Physical Rehabilitation Facility Closing and Its Alternative Solution

It was announced on May 30,2012 that Rutland Regional Medical Center’s inpatient rehabilitation unit in Vermont would be closing its doors. Many current and former patients have protested and urged the facility to remain open. They maintain that they received excellent care there and would consider it a tragedy if that help couldn’t be provided to others in need. “Without the superior care I received there back in the summer of 1998, I would not be living life as comfortable as I am now”, said one of its former patients. When a vital institution such as a rehabilitation center is forced to close its doors for financial or other reasons many people suffer–patients as well as the professional and lay staff. In the case of the cancellation of physical rehabilitative services it is important to know that alternative physical therapy solutions exist. Specifically the system being used more and more these days is called TELEREHABILITATION, aka telemedicine, telehealth and other similar terminology. In the field of physical rehabilitation one system stands out above the others. Known as the TUTORs this system is used usually by patients who are in or who have been discharged from an inpatient rehabilitation facility or who live at too great a distance from a facility. They can receive a good deal of their physical therapy needs through the use of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. These physical therapy products are designed to allow the patient to receive intensive exercise programs monitored and regulated by physical and occupational therapists who may be miles away. The TUTORs consist of comfortable ergonomic gloves or braces strategically located on various parts of the body and powerful dedicated rehabilitation software in the form of challenging games. These games allow the patient to practice isolated and/or interjoint coordination exercises. This controlled exercise practice will prevent the development of compensatory movement patterns. The dedicated software allows the therapist to fully customize the exercises to the patient’s movement ability.The TUTORs are designed for patients who have experienced limited joint or limb movement ability due to a stroke, brain or spinal cord injury, Parkinson’s disease, MS, CP and other upper and lower extremity difficulties. Currently in use in leading U.S. and European hospitals and clinics the TUTORs are available for children as young as 4 and are fully certified by the FDA and CE. See WWW.MEDITOUCH.CO.IL for further information.

Online Health, E-Health, E-Medicine,Tele-Medicine, Tele-Health, Tele-Rehabilitation

Once the age of computers arrived it was a foregone conclusion that its applications would soon incorporate online health services. E-Health was introduced as a further development of the idea of telemedicine. It began to be used by many academic institutions, professional bodies, and funding organizations . The prefix ‘tele’ derives from the Greek for ‘at a distance’. Nowadays, eHealth is understood as the “use of information and communication technologies locally and at a distance” that combines and integrates health information and communication technologies. Telemedicine is a new interdisciplinary approach to practice medicine with enormous potential and new perspectives for development. Ethical and medicolegal concerns, human and cultural factors, and reimburstment for services are still issues of telemedicine that need to be fine tuned. During the last decade of the 20th century, e-commerce exploded giving new ways to conduct business and financial transactions through the Internet. Various e-terms began to appear and proliferate in combination to Internet development. E-Health was introduced as a consequence of e-applications, and as a further development of the idea of telemedicine. What do those terms mean? Many previous articles have dealt with the question of how telemedicine and eHealth can or should be defined. The aim of this article is to discuss the understanding of telemedicine and eHealth definitions already developed in the literature, which have been published to date, and compare them to clinically oriented definitions already established. There is hope that a better understanding of the meaning and perspectives of telemedicine and eHealth will improve communication and cooperation of many medicine and technology specialists. The definition of eHealth is based on a wide variety of meanings combining informatics technology and health and wellness, where the concept of wellness refers to public health and health promotion. It also relates to health services delivery (e.g., health care, health industry products). E-Health represents a new concept of health care. Technology is incorporated into the definition. Additionally, internet and internet related technologies belong to that technology. Finally, eHealth combines and integrates health, information and communication technologies. The idea of eHealth presents a unique opportunity for the development of public health. The World Health Organization and other subsidiaries of the United Nations have drawn up strategies for eHealth that include the use of it for public-health purposes and health-care delivery. The main ideas of the strategy focus on “eHealth for all by 2015 ”. The term eHealth is currently used by many medical professionals, academic institutions, and representatives of technology in medicine. Despite the lack of a clear and precise definition it has become a widely accepted neologism. The widespread use of this term suggests the need of electronic health among the many individuals and organizations. Telemedicine has worldwide implications. The target of eHealth is wide and concentrates on improving and increasing the cost-effectiveness of health care at large and to solve problems related to access, care, cost, quality, and portability of health care services locally, regionally, and worldwide . Telemedicine seems to focus on the same target, but is restricted to relations between patient and physician . The ultimate benefits of implemented telemedicine go directly or indirectly to a patient. The term eHealth encompasses a set of disparate concepts, including health, technology, and commerce. It has raised the promise that information and communication technologies will improve medicine and the health care system. The term telehealth was developed to substitute for the term telemedicine . In the early years of the twenty first century more fashionable terms such as “online health” and “e-health” appeared due to internet expansion. Some authors suggest new terms as approximate synonyms. It is reported that “telemedicine encompasses all of the health care, education, information and administrative services that can be transmitted over distances by telecommunications technologies”. Nowadays, eHealth is understood as the “use of information and communication technologies locally and at a distance”. The technology is viewed both as a tool to embodiment of eHealth itself to expand, or to enhance human activities, but not substitute for them. One of the benefits of telemedicine can be that it allows the patient to receive more immediate care. That may be expressed by utilizing digitalized products and systems. The impact on health systems may become more efficient by improving access to care, especially in remote areas, for people with disabilities and for the elderly. That creates new opportunities for faster and more comprehensive epidemiological surveillance and for better patient care. A global approach to handling data flows should be able to promote standardization and low-cost services. That opens the new platform for international participation and collaboration on information and communication technologies with other providers which can in turn remove barriers for health data flow. The main lines of the strategy for the telemedicine societies are to integrate eHealth applications into health systems and develop norms, standards, guidelines, information and training materials. National centers and networks of excellence will mobilize collaboration for determining evidence based eHealth. E-Health for citizens, patients and health professionals should meet quality, safety and ethical standards. The value of eHealth is to improve the quality and the economy of the present health systems. However, many eHealth and telemedicine applications are currently unregulated or insufficiently regulated. Any adverse, negative, harmful, or disadvantageous effects are rarely mentioned while describing eHealth or telemedicine . The whole range of medical activities including diagnosis, treatment and prevention of disease, continuing education of health-care providers and consumers, and research and evaluation is encompassed. Grigsby and Sanders pointed out that telemedicine is defined as “the use of electronic information and communications technologies to provide and support health care when distance separates the participants” or the specialty which “encompasses all of the health care, education, information and administrative services that can be transmitted over distances by telecommunications technologies. Telemedicine subjects include the interaction between the medical service receiver and the expert (i.e. real-time or prerecorded). Neither health care provider nor medical service receiver is moved, but only information is transmitted (e.g. text, audio, video). Telemedicine practice is now performed in industrialized countries, but there is an increasing interest in the use of telemedicine in developing countries. One of the most promising aspects of all the e applications is telerehabilitation. This is manifested through the use of the TUTOR system. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have been in use now for several years in some of the leading rehabilitation facilities in the U.S. and Europe. These physical therapy products provide intensive exercise programs with augmented feedback for patients who have had a stroke, Parkinson’s disease, brain or spinal cord injuries, CP, MS, Brachial Plexus injuries and other upper and lower surgeries that have affected the movement of various limbs. When the patient is discharged from acute care or lives too far from a rehabilitation facility he can access this physical therapy solution right in his home through the use of telerehabilitation. The physical or occupational therapist at the other end will evaluate and quantify the patient’s impairments and customize an exercise program for him. Certified by the FDA and CE the TUTOR system is appropriate for adults as well as children from the age of 4 or 5. See WWW.MEDITOUCH.CO.IL for more information.

Telemedicine-Does It Work for Physical Therapy?

While Telemedicine may be a form of medical treatment decades old today there are innumerable devices that offer that convenience. Telemedicine ,which has several aliases, uses real time to connect medical provider and patient in dispensing medical care. This is extremely helpful if the medical condition is minor and the patient has difficulty in visiting the doctor personally for any number of reasons such as distance. Insurance companies and employers love the system as it reduces costs. The use of this medium is on the rise as consumers benefit by being able to access 24/7 care as well. Its use may exceed $27 billion within the next 4 years. The question remains, though, as to whether this system is as good as face to face visits. There is also the aspect of using telemedicine for treatments such as physical rehabilitation for patients recovering from stroke and other neuromuscular diseases or injuries. It is also necessary to establish the safety of the system. In the case of the TUTOR system, as one of the newest physical therapy products on the market, the testing and clinical use has shown a marked improvement in the patient’s movement ability after using the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. These products are ergonomic gloves or braces that fit comfotably on the affected limb and then connect to powerful evaluation software created exclusively for the TUTOR. The intensive exercise program is monitored by phsical or occupational therapists who then customize an exercise plan for that specific patient. All exercises are recorded and evaluated leading to enhanced functional rehabilitation. The TUTORS are currently in use in leading U.S. and European hospitals and clinics and, of course, can handle telerehabilitation services as well from the patient’s home. See WWW.MEDITOUCH.CO.IL for more information.

Help for Developmental Coordination Disorder

Developmental Coordination Disorder (DCD) is a type of disorder that occurs during childhood but can eventually lead to development coordination problems. This can cause clumsiness and other similar disorders that can carry on throughout life. Although a small number, relatively 6%, of all children have some form of disorder leading to developmental coordination problems. These children may have one or more of the following: Holding an object with a steady grip. Tripping over themselves although there is nothing impeding their way. Having difficulty stopping while running. Walking in an unsteady way. Sometimes these disorders occur in combination with communication or writing difficulties. There are 3 distinct types of dysfunctions. Gross motor, fine motor and psychosocial. In gross motor dysfunction the child may have a strange way of running, may fall frequently, may handle things in a clumsy way and may find it difficult to follow orderly instructions. These children often are poor at sports and other events and as a result may lose muscle force and tone. Fine motor coordination can manifest themselves by inadequate writing, drawing, dressing and gripping difficulties. Psychosocial coordination difficulties may include reading, communication and learning problems which can result in the child and adult not being accepted by their peers and having only a small number of friends. These individuals may also suffer from low self esteem, confidence and have anxiety. In the past parents were told that their affected children will outgrow the disorder however recent research shows that this may not be the case. Children with these disorders are also somewhat overweight. Medical attention is recommended. One of the remedies is physical education and therapy. Using a computer, rather than writing down notes can help children who have trouble with writing. Encouraging physical activity is a very important way to help prevent obesity. Early treatment most likely leads to future success. In the realm of physical activity one of the best and most fun ways to overcome these difficulties may be the TUTOR system. Children from the age of 4 and up can make themselves available to play games that were exclusively designed for the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. Wearing comfortable ergonomic gloves and braces the patient/child can get involved in direct intensive exercise programs. These programs will teach the user how to coordinate a ball or car on the right track and teach him how to stay focused. A physical/occupational therapist will record anprogress and devise a specific program for that person. In this way there wil be an incentive to improve more and more. These physical therapy products can also be used at home when it’s difficult to get to a rehabilitation facility. This is done through the use of telerehabilitation. The TUTOR physical therapy products are FDA and CE certified. See WWW.MEDITOUCH.CO.IL for more information.

Possible New Therapy for Parkinson’s Disease Symptoms

May 2, 2012 A Tel Aviv University researcher and movement disorders specialist at Rabin Medical Center Dr. Nirit Lev, is developing therapy to halt symptoms in Parkinson’s patients. The ability to modify the activity of DJ-1 could change the progress of the disease, she says. Working in collaboration with Profs. Dani Offen and Eldad Melamed, Dr. Lev has now developed a peptide which mimics DJ-1′s normal function, thereby protecting dopamine- producing neurons. What’s more, the peptide can be easily delivered by daily injections or absorbed into the skin through an adhesive patch. Parkinson’s disease, a disorder which affects movement and cognition, affects over a million Americans, including actor Michael J. Fox, who first brought it to the attention of many TV-watching Americans. It’s characterized by a gradual loss of neurons that produce dopamine. Mutations in the gene known as DJ-1 lead to accelerated loss of dopaminergic neurons and result in the onset of Parkinson’s symptoms at a young age., Based on a short protein derived from DJ-1 itself, the peptide has been shown to freeze neurodegeneration in its tracks, reducing problems with mobility and leading to greater protection of neurons and higher dopamine levels in the brain. Dr. Lev says that this method, which has been published in a number of journals including the Journal of Neural Transmission, could be developed as a preventative therapy. Preserving dopamine-producing neurons can mean the difference between living life as a Parkinson’s patient or aging normally, says Dr. Lev. In pre-clinical trials, the treatment was tested on mice utilizing well-established toxic and genetic models for Parkinson’s disease. From both a behavioral and biochemical standpoint, the mice that received the peptide treatment showed remarkable improvement. Symptoms such as mobility dysfunctions were reduced significantly, and researchers noted the preservation of dopamine-producing neurons and higher dopamine levels in the brain. Preliminary tests indicate that the peptide is a viable treatment option. Though many peptides have a short life span and degrade quickly, this peptide does not. Additionally, it provides a safe treatment option because peptides are organic to the body itself. According to Dr. Lev, this peptide could fill a gap in the treatment of Parkinson’s disease. “Current treatments are lacking because they can only address symptoms — there is nothing that can change or halt the disease,” she says. “Until now, we have lacked tools for neuroprotection.” The researchers also note the potential for the peptides to be used preventatively. In some cases, Parkinson’s can be diagnosed before motor symptoms begin with the help of brain scans, explains Dr. Lev, and patients who have a genetic link to the disease might opt for early testing. A preventative therapy could help many potential Parkinson’s patients live a normal life. For those who, unfortunately, do contract the disease there is hope to regain functional mobility through the use of the TUTOR system., The newly developed system consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have become a key system in neuromuscular rehabilitation for, Parkinson’s patients, stroke victims and those recovering from 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 they are actually doing. The accompanying software uses special rehabilitation games to set a new target for this movement in terms of the patient’s ability to move their affected limb. These physical therapy products then measure the limb movement and give feedback on the success to the patient. In this way the TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice. The TUTOR system is now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. See WWW.MEDITOUCH.CO.IL for more information.

How Laughter Can Help Physical Therapy Rehabilitation Progress

Jon Silo, 85, a former Broadway and television comedic actor, and his wife Ruth, 70, a former actress, are volunteer leaders of Laugh Therapy.Jon and Ruth Silo come to patients at Cedars-Sinai hospital in Los Angeles every two months to entertain patients who are undergoing therapy to recover from strokes, neurological, orthopedic or work-related injuries. The Silo’s method is to encourage patients to express themselves by focusing on something positive or amusing that has happened in their lives. The couple may tell humorous tales and stories from their own lives to get the conversation going and put the patient’s mind more at ease in the group setting. Groups consist of four to 25 people and usually are made up of elderly patients. Patients confined to their room are visited directly by the Silos. “We want to give them something happy,” Jon Silo said. “It is so touching to see people happy that we walk home hugging each other and think of how we helped the patients.” The Silos used to perform at USO shows across the United States. “Comedy became a part of my life,” said Jon Silo, who has performed in productions such as “Oklahoma!” and “Can-Can,” in addition to numerous television series and commercials. “I always liked comedy the best because I wanted to see people happy.” During a hospital stay of his own Jon met Dr. Harry Glassman, who noticed the Silo family’s optimistic outlook on life. Glassman thought that they could become an asset to the hospital because their own experiences had led them to recognize the healing value of laughter. Until two years ago, physical rehabilitation patients at Cedars-Sinai watched videos to get their dose of comedy and laughter. At Glassman’s suggestion, the couple became volunteers. “This is not entertainment,” Ruth Silo said. “It is (teaching) a philosophy to cope and live with to get well.” Laughter has always been known to have positive results on social behavior but it can be equally as helpful during recovery and physical rehabilitation following all kinds of illnesses and surgeries. When a patient is happy he will likely be encouraged to perform his rehabilitation exercises in a more positive way and thereby speed up the process of recovery. When a patient who is recovering from stroke, MS, CP,Parkinson’s disease, brain or spinal cord injuries or any other upper or lower limb surgery uses state of the art physical therapy products such as the HANDTUTOR, ARMTUTOR, LEGTUTOR or 3DTUTOR he will undoubtedly make progress in his rehabilitation program. Occupational and physical therapists use these products 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. They are 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 (with laughter) can optimize the patient’s motor, sensory and cognitive performance and allow 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.MEDITOUCH.CO.IL for more information.

Medical Science Fiction or Reality?

One of the current best selling books is called The Man with the Bionic Brain and Other Victories over Paralysis by Dr. Jon Mukand. Neurosurgeons have implanted a set of microelectrodes in a man’s brain that recognize his thought patterns and allow him to control a computer cursor. He is able to use e-mail, manipulate a prosthetic hand, adjust TV settings, and play video games—all just by thinking about performing these tasks. This is the story of first hand accounts of survivors of stroke, spinal injuries, and brain trauma and some of the amazing technology that has improved their lives. It tells of behind-the-scenes views of cutting-edge medical research and discoveries, The Man with the Bionic Brain and Other Victories over Paralysis is an insightful and inspirational book about how biomedicine gives hope to people with disabilities and enables them to take control of their futures. Since this is still in the fiction state patients suffering from stroke, brain or spinal cord injuries, MS, CP and other upper and lower limb surgeries should rely more on existing systems and physical therapy products to achieve a return to normal movement of their affected limb(s). One of the most cost effective and innovative medical devices to come on the market in recent times is the TUTOR system. This breakthrough product consists of a HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. The TUTORs are comfortable ergonomic gloves or braces that are connected to a computerized, exclusive and intensive exercise program. The exercises, in the form of games, encourage the patient to excel at the competition and thereby increase the movement of the affected limb. Physical therapists monitor the progress and create a customized program for that particular patient. This in turn increases the efficiency of the limb movement. The TUTOR products can be used at home if the patient has graduated from inpatient treatment or is located at too great a distance from a physical therapy facility. Currently in use in leading U.S. and European rehabilitation hospitals and clinics the TUTORs are fully certified by the FDA and CE. See WWW.MEDITOUCH.CO.IL for more information.

Physical VS. Occupational Therapist–Is There a Difference?

They both work with the body. They both do their work in a nursing home, outpatient clinic or in the patient’s home. They both have to possess a Bachelor’s or Master’s degree in their field. They both have to intern under a licensed therapist and pass state tests. However after that there are only a few similarities between a physical therapist (PT) and an occupational therapist (OT). In general the PT works from the waist down and the OT works from the waist up. The PT will generally work on balance, walking, and general movement. In a nursing home the PT, especially for the elderly, may concentrate on helping the stroke victim walk or sit without leaning to one side. The OT ‘s function will be to teach the patient how to maintain independence in their basic self care needs and performance of activities of daily living. This may include recommending appropriate devices and gadgets to increase safety and functional ability. As an example, an OT may recommend modifications to a home to help a senior feel more comfortable there, to rearrange the furniture and home layout, to acquire equipment to prevent hand tremors during eating, and even teaching an elderly stroke victim how to get dressed with only one hand. Often, the PT and OT work together to provide rehabilitation therapy. This joint effort ensures that a patient can move well and also remain as independent as possible. When it comes to equipment that the PT and OT provide and work with the TUTOR system is in the forefront of medical devices created to assist the stroke victim how to regain his limb mobility. Consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR these physical therapy products provide intensive and challenging exercises that allow for repetitive training tailored to the patient’s performance. In the case of the HANDTUTOR, for example, an ergonomic glove has been designed to detect finger and wrist motion and it has an open palmar surface to give maximum motor and sensory input. The glove comes in ten different sizes to allow for treatment of patients from the age of five to adult. The TUTOR system is also used for victims of Parkinson’s disease, MS, CP, brain/spinal cord injuries and other upper and lower limb disabilities. Currently in use in leading U.S. and European rehabilitation hospitals and clinics the TUTORs can also assist patients that are homebound through the use of telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

TBI and Anger–What’s the Connection?

As severe as a Traumatic Brain Injury (TBI) can be with all its ramifications there is one aspect and result that may be the most destructive. Much research has shown how anger and irritability is a result of TBI. In fact 2/3 of moderate or severe TBI can affect the management of stress and temper control. These are unmet needs and may persist or even worsen up to 10 years after the original occurrance. These flareups can affect family, social relationships, employment and reputation. They can even exclude the patient from treatment programs creating a vicious cycle of further isolation from support. If the symptoms are severe enough the physician may prescribe neuroleptics which can have side effects that by themselves limit recovery. Some of the remedies that have shown success for this anger and aggressive behavior are stress inoculation training and behavior modification. If the patient is suffering from limb immobility as a result of the TBI the frustration can add to his irritability therefore remedies for that should also be considered. One of the more successful systems for accomplishing that include the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. These are comfortable ergonomic gloves or braces that are attached to the affected limb and then to computers that contain exclusive and intensive exercises. The patient will use his own strength, rather than that of a robot or electric impulse, to maneuver through a series of challenging games. A physical therapist will adjust the exercises to the ability of the patient. The exercises are tailored to a range of motion, accuracy and speed of movement, cognitive function and isolated or combined movement ability. These safe and affordable physical therapy products are available for use by children as well as adults and can be used in the patient’s home through the use of telerehabilitation. The TUTOR system can be implemented, as well, to patients suffering from Parkinson’s disease, CP, MS, stroke and other upper and lower limb disabilities. They are currently in use in leading U.S. and European rehabilitation facilities and clinics. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are fully certified by the FDA and CE. See WWW.MEDITOUCH.CO.IL for more information.

When is a Physical Therapist Assistant Not an Assistant?

A physical therapy assistant usually works in a healthcare or physical rehabilitation setting under the supervision of a certified physical therapist. He is directly in charge of assisting the therapist that treats patients who are recuperating from different types of illnesses or injuries and who need physical therapy of some kind. Short of treating patients, the assistant does all the other things such as prepping the treatment area, helping the patients to move and other tasks that alleviate the job of the physical therapist himself. Physical therapy assistants can work in many places which include ambulatory health care facilities, state hospitals, private hospitals, nursing centers and residential care facilities. Assistants also work for a physical therapist who has an independent practice. But now a physical therapist assistant can also act as the therapist himself if, after the proper training, he is at the receiving end of telerehabilitation for physical therapy products such as the TUTOR system. Patients who have suffered from stroke, MS, CP, brain/spinal cord injuries, Parkinson’s, upper or lower limb surgeries and other limb disabling diseases or injuries can begin to use tele health systems if they have recovered sufficiently to be discharged from an inpatient setting or if they live too far away from a rehabilitation facility. The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR and 3DTUTOR) have become a key system in neuromuscular rehabilitation that can be implemented through telerehabilitation. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning intensive active exercises and movement practice. The HANDTUTOR, ARM TUTOR, LEGTUTOR and 3DTUTOR consist of a 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 exclusive 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. It allows the patient to understand which effort is more successful in moving their affected limb again. In this way the TUTOR system provides exercises that are challenging and motivating as they 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. They are fully certified by the FDA and CE and are available for children as well as adults. See WWW.MEDITOUCH.CO.IL for more information.

Inpatient or Outpatient Physical Therapy?

Recent surveys show that most of the physical rehabilitation for spinal cord injury patients occurs after discharge from inpatient programs. The significance of this data is that the high costs of inpatient programs are reduced and rehabilitative work can be conducted successfully after discharge. Significant to that success is the type of physical therapy solution that is applied to the rehab program. Using one of the latest systems will be crucial to the success of the patient in his rehabilitation. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are one of the most cost effective physical therapy products available today. They consist of ergonomic gloves or braces attached to the affected limb of the patient and then to exclusive software where the patient uses his own power to accomplish tasks outlined in a series of games. These games offer the patient intensive exercises which if repeated often enough will allow him to improve the mobility of the affected limb. The TUTOR system was designed to function in the same way for patients with spinal cord or brain injury, Parkinson’s disease, stroke, MS, CP and upper or lower limb surgeries. The TUTOR system has been successful in leading U.S. and European rehabilitation facilities and clinics and can also be used in the patient’s home through the use of tele rehabilitation. In this method physical and occupational therapists record the progress made by the patient and customize a specific program to the patient’s ability. The TUTORs are fully certified by the FDA and CE. See WWW.MEDITOUCH.CO.IL for more information.

U.S. Congress Passes Bill to Allow More Technology for Disabled Individuals

The following is a portion of a new bill that recently was passed by the U.S. congress to allow more access to rehabilitation devices through Medicare. A BILL To amend title XVIII of the Social Security Act to provide for coverage and payment for complex rehabilitation technology items under the Medicare program. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ‘Ensuring Access to Quality Complex Rehabilitation Technology Act of 2012’. SEC. 2. FINDINGS. Congress finds the following: (1) Individuals with disabilities and significant medical conditions such as Cerebral Palsy, Muscular Dystrophy, Multiple Sclerosis, Spinal Cord Injury, Amyotrophic Lateral Sclerosis, and Spina Bifida experience physical, functional, and cognitive challenges every day. (2) Complex rehabilitation technology items (CRT items), including products such as complex rehabilitation power wheelchairs, highly configurable manual wheelchairs, adaptive seating and positioning systems, and other specialized equipment, such as standing frames and gait trainers, enable individuals to maximize their function and minimize the extent and costs of their medical care. (3) Access to CRT items and related services can be threatened by inadequate coding, coverage, and payment policies for such items and services. These policies have restricted access to existing complex rehabilitation technology and stifled innovation. Access challenges have increased over the past several years and, without meaningful change to these policies, will only become greater in the future. (4) Current Medicare policies often fail to adequately address the needs of individuals with disabilities, to consider the range of services furnished by complex rehabilitation technology suppliers, and to recognize and account for the complexity and unique nature of the equipment itself. (5) A significant factor responsible for such access challenges is that individually-configurable CRT items do not have a distinct payment category under the Medicare program, but instead are classified within the broad category of durable medical equipment (DME). CRT items serve patients with serious medical conditions that require a broader range of services and specialized personnel than what is required for standard DME. Customizable CRT items also require more resources in the areas configuring, training, and education to ensure appropriate use and to optimize results. (6) Unlike most DME, a medical model incorporating an interdisciplinary team approach is necessary to ensure proper customization and use of a CRT item. This team typically includes a physician, a licensed physical or licensed occupational therapist (with no financial relationship with the CRT supplier), a qualified CRT professional, the individual using such item, and sometimes a caregiver for such individual. (7) The Medicare program should recognize the specialized nature of the CRT service delivery model, the required supporting processes and technology-related CRT services, the credentials and competencies needed by the providing suppliers and critical staff, and the related costs involved. A separate benefit category for CRT items would allow for unique coding, coverage, and payment rules and policies that address the unique needs of persons with disabilities and acknowledge the extensive service component. The TUTOR system is one of the most cost effective and useful physical therapy products now being used successfully in leading U.S. and European rehabilitation hospitals and clinics. Fully certified by the FDA and CE the devices are known as the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. These products are ergonomic gloves and braces that are connected to custom made powerful software that givers the therapist objective and quantitative information on the patient’s functional impairment. The information is then recorded and allows the therapist to fully customize the treatment session. The treatment consists of intensive customized exercises with augmented feedback leading to enhanced functional rehabilitation. The TUTOR system is available for children and adults and can be used at the patient’s home, if necessary, through tele rehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

What is Rehabilitation of a Spinal Cord Injury?

When treating a person who has a spinal cord injury, the ultimate goal is repairing the damage created by the injury. Treatment should not be limited to one method as greater improvements are achieved with a variety of methods. Furthermore, increasing activity will increase recovery. The rehabilitation process after a spinal cord injury begins in the acute care setting. Physical therapists, occupational therapists, social workers, psychologists and other health care professionals work as a team to decide on goals with the patient and develop a plan of discharge that is appropriate for the patient’s condition. The amount of time a patient is immobilized may depend on the level of the spinal cord injury. Physical therapists work with the patient to prevent any complications that may arise .Other complications that arise from immobilization are muscle atrophy and Osteoporosis, especially to the lower limb, increasing the risk of fractures to the femur and tibia. While passive weight bearing of paralyzed lower extremities appears to be ineffective, stressing the bones through muscular contractions initiated by functional electrical stimulation (FES) have yielded positive results in some cases. Generally, the frequency is effective with three or more weekly exercise sessions. Studies of duration suggest that several months to one or more years of FES are necessary. Improvement of locomotor function is one of the primary goals for people with a spinal cord injury. SCI treatments may focus on specific goals such as to restore walking or locomotion to an optimal level for the individual. The most effective way to restore locomotion is by complete repair, but techniques have not yet been developed for regeneration. Treadmill training, over groundtraining, and functional electrical stimulation can all be used to improve walking or locomotor activity. These activities work if neurons of the central pattern generator (CPG) circuits, which generate rhythmic movements of the body, are still functioning. With inactivity, the neurons of CPG can degenerate. Therefore, the above activities are important for keeping neurons active until appropriate regeneration activities are developed. As a team, health-care professionals help to re-orient the patient, provide support for the patient and family, and begin to develop goals with the patient. Occupational therapy plays an important role in the management of SCI. Recent studies emphasize the importance of early occupational therapy that is begun immediately after the client is stable. This process includes teaching of coping skills, and physical therapy. In the first step, acute recovery, the focus is on support and prevention. Interventions aim to give the individual a sense of control over a situation in which the patient probably feels little independence. As the patient becomes more stable, they may move to a rehabilitation facility or remain in the acute care setting. The patient begins to take more of an active role in their rehabilitation at this stage and works with the team to develop reasonable functional goals. Though rehabilitation interventions are performed during the acute phase, recent literature suggests that 44% of the total hours spent on rehabilitation during the first year after spinal cord injury, occur after discharge from inpatient rehabilitation. Participants in this study received 56% of their total physical therapy hours and 52% of their total occupational therapy hours after discharge. This suggests that inpatient rehabilitation lengths of stay are reduced and that post-discharge therapy may replace some of the inpatient treatment. One of the newest physical therapy products to achieve the above goals is the TUTOR system. This set of devices (HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR) has been developed to achieve renewed mobility to affected limbs which have been disabled due to spinal cord or brain injury, Parkinson’s disease, CP, MS,stroke, head injuries Radial/Ulnar nerve injuries, Brachial Plexus injuries and other upper or lower surgery disabilities. The HANDTUTOR is an ergonomic glove and the ARMTUTOR, LEGTUTOR and 3DTUTOR are comfortable braces that are attached to the specific limb and then connected to customized software where th epatient conducts intensive exercises with exclusively created games. These games are challenging and allow the patient to develop usage of his affected limb. Through the use of telerehabilitation the patient can even accomplish this exercise program at home if he is located too far from a rehabilitation facility. Physical/occupational therapists respond and record the patient’s progress in order to create a customized exercise program appropriate to that particular patient. The TUTOR system is now in use in leading U.S. and European hospitals and clinics. They are FDA and CE certified. See WWW.MEDITOUCH.CO.IL for more information.

Physical Therapy Solutions of the Future

Many of us remember when, decades ago, we read in comic books how Dick Tracy spoke on a ”wrist radio” to communicate with headquarters in pursuing a criminal. We were in awe when science fiction was portrayed in the same comics as travel between earth and celestial bodies or to and from man made space stations. Today almost everyone on earth possesses a cellphone to communicate with friends and family. Space travel today even has ”graduated” from an ”obsolete” system of shuttles to an international space station and one can read as ”history” about how man traveled to the moon and back. That’s how far man has come in this modern age. Medicine has also moved rapidly through so many phases of improvement and innovation that today not only do people live longer but that under certain circumstances a patient may never meet his doctor or therapist on a face to face basis but rather through electronic systems. Surgery can be performed remotely and physical therapy can be administered through tele rehabilitation. One of the newest physical therapy products being used extensively today is the HANDTUTOR. It and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) are at the forefront of physical therapy solutions that allow patients suffering from Parkinson’s disease, CP, MS, stroke, brain and spinal cord injury as well as upper and lower limb surgeries to receive state of the art assistance in recovering use of a disabled limb. This is done through the use of customized ergonomic gloves and braces that are connected to exclusive software where the patient is involved in intensive exercises through the use of challenging games. The results are channeled to a physical/occupational therapist who records them and creates a customized therapy program for the patient. This is especially helpful to the patient who has recovered sufficiently to be discharged from acute care and/or for those patients who cannot afford or live too far from a professional physical therapy facility. The TUTOR system is one of the most cost effective physical therapy products on the market today and is fully certified by the FDA and CE. Go to WWW.MEDITOUCH.CO.IL for more information.

TBI Criteria of the U.S. Social Security Disability Benefit Program

There are 5 criteria that are used by the U.S. Social Security Administration to determine the need for disability assistance if a person has suffered a Traumatic Brain Injury (TBI) 1. Is the individual earning more or less than $1010 per month from employment. More will disqualify him. 2. The TBI has to be severe enough to affect the patient‘s walking, sitting, lifting, reaching, pushing, standing, pulling, carrying or handling, seeing, hearing and speaking, understanding/carrying out and remembering simple instructions, responding appropriately to supervision and more. 3. The disability has to meet or equal a medical listing listed under neurological disorders. Sometimes the actual severity of a mental impairment may not become apparent until six months post-injury thereby postponing the financial benefit payment. 4. If a person is able to do work that he had done previously he may be denied any benefits. 5. A review is conducted of age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. When someone suffers a traumatic brain injury and it is determined that there is a reasonable chance of recovery the TUTOR system should come into play. Victims of brain injury and stroke can benefit greatly from the Tutor system which consists of the HANDTUTOR, ARMTUTOR, LEGTUTOR and the 3DTUTOR. The TUTOR system is one of the newest physical therapy solutions and is being used successfully in leading U.S. and foreign hospitals and clinics. It is also benefiting home care patients through the use of telerehabilitation. The newly developed physical therapy products have become a key system in neuromuscular rehabilitation and physical therapy for brain injury patients including, post stroke and TBI. These innovative tools implement an impairment based program with augmented feedback that encourage practice and motor learning through intensive active exercises. The exercises are challenging and motivating and are 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 patient’s 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.MEDITOUCH.CO.IL for more information

Physical Therapy Products and Solutions for Foot Surgery Rehabilitation

It has been reported by Linda Weber that more and more surgeons realize that physical therapy after bunion surgery can improve range of motion and other functional outcomes. Formally known as ”hallux valgus surgery” most surgeons will tell you that the outcomes of this surgery with physical therapy follow up are very good. But not all agree to what degree post-operative physical therapy contributes to functional outcomes. Sometimes doctors discharge patients with a self-administered exercise and massage routine and nothing more. Others prescribe an extensive supervised physical therapy protocol that can last from four to eight weeks besides home-based exercises. To complicate matters, patients start PT at various times after surgery, depending on the rate of healing and the type of procedure. Even though some physicians believe that if they recommend post surgical therapy it will seem as if they didn’t do a good job others feel that, in actuality, the physician is helping his patient optimize results and the overall post-surgical experience and that post-operative physical therapy can significantly improve range of motion and weight bearing outcomes. In a November 2009 and January 2010 follow up study a physical therapy group significantly outperformed a control group on the Foot Function Index (FFI) and the ACFAS Universal Foot and Ankle Scoring System. Physical Therapist Loshigian said ”Patients who have some sort of formal or informal physical therapy after hallux valgus surgery have better overall results and the progression of healing is more consistent and reliable.” The TUTOR system of physical therapy solutions affords one of the the finest in post lower limb surgery physical therapy tools. The LEGTUTOR™ system has been developed to allow for functional rehabilitation of the lower extremity including the hip, knee, ankle and foot. The system consists of an ergonomic wearable leg brace and dedicated rehabilitation software. The LEGTUTOR™ rehabilitation concept is based on performing controlled exercise rehabilitation practice at a patient customized level with real time accurate feedback on the patient’s performance. This allows the physical therapist to set the exercise practice, performed through customized rehabilitation games, to the patients movement ability. Patients who are post knee surgery, for example, must do isolated repetitive knee flexion and extension exercises both in the lying, sitting and standing position to strengthen their knee. Having the exercises in the form of a customized rehabilitation game will motivate the patient to perform repetitive movement practice which is the mainstay of a physical therapist’s manual exercise technique. In addition, the LEGTUTOR™ system allows for a range of biomechanical evaluations including speed, passive and active range of motion and motion analysis of the lower extremity, these evaluations allow the physical therapist to report on the patient’s movement performance and show the patient the improvements that they are making. The LEGTUTOR™ is also used for other orthopedic and trauma rehabilitation including total hip surgery as it offers the possibility to do repetitive, isolated and combined hip movement practice. Patients with neurological lower limb movement impairments including stroke, CP and spinal and brain injury patients also benefit from the use of the LEGTUTOR. The LEGTUTOR along with its sister products the ARMTUTOR, LEGTUTOR and 3DTUTOR allow for controlled exercise of single and multi joints– like a foot movement at post bunion surgery– within the normal movement pattern. This prevents the development of undesired and compensatory joint movement and ensures better performance of functional tasks. The LEGTUTOR™ and the ARMTUTOR, HANDTUTOR and 3DTUTOR – the TUTOR system– is used by many leading rehabilitation centers worldwide and has full FDA and CE certification. See WWW.MEDITOUCH.CO.IL for more information.

The ”Game” of Physical Therapy Solutions

A study by Marlene Sandlund etal published in Disability and Rehabilitation, April 2012 discusses parents’ perceptions of using low-cost motion interactive video games as a physical therapy solution in home training for their children who have cerebral palsy. The parents’ perception of the ”game” training was very positive. They expressed the view that motion interactive video games may promote positive experiences of physical training in rehabilitation, because the social aspects of gaming were valued. Further, the parents experienced less need to take on coaching while gaming stimulated independent training. However, they expressed a desire for more controlled and individualized games in order to better challenge the specific rehabilitative need of each child. The conclusions reached were that low-cost motion interactive games may provide increased motivation and social interaction over home training and also promote independent training with reduced coaching efforts for the parents. They felt that in future designs of interactive games for rehabilitation purposes, it is important to preserve the motivational and social features of games while optimizing the individualized physical exercise. Children with neurodevelopmental disorders like cerebral palsy (CP) are in need of fun and engaging rehabilitation methods to enhance motivation and increase compliance with motor training.There is a rising interest among clinical professionals and parents to use motion interactive games as a rehabilitation device for these children. In this qualitative study parents perceived that motion interactive games can enhance motivation for practice, stimulate the child and reduce the parental efforts related to home-based rehabilitation of children with CP. While all of the above statements are true it would be much more efficient and worthwhile if the interactive games were designed exclusively for CP patients and monitored by professional therapists who specialize in these specific physical therapy solutions. Such is the function of the TUTOR system. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have been around now for several years assisting patents with CP as well as MS, stroke, spinal cord/brain injury and other upper and lower limb injuries/surgeries. The TUTORs are among the most cost efficient medical devices created for these types of rehabilitation. The methods incorporated in these physical therapy products is a series of challenging games that were specifically formulated to rehabilitate such patients. Games like ”snowball”, ”car race”, ”bubbles”, ”track a target”, ”asteroid attack”, ”sky defender” and more give the child patient (as well as the adult patient) a series of fun games to rehabilitate their affected limbs. Children as young as 4 or 5 years of age can avail themselves of these exercises. Through the use of telerehabilitation the patients can connect to professional therapists at the other end of the internet connection. See WWW.MEDITOUCH.CO.IL for more information.