or suffers from Parkinson’s disease, stroke or other limb disabling illnesses the best method of recovery, if possible, is a natural one. Rather than be encumbered with bulky,expensive and complicated machinery that merely sends an electronic signal or causes the joint or limb to move through an external force it would be far more efficient and enabling to have the patient himself ”do the work”.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are just those kind of devices. They guide, but don’t cause, the patient to move his affected limb or joint. The patient must use his own effort to excel at one of the many challenging games that exist on dedicated software created exclusively for the TUTORs. These exercises are then recorded and customized to the patient’s level by physical and occupational therapists who monitor the patient’s progress. By implementing this system the patient will speed up his fine motor, sensory and cognitive impairments so that he has a successful recovery and can regain his activities of daily living (ADL‘s) and thereby his quality of life.
Currently in use in leading U.S. and European hospitals the TUTOR system can be used at home as well through the use of telerehabilitation. It is designed for children from the age of 4 and adults.
See WWW.HANDTUTOR.COM for more information.

The Lone Star State and the Tutor System

The fiscal year of 2012 will be one of greater assistance to Texans that have had a brain or spinal cord injury according to an announcement made in February 2012. An $8.6 million grant was given to the Department of Assistive and Rehabilitative Services of the Texas Department of Health and Human Services.The additional funding will be able to serve more Texans than previously estimated especially those that need intensive therapies to help them live independently in their communities.
It is hoped that the department will utilize some of these additional funds to purchase state of the art rehabilitative equipment such as the TUTOR system. These recently developed devices are already in use in leading U.S. and European hospitals and clinics. The TUTOR system is comprised of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. The system is used for physical rehabilitation for those who have suffered brain or spinal cord injury, stroke, CP, MS, upper or lower extremity limb surgeries and other disabling illnesses.
The TUTORs consist of gloves or braces that are placed strategically on the patient’s body and then connected to dedicated software where the patient can use his own power to accomplish challenging tasks. The TUTOR’s software has a series of games with which the patient will be able to accomplish a specific task causing intensive exercises to be mastered. The games allow physical and occupational therapists (PT) (OT) to customize the right exercise parameters to the patient’s movement ability and report on the patient’s exercise progress.
The system is available at home for patients who no longer need hospitatlization or who can’t get to a clinic. This is accomplished through the use of telerehabilitation. The TUTORs are available for children as well as adults and are FDA and CE approved.
See WWW.HANDTUTOR.COM for more information.

The Tutor System as a Long Term Rehabilitation Device

In an article written by D. Shaun Gray of the University of Alberta, Canada he states that the severely traumatic brain injured patient may have a prolonged recovery. Therefore because of this disadvantage the TBI patient may not be a candidate for typical rehabilitation programs. Further research shows that indeed these kinds of patients are capable of significant improvement but over a period of months to years. Further it shows that rehabilitation reduces long term costs of care. Obviously further research is needed to discover the effectiveness of current programs that specialize in these kind of rehabilitation programs.
The TUTOR system is one of the best tools in physical rehabilitation recovery to allow for a paced improvement and is one of the most cost effective medical devices to have been created recently. The TUTORs (HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR) are gloves or braces that are placed strategically on various parts of the body and through the use of dedicated software allow the TBI patient to receive intensive exercises that are customized to his particular level of capability. A physical therapist (PT) or Occupational therapist (OT) assists the patient to initiate and monitor the program that the patient himself is challenged with. The pace of exercise can be flexible to suit the capabilities of the patient.
Currently in use in leading hospitals and clinics throughout the U.S. and Europe the TUTORs are capable of being used at home when the patient recovers sufficiently through telerehabilitation. The TUTORS are certified by the FDA and CE.
See WWW.HANDTUTOR.COM for more information.

How the Tutor System Ensures Balance in Parkinson’s Patients

Fuzhong Li, Ph.D.at al conducted a study to see if Tai-Chi would be helpful in treating balance problems of Parkinson’s patients. The results were published in the New England Journal of Medicine on Feb. 9, 2012.
It’s known that patients with Parkinson’s disease have impaired balance which leads to diminished functional ability and can increase the risk of falling. Exercise is routinely encouraged by health care providers but few programs have been proven effective. The TUTOR system is one that has had many successes.
In the study, 195 patients were given Tai chi, resistance training, or stretching exercises. The patients participated in 60-minute exercise sessions twice weekly for 24 weeks.
The Tai chi group performed consistently better than the resistance-training and stretching groups The Tai chi group also performed better than the stretching group in all secondary outcomes and outperformed the resistance-training group in stride length and functional reach. Tai chi lowered the incidence of falls as compared with stretching but not as compared with resistance training. The effects of Tai chi training were maintained at 3 months after the intervention. No serious adverse events were observed.
The conclusions drawn were that Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson’s disease, with additional benefits of improved functional capacity and reduced falls. The TUTOR system in addition to Tai Chi training can also achieve improvement in therapy training for Parkinson’s patients.
The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation for stroke victims and those recovering from Parkinson’s, brain and spinal injuries, MS, CP and other limb movement limitations. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR consist of wearable glove and braces that detect limb movement showing the patient how much active or assisted active movement he is actually doing. The rehabilitation software uses special rehabilitation games to set a new target for this movement in terms of the patient’s ability to move his limb. The devices then measure the limb movement and give feedback on the success in trying to gain this new movement objective. In this way the patient is given movement feedback that allows him to understand which effort is more successful in moving his affected limb again. The TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR are now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. See WWW.HANDTUTOR.COM for more information.

The Tutor System as a Great Motivator for Recovering Patients

Sarah O. Schuck, BA, OTS, Amy Whetstone, BSW, OTS etal of the Department of Occupational Therapy, Xavier University, Cincinnati, Ohio and the
School of Allied Medical Professions, Neuromotor Recovery and Rehabilitation Laboratory, The Ohio State University, Columbus, Ohio conducted a study that proved that motivation to recover is a very powerful incentive to excel in rehabilitation therapy after a stroke or for patients with Cerebral Palsy.
The TUTOR system’s dedicated and customized software contains a series of challenging games that encourage and motivate the patient to accomplish the tasks created. The TUTORS (HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR) are designed to give the recovering patient intensive exercise programs that will enhance the recovery of his affected limb’s movement.
The TUTOR systems allow the physical and occupational therapist to report on and evaluate the patient’s functional rehabilitation progress. This allows the OT and PT to prescribe the correct customized and motivating intensive exercise practice to the manual rehabilitation therapy.
In the study the participants experienced increased quality of life, a greater propensity to use their affected arm, hand or leg and enhanced task performance without exhibiting motor changes. This is a goal that the TUTORS aim to achieve.
The Tutors are now available at leading U.S. and European hospitals and clinics. They are designed for use by children as well as adults. The TUTORS are certified by the FDA and CE and can be used through telerehabilitation in the patient’s home.
See WWW.HANDTUTOR.COM for more information.

CIMT–A Method That Has Success With the Tutor System

In a study about how Constraint-Induced Movement Therapy (CIMT) is effective with Duration of Adherence among Stroke Survivors with Hemiparesis, Olumide Olasunkanmi Dada and Arinola Olasumbo Sanya of the Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria discuss their recent study.
The two components of CIMT are the training of the more-impaired arm to perform functional tasks, and the restraint of the less-impaired arm. One of the challenges was that the application of CIMT must assure adherence to the use of the restraint.
A need was established to determine any factors that may influence adherence to CIMT, as this would allow it to be delivered more effectively, and thereby prevent situations where unrealistic expectations are placed on those individuals that are affected by a stroke.
Thirty stroke survivors with hemiparesis were recruited from physiotherapy out-patient clinics. Records were kept during the period they wore the restraint. The information logged was motor function and functional use of the upper limb.
The results showed the influence of socio-economic status. Participants of middle socio-economic status adhered for a longer duration. Age had weak and no significant correlation.
The conclusion drawn was that socio-economic status should be considered when applying CIMT.
The HANDTUTOR specifically has been an effective device to be used together with CIMT. It, together with its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR), aims to increase the amount of use and quality of movement of the weaker arm or limb by following a structured treatment program.
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 and CP patients.
The program involves a number of components, in particular the use of repetitive training practice or repetitive impairment practice. This involves the child or adult doing intensive customized repetitive isolated exercises with the weaker arm arm using the ARMTUTOR and hand using the HANDTUTOR. The exercise practice was customized by the physical and occupational therapist to the patient’s movement ability. The dedicated rehabilitation software provides information on the patient’s performance and corrects the patient in the form of biofeedback when they are not doing the movement correctly. This means that the training practice is customized to the patient’s movement ability regarding their functional ability. The patient can also begin to understand how his limbs are moving as the biofeedback is amplified for movement feedback. Together with a score on how well the patient is performing allows the patient and PT to better understand the intensive and motivating exercise practice. 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 TUTORS have been used effectively together during CIMT training and therapy and most recently at the Rusk rehabilitation hospital children’s summer camp. The TUTORS are designed to be used by children as well as adults..
The TUTORS are currently being used in leading hospitals and clinics in the U.S. and Europe and are fully certified by the FDA and CE. See WWW.HANDTUTOR.COM for more information.

The Tutor System can be Used Successfully with Bobath or CIMT Methods in Physical Rehabilitation

A trial study was conducted by Burcu Ersoz Huseyinsinoglu etal of the Stroke Unit, Florence Nightingale Hospital, Istanbul, Turkey to determine which method of rehabilitation is more effective for stroke victim’s arm function–the Bobath Concept or Constraint-Induced Movement Therapy (CIMT).
The objective of the study was to compare the effects of the Bobath Concept and CIMT on arm functional recovery among stroke patients that had a high level of function on the affected side.
This was a single-blinded, randomized controlled trial that took place in an outpatient physiotherapy department of a stroke unit. 24 patients were randomized to both systems.
The Bobath group was treated for 1 hour whereas the CIMT group received training for 3 hours per day for 10 consecutive weekdays.
The conclusions drawn were that CIMT and the Bobath Concept have similar efficiencies in improving functional ability, speed and quality of movement in the paretic arm among stroke patients that have a high level of function. CIMT seems to be slightly more efficient than the Bobath Concept in improving the amount and quality of affected arm use.
Both methods are enhanced when the TUTOR system is in place.
The ARMTUTOR has been developed to allow for functional rehabilitation of the shoulder, elbow, wrist or upper extremity. The system consists of an ergonomic wearable arm brace and dedicated physical rehabilitation software. The ARMTUTOR system allows for interactive rehabilitation exercise and a range of biomechanical evaluations including speed, passive and active range of motion and motion analysis of the upper extremity. This quantitative data allows physical and occupational therapists (PT) (OT) to customize the right exercise parameters to the patient’s movement ability and report on the patient’s exercise progress. The ARMTUTOR rehabilitation concept is based on performing controlled and repetitive exercise rehabilitation practice. It does this through the use of various games which are at a patient-customized level with real time accurate feedback on the patient’s performance. The rehabilitation games are suitable for a wide variety of neurological and orthopedic injuries and diseases.
The games challenge the patient to perform the exercise at a customized difficulty level. This level is set by the OT or PT and encourages the patient to do intensive repetitive exercise practice.
The ARMTUTOR allows for isolated and a combination of elbow and three directional shoulder treatments. The system provides detailed exercise performance instructions and precise feedback on the patient’s exercise performance. Overall, controlled exercise of multijoints within a normal movement pattern will prevent the patient developing an undesired or compensatory joint movement pattern and this will ensure better performance of functional tasks.
The Arm Tutor and its sister devices (LEGTUTOR, HANDTUTOR, 3DTUTOR) are used wordwide in hospitals and clinics and are FDA and CE certified. They can be used at home through telerehabilitation. See WWW.HANDTUTOR.COM for more information.

Parkinson’s Patients Benefit from HandTutor and ArmTutor

Alexander Michael Crizzle, MPH and Ian J Newhouse, PhD writing for the Clinical Journal of Sports Medicine
ask whether physical exercise is beneficial for persons with Parkinson’s disease?
They reviewed existing studies evaluating the effectiveness of physical exercise on mortality, mobility, strength, balance, and activities of daily living (ADL) for Parkinson’s disease (PD) patients.
Only patients with PD were included in the intervention study. The intervention included some form of physical or therapeutic exercise after which the effects of the physical exercise were evaluated.
Outcomes in the studies were measured in terms of physical improvements in patients with PD, such as improved axial rotation, functional reach, flexibility, balance, muscle strength, short-step gait, and mobility. All studies reviewed show that exercise improves overall performance in PD patients. Improvements were measured using standardized tests and other measurement scales.
The results of the research support the hypothesis that patients with PD improve their physical performance and activities of daily living through exercise.
The TUTOR system was developed to afford Parkinson’s patients a comfortable and challenging set of exercises that could return at least a modicum of normal movement to their affected limbs.
The HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation for Parkinson’s patients as well as those suffering from stroke,brain and spinal injuries, MS, CP and other limb movement limitations. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR consist of a wearable glove or braces that detect limb mobility showing the patient how much active or assisted active movement he is actually doing. The rehabilitation software uses special rehabilitation games to set a new target for this movement in terms of the patient’s ability to move his limb. The devices then measure the limb mobility and give feedback on the success of the patient in trying to gain this new movement objective. In this way the patient is given feedback that allows him to understand which effort is more successful. The TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospital rehabilitation clinics. See WWW.HANDTUTOR.COM for more information.

The Tutors Assist Physical Rehabilitation for Wheelchair Bound Patients

A study published in the American Journal of Physical Medicine & Rehabilitation on February16, 2012 and written by Marlene Aparecida PhD etal discusses how individuals with Spinal Cord Injury are affected by wheelchair sports on their respiratory muscle strength and thoracic mobility.
Thirty male subjects with chronic spinal cord injury took part in the study and were divided into four groups: sedentary subjects with quadriplegia, wheelchair rugby athletes with quadriplegia, sedentary subjects with paraplegia, and wheelchair basketball athletes with paraplegia . The study’s main outcome measures were maximal inspiratory and expiratory pressure and the respiratory coefficients at the axillary and xiphoid levels.
The conclusions reached were that physical training seems to have a positive influence on respiratory muscle strength and thoracic mobility, especially in subjects with quadriplegia.
Physical training for incomplete paralysis is one of the issues that is accommodated with the use of the TUTOR system.
The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation and physical therapy for interactive rehabilitation exercise. These innovative devices implement an impairment based program with augmented feedback and encourage motor learning through intensive active exercises. These exercises are challenging and motivating and allow for repetitive training tailored to the patient’s performance. This training is then customized by the occupational and physical therapist to ensure that the patient stays motivated to do intensive repetitive manual therapy and exercise practice.
The HANDTUTOR, LEGTUTOR, ARMTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. and foreign hospitals with theTUTORS being used in clinics and in the home. Home care patients can be supported by the occupational and physical therapist offering tele-rehabilitation. See WWW.HANDTUTOR.COM for more information.

How the Hand, Arm, Leg and 3D Tutor System Assists the TBI Patient

Inpatient rehabilitation is designed to help a Traumatic Brain Injury (TBI) patient improve function after a moderate to severe TBI event. Amongst other problems faced by the patient are those of a physical nature i.e. loss of strength, coordination and movement. Most TBI rehabilitation inpatients participate in physical therapy and occupational therapy in an individual or group format.
One of the professionals that is assigned to the patient is a physical therapist (PT). The PT will help the patient improve physical function and mobility. The PT’s role is to teach the patient to be as physically independent and as safe as possible within the environment. This is accomplished through therapeutic exercises and re-education of muscles and nerves with the goal of restoring normal function. Specific goals to be accomplished in the physical therapy gym include strengthening muscles and improving endurance, walking and balance.
The other professional that will be involved is an Occupatonal Therapist (OT). The OT provides training in activities of daily living to help the patient become become more independent. The OT will work with the patient to improve strength, balance and trunk control amongst other skills. These therapists will also teach exercises that strengthen muscles used in speech and swallowing.
After inpatient rehabilitation, when the patient has shown sufficient improvement to leave the hospital, the question arises as to how rehabilitation will continue. This may become a problem for those patients that are well enough to be at home but not well enough to travel for therapy. At times an outpatient clinic may be found that is not too far from the patient’s home.
Luckily a solution exists that solves many, if not all, of these issues. Called the TUTOR system it is a set of devices (HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR) that have been recently developed to be used in physical rehabilitation of TBI patients both inpatient and outpatient and at home via telerehabilitation. The TUTORS can help the patient regain strength, movement and coordination of their affected limbs. Guided by a professional physical therapist the TBI patient will have a brace or glove attached to an appropriate area of his body and begin to “play” games on an attached computer which has dedicated software geared to improving the various muscles and limbs of the patient. In addition the progress made by the patient is then monitored and recorded so as to customize future sessions where further progress is achieved.
The TUTORS are currently in use in leading U.S. and foreign hospitals and clinics and are available for children as young as 4 years of age. The TUTORS are FDA and CE certified. See WWW.HANDTUTOR.COM for further information.

The Tutor System as a Tool in Cancer Rehabilitation

Cancer and treatment can cause physical problems including pain, fatigue, and muscle weakness. These may then interfere with life in a variety of ways including physically, emotionally and practically. While not all cancer survivors need rehabilitation services that are guided by health care professionals, most will need to at least work on improving strength and stamina.
Expert advice and guidance may help to improve health and ability more quickly and to a greater degree. There are many resources and therapies to help cancer survivors with fatigue, pain, and overall ability to function. Survivors who want to continue to work or return to employment may benefit from rehabilitation services to help them do so.
Some survivors, though, may have muscular or orthopedic problems and there may be uncertainty about how much to exercise or how to best exercise. A plan for rehabilitation can help a survivor to move forward while being as active as possible.
Each member of the rehabilitation team is likely to also work with the patient to develop a plan for their specific area of expertise. For example, a physical therapist will develop a plan to help recover physical strength and abilities. When that occurs it would advantageous to find the best method of doing so. This is where the TUTOR system comes in. The TUTORS ( HANDTUTOR, ARMTUITOR, LEGTUTOR and 3DTUTOR) have been developed to create an intensive exercise program for patients who have suffered from upper or lower extremity surgeries and many other disabling diseases. By involving oneself in the best exercise program normal movement returns to the affected limb.
The newly developed HANDTUTOR, for example, has become a key system in neuromuscular rehabilitation for TBI and stroke victims and can be used for cancer patients and those recovering from spinal cord injuries, Parkinson’s, MS, CP and other limb movement limitations. A plan for rehabilitation can help a survivor to move forward while being as active as possible. The HandTutor is a hand therapy tool used by occupational and physical therapists. These innovative devices implement an impairment based program with augmented motion feedback that encourage motor learning through intensive active exercises and movement practice. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR consist of wearable glove and braces that detect limb movements showing the patient how much active or assisted active movement they are actually accomplishing. The rehabilitation software uses special rehabilitation games to set a new target in terms of the patient’s ability to move their limb. The devices then measure the limb movement and give feedback on the success of the patient in this new objective. In this way the patient is given feedback that allows the patient to understand which effort is more successful in allowing them to move their affected limb again. Subsequently the TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. See WWW.HANDTUTOR.COM for more information.

Tutor System Uses Intensive Exercise in Parkinson’s Therapy Treatment

Published in KENTPATCH. Dateline February 18, 2012
Dr. Angela Ridgel, an assistant professor of exercise science/physiology, at Kent State University is spearheading two projects that involve exercise therapy which is exactly what the TUTOR system is based on.
The projects help individuals with Parkinson’s disease improve their cognitive and motor functions through exercise therapy that can delay the progression of Parkinson’s and lower the Parkinson’s medications dosages..
” I believe, and my research is proving, that we can use exercise therapy to promote improvements in the way the nervous system works and improve the lives of these individuals,” said Dr. Ridgel.
The first research study is called “The Parkinson’s Disease Cognitive Intervention”.
With support from Kent State’s Dr. John Gunstad, associate professor of psychology, and Dr. Ellen Glickman, professor of exercise physiology, Ridgel is currently studying the impact of upper and lower extremity exercise on cognition and motor function in addition to cerebral blood flowand cardiovascular fitness and muscle strength in individuals with Parkinson’s disease.The goal is to add additional exercise therapy to previous methods.
Dr. Ridgel’s findings have shown improvements in cognitive function, mobility and oxygen saturation in the brain following comprehensive exercise intervention.
Other extensive psychological evaluations measuring memory, attention, problem-solving and language may lead to additional methods for Parkinson’s rehabilitation,according to Dr. Gunstad.
Ridgel will present the results of the study in May at the American College of Sports Medicine conference .
The second research study involves a “smart bike” that would allow the therapists to create a database of symptoms and responses. The database could then design a cycling program tailored to an individual’s unique challenges and capabilities.
Beginning in June, Ridgel will use the “smart bike” to assess the individual’s effort, performance, skill level and therapeutic value. The goal is to devise a computer-driven system that alters resistance, speed and time to benefit the individual. The ”bike” will produce a customized exercise program to benefit individuals with Parkinson’s.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are all devised to implement an intensive and customized exercise program.
They have become a key system in neuromuscular rehabilitation for stroke victims and those recovering from brain and spinal injuries, Parkinson’s, MS, CP and other limb movement limitations. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR consist of wearable glove and braces that detect limb movement showing the patient how much active or assisted active movement they are actually doing. The rehabilitation software uses special rehabilitation games to set a new target for this movement in terms of the patient’s ability to move their limb. The devices then measure the limb movement and give feedback on the success of the patient in trying to gain this new movement objective. In this way the patient is given movement feedback that allows him to understand which effort is more successful and gets him to move his affected limb again. In this way the TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. See WWW.HANDTUTOR.COM for more information.

ArmTutor Used in Conjunction With New Tasmanian Table.

In a story released on February 19, 2012 for ABC News a Tasmanian hospital has developed a special table to be used by stroke victims to assist them with their physical therapy. Staff from the Launceston General Hospital and volunteers from Technical Aids for the Disabled in Tasmania have developed this special tool over a period of 5 years which would be very helpful while stroke patients use the ARMTUTOR.


The newly developed ARMTUTOR can play an integral part in post stroke and other upper limb rehabilitation. The ARMTUTOR provides the physiotherapist and occupational therapist the ability to customize manual therapy for the shoulder, elbow and wrist. Together with its sister devices (HANDTUTOR, LEGTUTOR, 3DTUTOR) it has been developed to allow for functional rehabilitation of the upper extremity – hand, arm and lower extremity — leg, hip. The ARMTUTOR system consists of an ergonomic wearable arm brace and dedicated rehabilitation software.


The ARMTUTOR system allows for the occupational and physical therapist to implement biomechanical evaluations which include speed, passive/active range of motion and motion analysis of the upper extremity. This, to best customize the shoulder and elbow exercises provided by the ARMTUTOR. In addition, quantitative biomechanical data allows for objective evaluation and rehabilitation treatment follow up by the occupational and physical therapist. The ARMTUTOR rehabilitation concept is based on performing controlled and motivating exercise rehabilitation practice at a patient customized level with real time accurate feedback on the patient’s performance. The exercises are designed in the form of challenging games that are suitable for a wide variety of orthopedic injury and disease. The games challenge the patient to perform the exercise task to their best ability.


The ARMTUTOR allows for isolated and a combination of elbow and three directional shoulder treatment and is used after arthroscopic surgery procedures. The system provides detailed exercise performance instructions and precise feedback on the patient’s performance. This encourages motivation. Controlled exercise of multijoints within the normal movement pattern prevents the development of undesired and compensatory joint movement and ensures better performance of functional tasks.


The ARMTUTOR system is being used by many leading rehabilitation centers worldwide and has full FDA and CE certification. See WWW.HANDTUTOR.COM

Post Breast Surgery Physical Therapy Can Be Enhanced by the ArmTutor

Kelli Easterling reporting in YOURDAILYJOURNAL.COM in February 2012 reports on the advice that after breast surgery, lymph node removal or breast radiation women should get involved in exercise to help in the recovery according to health care professionals. There are DVDs that explain how that can be done. It is vital that women who endure these kind of cancer surgeries return to a normal full range of motion so that they are able to resume a normal lifestyle.
One of the successful methods of such exercise can include the ARMTUTOR.
The ARMTUTOR system has been developed to allow for functional rehabilitation of the arm, shoulder, elbow, wrist or anywhere in the upper extremity. The system consists of an ergonomic wearable arm brace and dedicated physical rehabilitation software. The ARMTUTOR system allows for interactive rehabilitation exercise and a range of biomechanical evaluations including speed, passive and active range of motion and motion analysis of the upper extremity. This quantitative data allows physical and occupational therapists (PT) (OT) to customize the right exercise parameters to the patient‘s movement ability and report on the patient’s exercise progress. The ARMTUTOR rehabilitation concept is based on performing controlled and repetitive exercise rehabilitation practice. It does this through the use of various games which are set at a patient-customized level with real time accurate feedback on the patient’s performance. The rehabilitation games are suitable for a wide variety of neurological and orthopedic injuries and diseases.
The games challenge the patient to perform the exercise at a customized difficulty level. This level is set by the OT or PT and encourages the patient to do intensive repetitive exercise practice.
The ARMTUTOR allows for isolated and a combination of elbow and three directional shoulder and arm treatments. The system provides detailed exercise performance instructions and precise feedback on the patient’s exercise performance. Overall, controlled exercise of multijoints within a normal movement pattern will prevent the patient developing an undesired or compensatory joint movement pattern and this will ensure better performance of functional tasks.
The ARMTUTOR and its sister devices (LEGTUTOR, HANDTUTOR, 3DTUTOR) are used wordwide in hospitals and clinics and are certified by the FDA and CE. They can be used at home through telerehabilitation. See WWW.HANDTUTOR.COM for more information….

Tutors as a Supplement for Elderly Exercise Programs

Dr. Maria A. Fiatarone etal conducted a study and published it in the New England Journal of Medicine. The subject of the study was “Exercise Training and Nutritional Supplementation for Physical Frailty in Elderly People“.
Despite undernutrition and disuse of skeletal muscle that are often cited as potentially reversible causes of frailty amongst the elderly , the efficacy of interventions targeted specifically at these deficits has not been carefully studied until now.
A randomized, placebo-controlled trial was held comparing progressive resistance exercise training, multinutrient supplementation, both interventions, and neither in 100 frail nursing home residents over a 10-week period.
The conclusions reached were that high-intensity resistance exercise training is a feasible and effective means of counteracting muscle weakness and physical frailty in elderly people. In contrast, multinutrient supplementation without concomitant exercise does not reduce muscle weakness or physical frailty.
In addition to these training sessions and nutrient supplements the elderly can avail themselves of modern devices such as the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR.
These TUTORS are innovative motion capture gloves and arm and leg braces that implement an impairment oriented training based program with augmented feedback and encourage motor learning through intensive and repetitive exercises. Intensive exercise practice is the physical and occupational therapists tool to improve the patient’s sensory, motor and cognitive movement ability. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR use movement feedback and dedicated rehabilitation games to make sure that the exercises performed by patients who suffered stroke, brain/spinal cord injuries, Cerebral Palsy and other upper or lower limb disabilities or surgeries are challenging and motivating.This is because, the physiotherapist or occupational therapist can tailor the repetitive exercises to the patient’s exercise performance ability.
Currently part of the rehabilitation program of leading U.S. and foreign hospitals the TUTORS are also used in clinics and at home through the use of innovative telerehabilitation using the internet. See WWW.HANDTUTOR.COM for more information.

The Tutor System and its Capabilities in African Rehabilitation Therapy

In a research study conducted by Dr. Andrew J. Haig for the Journal of Rehabilitation Medicine about the availability of medical rehabilitative care for people living in Antartica and Sub Saharan Africa it was found that for the Antarticans there was no major problem as when there was a need for such care the patient would merely be flown to world class healthcare facilities elsewhere. However for the approximately 78 million affected people on the African continent there was no such solution. Africa basically has no physical and rehabilitation medicine training programs, no professional organizations, no specialty board requirements, and no practising physicians in the field as of the time of the study.
Enter the TUTOR system with its versatility and availability in addition to it’s relatively low cost. The patient that suffers from a stroke, head/spinal cord injury, Parkinson’s disease, Cerebral Palsy, Multiple Sclerosis, Radial/Ulnar nerve or Brachial Plexus injuries and other upper or lower joint issues can avail himself of this state of the art rehabilitation device. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are recently developed braces and gloves that are placed strategically on affected parts of the body and then with the dedicated software that has been created exclusively for the TUTORS provide for intensive and repetitive exercises using various games.
The games challenge the patient to perform the exercises at a customized difficulty level. This level is set by the OT or PT, who can be located remotely through the use of telerehabiliation, and encourages the patient to do intensive repetitive exercise practice.
Although foreign charities and aid groups along with local governments would have to be involved the possibilities are endless as to the success the TUTORS can have with this population. The TUTOR system is FDA and CE certified and can be used by children as well as adults. See WWW.HANDTUTOR.COM for more information.

ArmTutor Used in Parkinson’s Disease Physical Rehabilitation

Published by the Hindawi Corporation in their 2012 journal edition there is a result of a study about Upper Extremity Motor Learning among Individuals with Parkinson’s Disease written by
K. Felix, etal of the Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
It has been found that motor learning occurs in the rehabilitation of individuals with Parkinson’s Disease (PD). With repetitive and structured practice of motor tasks, PD patients show improved performance, confirming that motor learning has probably occurred. Despite a number of studies that have been completed evaluating motor learning in people with PD, the sample sizes were small and the improvements were varied. The purpose of this meta-analysis was to determine the ability of people with PD and how they learn motor tasks.
A total of 58 individuals with PD and 56 participants without PD were included from seven studies.
The results of the meta-analysis suggest that motor learning in upper extremity function occurs in both neurologically healthy controls and individuals with PD through practice of upper extremity reaching tasks designed to reduce movement time. This effect is present immediately after the training period but also is sustained after a period of time. The control participants have a mild to moderate increased effect based on their mean effect sizes compared to people with PD. However, the large overlap of confidence intervals would suggest that both groups benefit from the practice in which they participate.
Overall, these results are consistent with work done previously in small studies that demonstrate skill acquisition and retention in people with PD in a number of motor tasks. Such studies have demonstrated acquisition and retention of motor skills in varied upper extremity tasks not included in this meta-analysis such as serial reaction time tasks and other sequential aiming movements. Furthermore, motor learning studies in people with PD have demonstrated improvement in balance and lower extremity function through their practice.
Results from this pooling of data provide evidence that upper extremity movement time can be improved by the use of practice of reaching tasks in persons with PD, albeit potentially to a lesser extent than is shown in individuals with no neurological problems. The interpretation of this meta-analysis indicates that practice of relevant motor tasks targeted at maximizing acquisition and retention improved movement speed.
The ARMTUTOR system has been developed to allow for functional rehabilitation of the shoulder, elbow, wrist or upper extremity for PD and other patients suffering from upper extremity limb movement disabilities.. The system consists of an ergonomic wearable arm brace and dedicated physical rehabilitation software. The ARMTUTOR system allows for interactive rehabilitation exercise and a range of biomechanical evaluations including speed, passive and active range of motion and motion analysis of the upper extremity. This quantitative data allows physical and occupational therapists (PT) (OT) to customize the right exercise parameters to the patient’s movement ability and report on the exercises’ progress. The ARMTUTOR rehabilitation concept is based on performing controlled and repetitive exercise rehabilitation practice. It does this through the use of various games which are at a patient-customized level with real time accurate feedback on the patient’s performance. The rehabilitation games are suitable for a wide variety of neurological and orthopedic injuries and diseases.
The games challenge the patient to perform the exercise at a customized difficulty level. This level is set by the OT or PT and encourages the patient to do intensive repetitive exercise practice.
The ARMTUTOR allows for isolated and a combination of elbow and three directional shoulder treatments. The system provides detailed exercise performance instructions and precise feedback on the patient’s exercise performance. Overall, controlled exercise of multijoints within a normal movement pattern will prevent the patient developing an undesired or compensatory joint movement pattern and this will ensure better performance of functional tasks.
The ARMTUTOR and its sister devices (LEGTUTOR, HANDTUTOR, 3DTUTOR) are used wordwide in hospitals and clinics. They are certified by the FDA and CE and can be used at home through telerehabilitation See WWW.HANDTUTOR.COM for more information….

Tutor system - LegTutor effective tool with intensive robotic and manual gait training in sub-acute stroke

In the February edition of Journal of NeuroEngineering and Rehabilitation Dr. Conesa and his group from Functional Rehabilitation Department and the Brain Injury Unit, Neurorehabilitation Hospital Institut Guttmann Barcelona, Spain and the Harvard Medical School, Boston, MA, USA report that 8 weeks of intensive physical rehabilitation including robotic and manual gait training was well tolerated by early stroke patients. The group saw significant gains in function with outcome measures including improved walking speed and balance scales. In particular, robotic training on the mid-level gait dysfunction group showed the best improvement. The gait training was split up into robotic gait training from 0-4 weeks and manual gait training weeks 4-8.

The LegTutor is a Leg brace that measures hip and knee movement. it is used to customize isolated and intensive manual gait exercsie practice and give the patients augmented feedback on their performance. The 3DTutor can be used to give intensive ankle exercise practice and assist in treating drop foot.

Foot drop caused by Radiculopathy treated by manual therapy and the 3DTutor

Disease of the spinal nerve roots and spinal nerves particular in the lumbar spine and sacral region of the spine can lead to pain. The locality of pain is dependent on which nerve root is affected. This condition is known as Radiculopathy or radiculitis. Radiculopathy is characterized by a pain that seems to radiate from the spine and extend outward to cause symptoms away from the source of the spinal nerve root irritation. Manual therapy by a physiotherapist, physical therapist, and use of the 3DTutor particular if the pain has led to movement impairment e.g. foot drop
is affective in improving functional walking ability and motivate the patient to exercise despite the pain.

National Institute of Health Panel Discusses Traumatic Brain Injury Problem

A number of years ago there was a panel discussion at a National Institutes of Health (NIH) event concerning ”Rehabilitation of Persons With Traumatic Brain Injury”. Although not recent it bears repeating.
The objective was to provide clinicians and biomedical researchers with information about and recommendations for effective rehabilitation measures for persons who have experienced a traumatic brain injury (TBI).
There were participants representing the fields of behavioral medicine, neuropsychology, neurology, family medicine, psychiatry, pediatrics, physical medicine and rehabilitation, occupational therapy, speech and hearing, nursing, epidemiology, biostatistics, as well as the public.
The conclusions that were reached were that traumatic brain injury results mainly from sports injuries, vehicular incidents, acts of violence and falls; it is more than twice as likely to occur in men as in women; the estimated incidence rate is 100 per 100,000 persons, including 52,000 deaths annually and that the highest incidence is among persons aged 15 to 24 years and 75 years or older and with a lower number in children up to 5 years of age.
Since TBI may result in lifelong impairment of physical, cognitive and psychosocial functioning and that prevalence is estimated at 2.5 to 6.5 million individuals, TBI is therefore a disorder of major public health significance. In addition mild TBI is significantly underdiagnosed and the likely burden to society is therefore even greater. Given the large toll of TBI and the fact that there is no cure, prevention is very important. However, the focus of the conference was the evaluation of and support for rehabilitative measures for the cognitive and behavioral consequences of TBI.
The TUTOR system has been created to optimize rehabilitation measures for the cognitive and behavioral consequences of TBI.
The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) has become a key system in neuromuscular rehabilitation for TBI, stroke victims and those recovering from brain and spinal injuries, Parkinson’s, MS, CP and other limb movement limitations. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR consist of wearable glove and braces that detect limb movement showing the patient how much active or assisted active movement he is actually doing. The rehabilitation software uses special games to set a new target for this movement in terms of the patient’s ability to move their limb. The devices then measure the limb movement and give feedback on the success of the patient in trying to gain this new movement objective. In this way the patient is given movement feedback that allows the patient to understand which effort is more successful in allowing them to move their affected limb again. In this way the TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. See WWW.HANDTUTOR.COM for more information.

Rehabilitation Units that Include the Tutor System Show Success

F. Simmonds and T. Stevermuer of the Spinal Rehabilitation Unit, Caulfield Hospital, Alfred Health, Caulfield, Victoria, Australia compared the rehabilitation outcomes and demographic characteristics for both non-traumatic SCI and traumatic SCI patients admitted into either (SCIRUs)– specialist spinal cord injury rehabilitation units or (NSRUs)–non-specialist rehabilitation units . They studied 668 patients in rehabilitation units in Australia.
They found that there are differences in the characteristics of SCI patients admitted to SCIRU compared with NSRU. NT-SCI patients admitted to SCIRU have greater functional gain. When the SCI patient undergoes physical rehabilitation in an RU he will be able to avail himself of the latest equipment and medical devices to alleviate his symptoms and return him as much as possible to a normal life.
One such tool is the TUTOR system. It consists of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR.
The newly developed HANDTUTOR, for example, has become a key system in neuromuscular rehabilitation for TBI and stroke victims and those recovering from spinal cord injuries, Parkinson’s, MS, CP and other limb movement limitations. The HANDTUTOR is a hand therapy tool used by occupational therapists. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR consist of wearable glove and braces that detect limb movements showing the patient how much active or assisted active movement they are actually accomplishing. The rehabilitation software uses special rehabilitation games to set a new target in terms of the patient’s ability to move their limb. The devices then measure the limb movement and give feedback on the success of the patient in this new objective. In this way the patient understands which effort is more successful in moving their affected limb again. Subsequently the TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. See WWW.HANDTUTOR.COM for more information.

Traumatic Brain Injury and the Tutor System’s Effectiveness

Traumatic brain injury (TBI) usually affects younger people and causes long lasting impairments in physical, behavioral, cognitive and social function. The physical deficits are not usually as disabling as the cognitive, behavioral and personality deficits. The recovery period from TBI can sometimes continue for 5 years after injury. Rehabilitation is effective using an interdisciplinary approach, with close liaison including the patient, family and care givers. The issues to be focused on are retraining in activities of daily living, cognitive, pain management, behavioural therapies and pharmacological management.

Because the social burden of TBI is significant family education and counselling, and support of patient and care givers is important. General practitioners also play an important role in providing ongoing support in the patient’s community by monitoring for medical complications, personality and behavioral issues, social reintegration, the coping skills of the care giver and return-to-work issues.
TBI is a disorder of major public health significance. Rehabilitation services which are matched to the needs of people with TBI, as well as the community’s nonmedical services, should optimize outcomes over the course of recovery. Both the patient with TBI and his social support network should be able to have access to rehabilitation services throughout the recovery period which could continue for many years after the injury. The services required will change as the patient’s needs change over time. Survivors of severe TBI have to face the challenge of resuming a meaningful life both for themselves and their families.
The TUTOR system (HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR) has been in the forefront of medical tools used in TBI physical rehabilitation. Although not a cure all the TUTORs afford one of the best hopes of allowing the TBI patient to return movement to affected limbs.
The newly developed TUTORs have become a key system in neuromuscular rehabilitation and physical therapy for interactive rehabilitation exercise. These innovative devices implement an impairment based program with augmented feedback and encourage motor learning through intensive active exercises. These exercises are challenging and motivating and allow for repetitive training tailored to the patient’s performance. This training is customized by the occupational and physical therapist to ensure that the patient stays motivated to do intensive repetitive manual therapy and exercise practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. and foreign hospitals with the TUTORs being used in clinics and in the patient’s home. Home care patients can be supported by the occupational and physical therapist via tele-rehabilitation. See WWW.HANDTUTOR.COM for more information.

The HandTutor as a Solution Used in MS Rehabilitation

Published in SAGE JOURNALS on February 2, 2012 Alexa K Stuifbergen etal of the School of Nursing, University of Texas Austin conducted a study whose objective was to explore the feasibility and effects of a cognitive rehabilitation intervention i.e. Memory, Attention, and Problem Solving Skills for Persons with Multiple Sclerosis (MAPSS-MS) – for persons with multiple sclerosis on cognitive performance, self-efficacy for control of symptoms, memory, and neuropsychological competence in activities of daily living (ADL).
The conclusions reached were that the MAPSS-MS intervention was well-accepted and feasible by participants. Given the large relative increase in use of compensatory strategies by the intervention group, it holds promise for enhancing cognitive function in persons with multiple sclerosis.
It is known that rehabilitation aims to optimize motor, sensory and cognitive performance to allow the patient to better perform everyday functional tasks and improve quality of life.
The HANDTUTOR improves fine motor, sensory and cognitive impairments through intensive active exercises with augmented feedback. These exercises are challenging and motivating and allow for repetitive training that is tailored to the patient’s performance. The HANDTUTOR system includes objective quantitative evaluations that provide a thorough documentation of patient performance and allow the therapist to customize the suitable rehabilitation program to the patient’s ability.
The HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) are available in leading US and foreign hospitals, are useable by children as well as adults, and are certied by the FDA and CE.
See WWW.HANDTUTOR.COM for more information.

Expanded Rehabilitation Facility Has Latest Equipment–Tutor System

It was reported on Thursday, February 09, 2012 that the Bryn Mawr Rehab Hospital is growing and expanding its programs and services.
The Malvern-based hospital recently renovated and expanded its acute rehabilitation facility. The center treats people recovering from strokes, brain injuries and other neurological disorders. It also treats those with more complex neurological issues.
Bryn Mawr Rehab Hospital is growing and expanding its programs and services.
The Malvern-based hospital recently began a major renovation and expansion at its acute rehabilitation facility. When completed, the new Comprehensive Outpatient Neurorehabilitation Center will expand the treatment area to accommodate people recovering from strokes, brain injuries and other neurological disorders.
The center will utilize state-of-the-art technology to complement the physical and cognitive rehabilitation programs so that their patients can achieve the highest level of independence possible.”
The new center will feature a Vestibular Rehabilitation Suite dedicated to enhancing balance, strength and endurance and a Visual Perception Suite designed for those recovering from concussions. They are making a solid investment in technology and the latest equipment available that can provide their patients with the highest level of care possible in a convenient, comfortable setting.
Bryn Mawr Rehab Hospital will incorporate the Smart EquiTest to assess balance control and posture stability. The hospital also will add the Neuro-Vision Rehabilitator, which incorporates Wii remotes and sensors to enhance auditory, balance and visual/motor abilities, and its third Dynavision device to address the growing number of patients being treated for concussion symptoms.
Being that Bryn Mawr will feature the latest and best rehabilitation equipment it would also include the TUTOR system.
Victims of stroke, TBI, SCI, upper and lower limb surgeries and a host of other physically disabling illnesses can benefit greatly from the TUTOR system which includes the HANDTUTOR, ARMTUTOR, LEGTUTOR and the 3DTUTOR. The TUTOR system is amongst the most cost effective medical devices for rehabilitative therapy in existence.
The newly developed HANDTUTOR and its sister devices have become a key system in neuromuscular rehabilitation and physical therapy. These innovative devices implement an impairment based program with augmented feedback that encourages intensive practice and motor learning through intensive active exercises. The exercises are challenging and motivating and allow for repetitive intensive training tailored to the patient’s performance and motor and sensory and cognitive movement ability. Customized simple and powerful rehabilitation software allows the physical and occupational therapist the ability to adjust the program and exercise difficulty to the patient’s movement ability. The system also includes objective quantitative evaluations that allow the physiotherapist and his occupational therapist colleagues to report on the patients exercise progress. Telerehabilitation features allow the HANDTUTOR, LEGTUTOR, ARMTUTOR and the 3DTUTOR to be supported by the physical rehabilitation team when the patient is at home. This ensures that the patient is motivated to do more practice between treatments by the therapists. The TUTOR system is suitable for children as well as adults.
See WWW.HANDTUTOR.COM for more information.

Tutor System one of the Most Promising Interventions for Elderly Physical Rehabilitation

Michaela M. Pinter and, Michael Brainin, of the, Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria published the following comment.
Stroke is known to be a leading cause of disability and therefore physical rehabilitation is a major part of patient care. Most interventions do not target elderly patients but there is unequivocal evidence to promote rehabilitation in multidisciplinary stroke units or integrated care of a multidisciplinary team in the community. Most research has focused on the effect of interventions on recovery in different forms of impairment and disability. The most promising options for motor recovery of the arm include constraint-induced movement therapy (CIMT), robotic-assisted strategies and devices like the TUTOR system which is the most cost effective.
Interventions to improve postural stability and gait include fitness training, high-intensity therapy, and repetitive-task training. However, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice are underway to test these interventions in the elderly, either alone or in combination with early mobilisation, cardiorespiratory fitness training and physical exercise.
The TUTOR system, consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR, present an excellent supplement to new and traditional therapies for patients with incomplete paralysis. This is because the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR allow the physical and occupational therapist to give patients customized, intensive and repetitive exercise practice according to their movement ability. In this way the dose and intensiveness of manual therapy can be increased as the patient is motivated to do the correct exercises without doing compensatory movement .
The HANDTUTOR, ARMTUTOR, LEGTUTORand 3DTUTOR has been shown to improve range of motion as well as speed and accuracy of movement and improve functional movement ability in stroke patients and and those who experienced SCI, brain injury or other upper and lower limb disabilities., The TUTOR is being used in leading rehabilitation departments in the US and UK in addition to outpatient and private clinics.
Patients discharged from inpatient rehabilitation departments are benefiting from the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR in the comfort of their own homes. through tele rehabilitation. The system is available for children and adults and is certified by the FDA and CE. See WWW.HANDTUTOR.COM

How the Tutor System helps Elderly Stroke Victims

A study of rehabilitation outcomes for elderly stroke patients was conducted by Samantha G. M. Yap, MBBS, MRCP, FAMS and Karen S. G. Chua, MBBS, MRCP, FRCP (Edin), FAMS.
The objective of the study was to identify and characterize injury variables as well as outcomes in persons with traumatic brain injury (TBI) who are 55 years and older and admitted to a rehabilitation unit. Fifty two individuals over a 4-year period were included in the study. It was discovered that the most common reason for injury was falls (61.5%).
The conclusions showed that most patients in this group had severe brain injury, which may have been due to a higher incidence of intracerebral hematoma. It also showed that older patients with TBI do benefit from physical rehabilitation with significant functional gains and a high rate of return to home and to community.
The Tutor system is the medical device of choice in stroke rehabilitation for the elderly as well as similar patients of younger ages. Consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR these devices have been developed to teach children and adults how to reuse their affected joints after hand and wrist injuries such as trauma or stroke, brain and spinal cord injuries, CP, MS, Complex Regional Pain Syndrome and a host of other serious debilitating diseases that affect hand, wrist and arm movement ability.
The unique and successful devices use a dedicated software that utilize games to enhance and improve the patient’s functional movement ability by motivating the patient to do intensive movement practice which is the key element in an occupational and physical therapist’s treatment of movement impairments. The games motivate the patient to excel and thereby to improve their range of motion and general use of the hand or wrist.
The TUTORS use tele rehabilitation for those patients that are home bound or who have recovered sufficiently to get their treatment at home. Leading U.S. and foreign hospitals and outpatient clinics now use the devices which can treat adults as well. See WWW.HANDTUTOR.COM for more information.

Post Stroke Physical Therapy Includes Tutor System

Until just recently, scientists usually thought that when a section of the brain was damaged, its function was lost forever. If stroke patients couldn’t use a weak or paralyzed arm they were taught to dress and bathe with their good arm. But now, sophisticated imaging tests of the brain have revealed that when nerve cells die, their functions are taken over by other cells.
This concept is known as neuroplasticity and has altered stroke rehabilitation considerably. “Now, we know that if you want to get motor recovery on the affected side, you have to use the affected side intensively and repetitively,” says Richard Zorowitz, MD, chief of physical medicine and rehabilitation of Johns Hopkins Bayview Medical Center in Baltimore. “By doing that it stimulates the brain to make new connections.”
Neuroplasticity is the principle behind new techniques such as mirror therapy as well as several other new technologies. They include electrical stimulation of the damaged limbs and robots that help patients repeatedly move those limbs.
Additionally and at a more cost effective price the TUTOR system (HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR) has shown to be very successful in returning normal limb function to stroke victims.
The newly developed devices have become a key system in neuromuscular rehabilitation for stroke victims and those recovering from brain and spinal injuries, Parkinson’s, MS, CP and other limb movement limitations. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR consist of wearable glove and braces that detect limb movement showing the patient how much active or assisted active movement they are actually doing.
The rehabilitation software uses special rehabilitation games to set a new target for this movement in terms of the patients ability to move their limb. The devices then measure the limb movement and give feedback on the success of the patient in trying to gain this new movement objective. In this way the patient is given movement feedback that allows the patient to understand which effort is more successful in allowing them to move their affected limb again. The TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. See WWW.HANDTUTOR.COM for more information.

Bobath or CIMT Therapies, Both Enhanced By the Tutor System

Burcu Ersoz Huseyinsinoglu and Yakup Krespi of the Stroke Unit, Florence Nightingale Hospital, Istanbul, Turkey and Arzu Razak Ozdincler of the Istanbul University School of Physical Therapy and Rehabilitation, Istanbul, Turkey conducted a study involving a comparison between the Bobath concept and the constraint-induced movement (CIMT) therapy concept for rehabilitating stroke patients.
Their objective was to compare the effects of therapies on arm functional recovery among stroke patients with a high level of function on the affected side.
A total of 24 patients were used. The Bobath group was treated for 1 hour whereas the CIMT group received training for 3 hours per day during 10 consecutive weekdays.
The conclusions they drew from the study were that there was no basic difference between the two methods as far as improving functional ability, speed and quality of movement in the paretic arm among stroke patients with a high level of function. Constraint-induced movement therapy seemed to be a bit more efficient than the Bobath Concept in general.
When it comes to these methods the tool of choice is the HAND and ARM TUTOR.
The ARMTUTOR™ and HANDTUTOR devices have been developed to allow for functional rehabilitation of the upper extremity including the shoulder, elbow and wrist. The system consists of an ergonomic wearable glove and arm brace together with dedicated rehabilitation software. The ARMTUTOR™ and HANDTUTOR allow the physical and occupational therapists to report on and evaluate the patient’s functional rehabilitation progress. This allows the OT and PT to prescribe the right customized and motivating intensive exercise practice which is the cornerstone to manual rehabilitation therapy. Intensive repetition of movement is achieved through challenging games set to the patient’s movement ability. The system provides detailed exercise performance instructions and precise feedback on the patient’s exercise performance. Controlled exercise of multijoints within the normal movement pattern prevents the development of undesired and compensatory joint movement and ensures better performance of functional tasks.
Tele rehabilitation allows the recovering patient to continue his physical therapy at home. All the TUTOR devices are FDA and CE certified. See WWW.HANDTUTOR.COM for more information.

Tutor System Emulates Famous Theory

Developed in the late 80s and early 90s, Winfried Hacker and his associates created a theory that today is applied in industry and science involving human action.
Hacker’s Action theory defines a task-oriented view of human behaviors. The main purpose is to describe how a person completes a task. There are certain repeated patterns during completion of each task.
There are also 3 levels of patterns throughout the completion of a task:
i) Motive-activity
ii) Goal-action
iii) Instrumental conditions-operations.
In this approach, accomplishment of a top-level activity depends on accomplishment of lower level actions followed by operations. Motives are inspirations causing a set of goals, and actions for these goals consist of various operations. Operations can be directly and subjectively observed and recorded.
The newly developed TUTOR system for use in physical rehabilitation following stroke, brain/spinal cord injury, Cerebral Palsy, Multiple Sclerosis and a host of other upper and lower limb disabilities apparently uses the Hacker Action Theory throughout its operation. The TUTORs, consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are wearable braces or gloves that connect to dedicated software designed to encourage self movement (not robotic) by the patients. The customized software consists of a series of games that the patient has to attempt to complete–”Instrumental Conditions Operations” (iii as above).
Each game has a specific goal that allows the patient to accomplish further movement of his affected limb–”Goal Action” (ii as above).
The motivation for all these actions is to get the patient to recover his normal movement ability or as close to it as possible following the disabling event–”Motive Activity” (1 as above).
The TUTORs have become a key system in neuromuscular rehabilitation and physical therapy for interactive rehabilitation exercise. These innovative devices implement an impairment based program with augmented feedback and encourage motor learning through intensive active exercises. These exercises are challenging and motivating and allow for repetitive training tailored to the patient’s performance. This training is customized by the occupational and physical therapist to ensure that the patient stays motivated to do intensive repetitive manual therapy and exercise practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. and foreign hospitals and are being used in clinics and in the patient’s home through the use of tele-rehabilitation. See WWW.HANDTUTOR.COM
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. and foreign hospitals and are being used in clinics and in the patient’s home through the use of tele-rehabilitation. See WWW.HANDTUTOR.COM

Newest Rehab Centers Need to Include Tutor System

Philip Lim, writing for GMAONLINE on February 4, 2012 reports about the progress achieved in stroke rehabilitation.
A Singaporean retiree Soon Eng Sam, 70, suffered a stroke that paralysed the left side of his body.
He was bedridden for three months and had regained some limb functions on the affected side with conventional physical therapy. He now hopes to hasten his recovery with the help of new devices designed to make rehabilitation fun.
Soon is one of the lucky patients to use the Centre for Advanced Rehabilitation Therapeutics (CART) which is described as one of the most advanced facilities of its kind in Asia.
There is a race against time as more and more people are approaching the ”golden age” making a center like this more and more important.
It is estimated that in about 20 years twenty percent of the population will be 65 or older. Now it is only 9.3 percent of the population.
Chan Kay Fei, head of Rehabilitation Medicine at the government-run Tan Tock Seng Hospital feels that technology will be more and more vital and therapists will not be able to meet all the needs of the aging population.
Enter–new medical devices.
One of the most innovative systems to be developed in recent times is the TUTOR system.
Rehabilitation using the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR is included in the USA at major rehabiliaiton in-patient and out-patient clinics as well as at private physical therapy clinics. Many patients including those suffering from a stroke or cerebral palsy as well as those who have had a TBI or Spinal cord injury can also avail themselves of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR through the use of tele rehabilitation in addition to clinics and hospitals. These devices have been developed to allow for functional rehabilitation of the whole body including the upper and lower extremity. The system consists of ergonomic wearable devices and dedicated rehabilitation software that provide patient instructions and feedback to encourage intensive massed controlled exercise practice. In this way, the Tutor system allows for controlled exercise of multijoints within the normal movement pattern which prevents the development of undesired and compensatory joint movement and therefore ensures better performance of functional tasks. This is important in the rehabilitation process for stroke, brain, spinal cord (SCI) and Cerebral Palsy in addition to other neurological and orthopedic injury and disease. Additional features of theTUTOR system include quantitative evaluation and objective follow up that is important in the physiotherapists treatment of the stroke patient.
The TUTORS are FDA and CE certified and are available for children as well as adults. See WWW.HANDTUTOR.COM for further information.

Telerehabilitation-an Important Tool in Post Stroke Physiotherapy

Telerehabilitation allows the rehabilitative process to continue remotely after being discharged from acute care. It can include complex tasks known to create rich conditions for neural charge. Researchers based in Minnesota performed a study to explore the feasibility of telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke. They also wanted to compare complex versus simple movements in the ankle to promote brain reorganization and behavioral change Their results are published in ”Physical Therapy”, February 2012.
Author Huiqiong Deng, MD, MS, from the University of Minnesota, Minneapolis, and his team conducted the pilot randomized controlled trial that included training done in the participant’s home. Testing was done in different research labs involving multi-camera gait analysis and functional magnetic resonance imaging (fMRI).
In the study there were 16 participants with chronic stroke and impaired ankle dorsiflexion who were randomly assigned to receive 4 weeks of telerehabilitation of the paretic ankle. Participants received either computerized complex movement training (track group) or simple movement training (move group). Behavioral changes were measured with the 10-m walk test and gait analysis using a motion capture system. Brain reorganization was measured with ankle tracking during fMRI.
The results showed that dorsiflexion during gait was significantly larger in the track group compared to the move group. Although the volume, percent volume, and intensity of cortical activation failed to show significant changes during the fMRI, the frequency count of the number of participants showing an increase versus a decrease in these values and from pretest to posttest, measurement was significantly differentin the two test groups. The track group decreased and the move group increased.
The researchers conclusion was that the results suggested that telerehabilitation that emphasizes complex task training with the paretic limb, is workable and can be effective in promoting further dorsiflexion in people that have chronic stroke.
Telerehabilitation has been one of the features and advantages of the TUTOR system. While recovering stroke patients will begin their physiotherapy in a hospital or clinic setting the TUTOR system has been designed to allow continuation of the therapy at home. The advantage is also available for those patients who live a distance from a PT clinic or are otherwise homebound.
Occupational and physical therapists use the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR – known as the TUTOR system – as a manual therapy tool to help them with their rehabilitative work.
The TUTOR system has shown much success in rehabilitation of joint movement. The newly developed TUTORS consist of ergonomic wearable devices. The HANDTUTOR is a glove for hand therapy and the ARMTUTOR is an arm brace for elbow and shoulder rehabilitation. The LEGTUTOR is a leg brace for leg and hip. The system is indicated for patients who have suffered TBI, a stroke, SCI, CP, MS, Parkinson’s disease and other mobility restraining illnesses. It is used by occupational therapists and physiotherapists 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 accompanying software system consists of motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises. The dedicated rehabilitation software allows the physical and occupational therapist to fully customize the exercises to the patient’s movement ability. In addition, the OT and PT can make objective follow up and reports on their patient’s progress. Rehabilitation aims to optimize 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 TUTORS are certified by the FDA and CE See WWW.HANDTUTOR.COM for more information.

Tutor System Knows No Discrimination

A study by Susan D. Horn, PhD etal written for the ”Archives of Physical Medicine and Rehabilitation” in November 2010 about black-white differences in patient characteristics, treatments and outcomes for inpatient stroke rehabilitation describes racial differences in patient characteristics, physical therapy (PT), nontherapy ancillaries, occupational therapy (OT), as well as functional outcomes at discharge in rehabilitation after stroke.
Dr. Horn used six inpatient rehabilitation facilities.There were black and white patients subdivided in case-mix subgroups for moderate strokes and severe strokes
The results identified significant black-white differences in multiple patient characteristics and intensity of rehabilitation care. White subjects took longer from the stroke itself until rehabilitation admission and were more ambulatory before the stroke. Black subjects usually had more diabetes. In patients who had a moderate stroke, black subjects were younger, were more likely female, and had more hypertension and obesity with body mass index. For patients that had severe stroke, black subjects were less sick and had higher admission FIM scores. White subjects received more time per day of OT, although black subjects had longer median PT and OT time in a session.
Dr. Horn’s conclusions were that reasons for differences in rehabilitation for black and white subjects should be investigated further to understand clinicians’ choice of treatments by race.
In a world of vast differences in population categories it is refreshing to know that even in physical rehabilitation everyone is entitled to the best of care. The TUTOR system (HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR) is one such set of medical devices that knows no bounds in achieving excellent results. Created for children as well as adults and for women and men and of all races the TUTOR system is one of the most affordable and successful devices to be used in physiotherapy and rehabilitation clinics.
The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation for stroke victims and those recovering from brain and spinal injuries, Parkinson’s, MS, CP and other limb movement limitations. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice. The HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR consist of wearable glove and braces that detect limb movement showing the patient how much active or assisted active movement they are actually doing. The rehabilitation software uses special rehabilitation games to set a new target for this movement in terms of the patients ability to move their limbs. The devices then measure the limb movement and give feedback on the success of the patient in trying to gain this new movement objective. In this way the patient is given movement feedback that allows him to understand which effort is more successful in allowing them to move their affected limb again. The Tutor system provides exercises that are challenging and motivating and allows for repetitive and intensive exercise practice.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. See WWW.HANDTUTOR.COM for more information.