Ski Accident Statistics and Their Physical Therapy Treatment

Skiing is one of the world’s favorite sports and as such there are a fair amount of injuries to skiers. An analysis of injury statistics compiled over 12 seasons, encompassing 2.55 million skier-days, at a ski resort in Wyoming was used for a ski accident survey. Ticket sales per year was the method of calculating the population surveyed. 9749 skiing injuries were indexed by region and severity according to diagnosis on the initial evaluation. The rates of injury were then analyzed as a function of time. During the 12 seasons the injury rate remained constant at 3.7 injuries per 1000 skier-days. During the study period the rate of lower extremity to upper extremity injury decreased from 4:1 to 2:1 . The ankle injury rate also decreased with time. 7% of all injuries were Ulnar collateral ligament sprains. 30% of all injuries were knee sprains. Anterior cruciate ligament tears increased as a function of time and accounted for 16% of all skiing injuries during the same study period. The most common injury was the medial collateral ligament sprain at 18% of all skiing injuries. In addition there were also forty-seven snowboard injuries recorded. All of the above injuries can be treated by physical therapy products known as the TUTOR system once the patient has been stabilized and is ready for rehabilitation. The TUTORs provide intensive exercise for all upper and lower limb injuries or surgeries. They are also effective for patients who have Parkinson’s disease, stroke, CP, MS, head and spinal cord injuries and other debilitating medical issues. The TUTOR system consists of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. These products include motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises. Controlled exercise practice will help to prevent the development of compensatory movement patterns. The dedicated software allows the therapist to fully customize the exercises to the patient’s movement ability. In addition the therapist can objectively and quantitatively evaluate and report on the treatment progress. The rehabilitation system optimizes the patient’s motor, sensory and cognitive performance and allows the patient to better perform everyday functional tasks to improve their quality of life. The TUTOR system is fully certified by the FDA and CE and is currently in use by leading U.S. and European hospitals and clinics. The suystem is available for children from the age of 5 and up and in the home through telerehabilitation.

Children’s Upper Limb Function and Constraint Induced Movement Therapy

Is there a connection between Constraint-Induced Movement Therapy (CIMT) and the resulting improved upper limb function for children with hemiplegic Cerebral Palsy? A study by Sheri Montgomery, OTR/L, FAOTA University of Utah OTD dated October 2012 discusses this theory. Children that have upper limb hemiplegia often have decreased ability to participate efficiently and effectively in tasks and occupations that require use of both hands. This may include fastening buttons while getting dressed, climbing the monkey bars or school activities such as opening a gym locker or completing a standardized academic assessment such as during play using a keyboard. Amongst the traditional strategies used by OTs for the treatment of upper limb hemiplegia are: fine motor skill reinforcement, strengthening of the affected limb, Electrical Muscular Stimulation (EMS) and Neurodevelopmental Treatment (NDT) techniques. In addition they have also implemented constraint-induced movement therapy programs as a type of intervention. Originally used only with adults this treatment has been used increasingly with children since 1990. CIMT was originally used in conjunction with Botox but the research wants to determine if it can be used alone. The question is can CIMT increase upper limb skills of children with hemiplegic CP to allow for age appropriate actions such as: self care and playing with other children? A review of nineteen studies was made that showed that: • Statistically and clinically significant improvement was noted in self-care and bilateral upper extremity use after two-weeks treatment with constraint-induced movement therapy for children with hemiplegic cerebral palsy. • The greatest improvement was when CIMT was paired with goal directed therapeutic intervention programs. Intensity of CIMT did not have any significant influence on the outcomes or improved motor skills. Bottom line evidence suggests that constraint-induced movement therapy results in an increased use of the affected limb, especially when matched with therapeutic interventions intended to increase strength, control and functional use. It made no difference if children wore the restraint for 3.5 hours a day or 10 hours. The greatest improvement in functional skills was observed when Constraint Induced Movement Therapy was paired with goal specific interventions. Today adult and child patients with upper limb hemiplegia can take advantage of one of the most effective physical therapy products for use in CIMT. The HANDTUTOR has been devised to provide intensive repetitive functional task exercises. The HANDTUTOR system allows for the customization of exercise tasks to a level that allows patients with severe movement dysfunction to start intensive exercise practice with their impaired hand. The HANDTUTOR improves patient functional upper extremity movement ability in severe and moderate movement dysfunction. The HANDTUTOR intensively trains simple movement parameters using isolated exercise practice. The tasks can be set according to the individual patient’s limits of movement ability and the difficulty of the tasks can be shaped. The feedback gives the patient information on his performance of the tasks and instructions on how to improve his movement. The HANDTUTOR and its sisters (ARMTUTOR, LEGTUTOR, 3DTUTOR) have been used successfully for the treatment of Parkinson’s disease, CP, MS, brain and spinal cord injury, stroke and other upper and lower limb disabilities. Fully certified by the FDA and CE the TUTOR system is available to be used at the patient’s home through the use of telerehabilitation. See WWW.MEDITOUCH.CO.IL for further information.

Traumatic Brain Injury and Youth Crime

A British report just published makes some surprising and alarming claims. Apparently, 60% of young people in the British justice system custody say they have experienced a traumatic brain injury. The report cites the fact that brain injury is more prevalent in the under 25 age group.This does not mean that brain injury turns those youths into criminals. The report, was written by Professor Huw Williams and commissioned by the Barrow Cadbury Trust for the Transition to Adulthood (T2A) Alliance. There is a prevalent belief in UK and US legislative authorities that once a person becomes 18 years of age he or she are mature individuals and therefore are responsible for their actions. This is at best unhelpful and at worst a tragedy of the criminal justice system. It can actually prolong the criminal behavior of an individual. There is a basic misunderstanding of age boundaries. Age limits and restrictions rarely correspond to scientific evidence. A 16-year-old isn’t any more resistant to the damaging effects of smoking than a 14-year-old. As soon as someone reaches a legally determined age, they don’t automatically mature overnight. There is no internal switch that gets flipped. ”Underage pregnancy” is somewhat of an oxymoron – if a female is physiologically capable of becoming pregnant, then she is old enough to reproduce as far as nature is concerned. But society rightly recognizes that just because someone is biologically capable of doing something, they are not necessarily mentally capable of doing it without causing damage to themselves or others. Ensuring an individual is mature enough to understand and handle the consequences of potentially damaging actions is why age restrictions exist. But this concept of “maturity” is where problems arise. The criminal justice system works under the assumption that, once an individual is 18, they are mature enough to be considered a typical adult.The argument made is that this is not the case, and that young adults should be recognized as a separate group by the criminal justice system, and their cognitive development maturity and socioeconomic factors should be considered fully when processing them, up to and including the court sentencing the individual. Scientific evidence and a literature review by Birmingham University supports this view. Studies into post-adolescent brain development reveal that brains continue to develop well into our 20s, and these developments are concerned with more complex abilities like: executive functioning and inhibition. The latter overrule our need for immediate reward, moderate our impulsive actions and regulate our emotions. That is what the majority of people would consider signs of maturity. There is another factor that has a serious impact on cognitive development and behavior of young adults and that is brain injury and trauma. Head injury is very serious . A concussion is serious, even if it does not cause lasting damage. Any injury to the head that causes even a short period of unconsciousness should be taken seriously, as it could result in a long-term injury. Because of the complexity of the brain and uncertain nature of brain injury, the eventual consequences of traumatic brain injury can vary, potentially leading to disorders such as schizophrenia. Many “criminals” are imprisoned who suffer from schizophrenia. Should they be in prison or under treatment elsewhere? In younger people brain injury is potentially more damaging, as it can potentially disrupt cognitive development. These disruptions could lead to an increased tendency for criminal behaviour. Those without a TBI [traumatic brain injury] are more likely to grow out of an immature and antisocial behavior by the time they get to the mid-twenties but those with TBI are likely to continue to grapple with these issues throughout young adulthood and beyond. There can be no generalization, however, that all youths who suffer from TBI will graduate into a criminal life. Most do not. But in young adults, brain injury increases the likelihood of eventual criminal behavior. However since there is a tendency for a relationship between criminal behavior and TBI this should be considered when making decisions about sentencing and rehabilitation. Today young people aren’t screened for brain injury and thus it is rare that there would be necessary rehabilitation. As a result, the main contact that many young people with TBI have with those that provide services is via the criminal justice system, which obviously can’t deal with and treat brain trauma. It is strongly suggested, though, somewhat impractical at this time, that young offenders should be screened for TBI and treated which would then cut the rates of a reoffense and save the taxpayer costs in the criminal justice system. Interestingly, work is already under way on some tools for determining the mental state and maturity of the offenders, such as targeted questionnaires. But ironically, this would be predicated on the fact that offenders would be honest with those responsible for prosecuting them. This would require a degree of maturity and control. The point made above is that they may lack the trait of honesty. We should be aware how damaging it can be to demand certain types of behavior from teenagers (and then punishing them based on this) without considering the physiological and cognitive changes they are undergoing. No one is suggesting that young offenders get away with their crimes but it is necessary to take into account the aspects of developmental maturity and brain injury which can affect their behavior and maybe reduce the likelihood of future crime and punishment. When Brain injury occurs and there is paresis in a particular limb the most effective physical therapy solutions should be found when the patient is sufficiently recovered. The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation for patients recovering from brain and spinal injuries, Parkinson’s disease, MS, CP and other limb movement limitations. These innovative physical therapy products implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice. The TUTORs consist of wearable gloves 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 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 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 in leading U.S. German, Italian, French, UK and other country’s hospitals and clinics. The TUTORs are available for adults and children from the age of 5 and up and are fully certified by the FDA and CE. They can also be used in the patient’s home through telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Decisions, Decisions, Decisions

All the time we read about a famous athlete that sustains an injury and has to undergo surgery as a result of an injury or overuse of an arm , hand or leg. There is always a lingering doubt if that surgery will suspend or cancel the athlete’s playing season or even career. Michelle G. Carlson, MD writes that when a hand surgeon, for example, treats a talented athlete, many questions come up. After the physician makes a diagnosis and decides on a treatment plan, that is often a challenge to any patient but here the questions first begin. When do you treat the patient? Is it possible for the athlete to return to play with that particular injury? Should the treatment wait until the season is concluded? If the decision is to treat immediately, how long a period of time will the athlete be out of play? Is this decision going to end the athlete’s season? or his career? Will being out for the season end his career? How do these questions affect the doctor’s decision? Physicians are expected to make choices where lost days of play can make tremendous differences in the career of collegiate, professional, or even high school athletes. This is why the decisions made should include involving the most sophisticated and advanced methods of treatment so that the athlete has the best chance of returning as fast as possible to his profession. Since most, if not all, limb surgeries necessitate a period of physical therapy during recovery it is imperative for the medical professional to seek out the best physical therapy solution available. Currently that would be the recently created TUTOR system. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are innovative physical therapy products that are speeding the improvement of limb repair in athletes and others who have undergone hand, arm, elbow, shoulder or leg surgery. The TUTORs are comfortable ergonomically designed gloves or braces which are strategically placed on the affected limb and with special sensors connected to dedicated software that detect motion. They provide an intensive exercise program through the use of special games geared to that particular patient . The physical or occupational therapist records and evaluates the patient’s performance and creates a customized program for that patient. In addition the TUTOR system aims to optimize the motor, sensory and cognitive performance of the user. Currently in use in leading U.S. and European hospitals and clinics the TUTORs are fully certified by the FDA and CE and can be used at the patient’s home through telerehabilitation. See WWW.MEDITOUCH.CO.IL for further information.

Recovering From Spinal Cord Injuries

It is very common that spinal cord injury patients will have feelings of fright, confusion or anxiety .They may also have feelings of disbelief because they are still alive even though they have severe disabilities. Actually rehabilitation consists of a multi pronged approach. It includes physical therapies, activities to rebuild skills and emotional and social support. The rehab team of specialists will normally include a physiatrist, recreational therapist, social worker, physical and occupational therapists, nutritionists, nurses, psychologists, case workers to coordinate everything and others. The first part of rehabilitation will consist of the physical aspect of getting the affected mobility returned. This may be accomplished only with the help of devices such as: wheelchairs, braces and walkers. To get the patient to communicate he will use normal typing, writing and phone devices. Muscle strengthening is part of actual physical therapy whereas redeveloping fine motor skills is within the role of an occupational therapist. Basic toileting routines and self grooming are also taught at this stage. If the patient shows the ability to cope, a vocational counselor (VC) will assess skills, dexterity, physical and cognitive capabilities to determine what might be available in terms of employment. The VC will also arrange for any assistive devices that may be needed in the workplace. If the patient will not be able to achieve gainful employment then the VC will find other places for the patient to spend his time in a productive manner. This could include hobbies, educational classes, getting involved in special interest groups, and participating in family and community events. Finally there is recreational therapy which would get the patient to use their abilities to participate in athletic activities at their level. This latter aspect can help to achieve a more normal lifestyle and allow for some raised self esteem. When deciding on the most appropriate form of physical therapy an effort should be made to utilize the most advanced form of physical therapy products. Such devices are now found in the form of the recently developed TUTOR system. Consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR these devices are at the forefront of assisting spinal cord injury patients to recover lost movement ability skills. The TUTORs implement an impairment based rehabilitation program with augmented feedback and encourage motor learning. The system allows the therapist to evaluate and objectively quantify and record the patient’s motor and cognitive impairments and then customizes a treatment session for that patient. Currently in use in leading U.S. and European hospitals and clinics the TUTORs are fully certified by the FDA and CE. They are usable by children as young as 5 as well as adults and can be used in the patient’s home through telerehabilitation. See WWW.MEDITOUCH.CO.IL for further information.

U.S. Army Enters Fight …Against Traumatic Brain Injury

It was reported by the Army News Service on August 31, 2012 that the U.S. Army together with the National Football League will be joining to increase the research into the causes, prevention and treatment of Traumatic Brain Injury (TBI). An agreement was reached and signed by Army Chief of Staff Gen. Ray Odierno and NFL Commissioner Roger Goodell to continue sharing their resources to combat TBI. Attending the event were soldiers and players who have had concussions during their service or games. Representatives of the medical corps and 200 cadets also participated. Ironically it is the tough discipline and feeling of team over self that they are taught which prevents soldiers and players from disclosing that they were injured and from seeking help after a concussion. These traits make it difficult for individuals to admit that they have a particular problem, especially mental. Gen. Odierno stated that the goal of the new program is to educate the soldier and player to come forward and be educated that they have to seek treatment both on the battlefield and on the playing field. The general discussed various examples of how dialogue and the sharing of research can monitor TBI. One of the methods is placing sensors in the helmets that are worn that can detect a concussion after a trauma to the head occurs. NFL commissioner Goodell told those assembled that basic cultures (of not disclosing concussions) have to change making players and soldiers share their experiences. The importance of disclosing the incident with officers higher in rank needs to take place without fear of retribution just because they disclosed what happened. Some officers and players told about their personal experiences and how they were reluctant to seek help. The NFL commissioner stated that not asking for help will no longer be tolerated. That there has to be accountability. That coaches and other players will no longer be able to make the decision. Only medical personnell will be allowed to judge whether a player or soldier can return to duty. Proper leadership and supervision includes allowing this to happen. ” Seeking help is playing smart.” he added. Both officials said that enough progress hasn’t been made yet and more needs to be done. There is an Army Directive that stipulates that soldiers have a minimum of 24 hours of downtime and need to get a medical clearance before returning to duty following a blast or vehicle incident. Maj. Sarah Goldman, program director of Army Traumatic Brain Injury at the Office of the Surgeon General, Rehabilitation and Reintegration Division, stated that more than 13,000 service members sustained some form of concussion since 2010 and 95 percent were returned to duty. Odierno, admitted that when he played football he would not have sought medical attention for a concussion. “I wouldn’t have taken myself out. Someone else would have had to.” He said that kind of thinking is wrong. The general added that the army and players have to have a bond to take care of each other no matter what the rank. When TBI occurs the best physical therapy solutions should be put in place. Currently that includes the TUTOR system. Victims of brain injury and stroke can benefit greatly from the Tutor system– the HANDTUTOR, ARMTUTOR, LEGTUTOR and the 3DTUTOR. The Tutor system is being used successfully in leading U.S. and foreign hospitals and clinics and is also benefiting home care patients through the use of telerehabilitation.This ensures that the patient is motivated to do more practice between treatments by the therapists. The newly developed HANDTUTOR and its sister devices have become a key system in neuromuscular rehabilitation and physical therapy for brain injury patients including, post stroke and TBI patients. These innovative physical therapy products implement an impairment based program with augmented feedback that encourages intensive practice and motor learning through active exercises. The exercises are challenging and motivating and allow for repetitive training tailored to the patient’s performance , motor , 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. The TUTOR system is suitable for children as well as adults. See WWW.MEDITOUCH.CO.IL for further information.

Ballet: An Art Form or Cause for Rehabilitation

Most of us don’t associate the art of Ballet dance with injury and rehabilitation however ballet is a source of both. There are many causes for such injuries. There may be environmental factors such as faulty dance surfaces. There may be inappropriately fitting footwear leading to foot conditions. There may be spinal cord issues which can be the cause FOR injury as well as a result OF an injury. An incorrect ”turnout” ( the ability of the dancer to turn his or her feet and legs out from the hip joints to a 90-degree position) on the part of the dancer may cause an injury. There may be an inbalance of soft tissue or inadequate quadricep strength. The beautiful but potentially harmful ballet steps of ”plies”-which is a smooth continuous bending of the knees; ”pointe” where the dancer performs steps while on the tips of the toes using a special block shoe and ”demipointe” can all cause serious injury or worse. Both male and female ballet dancers are susceptible to these injuries so when they occur the very best physical therapy solutions need to be at hand during their rehabilitation. Physical and occupational therapists have been using the TUTOR system to rehabilitate injured limbs of patients suffering from strokes, brain/spinal cord and upper and lower limb surgeries, Parkinson’s disease, Cerebral Palsy, Multiple Sclerosis and many other limb disabling medical conditions. It is only natural that the HANDTUTOR, LEGTUTOR and ARMTUTOR would be used in the treatment of ballet injuries as well. The TUTORs are comfortable, ergonomically designed gloves and braces that are strategically placed on the affected part of the body and with sensors attached to dedicated software the patient is subjected to intensive exercises. The therapists evaluate the results and then design a personalized exercise program for that patient. These physical therapy products are currently in use in leading rehabilitation hospitals in the U.S. and Europe. The TUTOR system is fully certified by the FDA and CE and can be used by children as young as 5 as well as adults. Telerehabilitation allows the patient to use the TUTORs in his own home. See WWW.MEDITOUCH.CO.IL for further information.

”Do Re Me Fa So La” and Physical Rehabilitation

Rehabilitation medicine combined with music therapy has been around for some time now. It as helped people with all kinds of physical disorders and even those affected by Rett syndrome. The benefits of adding music, an art, to a physical maneuver is unique and successful.Numerous studies have shown how physical therapy results are enhanced by adding music in the background or having the patient directly involved in creating the music. The music is actually ”instrumental” in physical recovery and health maintenance. One of the beautiful benefits of using music during physical rehabilitation is that one can witness the active and consistent participation of the patient which is often not the case with standard rehabilitation. The music itself encourages participation in exercises. It can also relieve the discomfort associated with the activities. It is the goal of regular music therapy to get the participant to express himself through the music so the common goal here is to alleviate symptoms of orthopedic, pediatric and neurological conditions in order to improve range of motion, strength, communication, balance and cognition and generally the quality of life. Occupational therapists are finding that music therapy assists clients to maximize the patient’s independence in their daily roles. When accompanying music is used in conjunction with physical rehabilitation it would be the ultimate combination if the physical therapy products in use were of the highest quality and most efficient. Such would be the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. These recently created devices are comfortable ergonomically designed gloves and braces that are strategically placed on affected limbs and through sensors are connected to sophisticated software. The software consists of exclusively designed games that the patient plays. Physical therapists monitor , record and evaluate the patient’s progress and design a specific exercise program for the patient. The patient himself activates the limb rather than an external robotic device that causes movement. In that way the patient has control and can progress further independently. The TUTOR system has been in use now for some time in leading U.S. and European hospitals and rehabilitation clinics. The TUTORs are fully certified by the FDA and CE, are available for children as well as adults and can be used at the patient’s home through the use of telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

New Formula Predicts Rehabilitation Outcome

The journal called ”Brain” featured an article on July 31, 2012 about a development that could revolutionize rehabilitation for stoke patients. University of Auckland researchers have shown how it may be possible to predict potential recovery in stroke patients for hand and arm function. Realistic goals for recovery may be set for patients and trial outcomes for new therapies may have also have better results through this approach. According to Professor Winston Byblow one of every six people will have a stroke at some time during their life and until now comparisons were made as to outcome based on group similarity to others with the same symptoms. An individual patient’s rehabilitation plan can not be known. ”We have developed the first clinical algorithm to actually predict the individual patient’s potential for recovery based on information gathered before rehabilitation even begins.” said Byblow. A test is administered to the hospitalized stroke patient within 3 days of the event. It is very quick and requires no special equipment. Dr Cathy Stinear, who authored the journal article, explains that in some cases additional testing may be required such as an MRI to determine whether the pathways in the particular side of the brain remain viable and to measure the integrity of neural pathways from the brain to the arm. When the algorithm is combined with the results of the tests a prediction can be made about patient recovery at 12 weeks which is when therapy would normally end. The information gleaned from this new test can be used to customize rehabilitation for the patient before it even begins. It is the first study to predict an individual’s potential for motor function recovery using test results obtained from that patient in the first days after stroke, according to Neurologist Professor Alan Barber, a member of the research team and Head of the Auckland Hospital Stroke Service . The research team is now in a three year trial period of the algorithm method to show if the outcomes really benefit the patient and increases the efficiency of hospital rehabilitation services. Once that prediction is made and actual rehabilitation commences the physical therapy product of choice may well be the HANDTUTOR and ARMTUTOR. The HANDTUTOR and ARMTUTOR™ have been developed to allow for functional rehabilitation of the upper extremity including the shoulder,arm, elbow and wrist. The system, recommended for use for a variety of injuries and diseases including stroke, Parkinson’s, CP, MS and other upper and lower limb disabilities , consists of an ergonomic wearable glove and arm brace together with dedicated rehabilitation software. The TUTOR systems (including the LEGTUTOR and 3DTUTOR) allow the physical and occupational therapist to report on and evaluate the patient’s functional rehabilitation progress. This allows them to prescribe the correct customized and motivating intensive exercise practice to the manual rehabilitation therapy. Intensive repetition of movement is achieved through challenging games set to the patient’s ability. The system provides detailed exercise performance instructions and precise feedback on the patient’s efforts. 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. Telerehabilitation allows the recovering patient to continue his physical therapy at home. The system is used by many leading rehabilitation centers worldwide and has full FDA and CE certification. See WWW.MEDITOUCH.CO.IL for more information.

Is Knee Surgery Really Needed?

The web is full of articles about knee surgery and how more and more people are opting for this painful solution to osteoarthritis. However a study recently concluded that there may be a way to avoid such an operation completely. A study was conducted in a large military hospital in Texas recently indicating that physical therapy consisting of manual therapy, stretching and strengthening as an exercise regimen may help people with osteoarthritis of the knee avoid a knee joint replacement surgery. During the study, 83 patients with osteoarthritis of the knee were randomly assigned to two groups.The first group of 42 patients received treatment consisting of manual therapy and therapeutic exercise twice a week for four weeks.The second group of 41 patients received a placebo treatment where they received ultrasound in a dosage far below a therapeutic level. The mean age of the partipants was 60 and 62 years respectively. Results were measured at four weeks, eight weeks, and one year post-treatment. The study reports that “Clinically and statistically significant improvements were observed in the treatment group but not in the placebo group”. The study also reports that “the average distance walked in the treatment group was 170 more than that in the placebo group. At one year, patients in the treatment group had clinically and statistically significant gains over baseline in walking distance. While 20 percent of patients in the placebo group had undergone knee arthroplasty, only 5 percent of patients in the treatment group had.” The study concluded with a statement saying “In patients with osteoarthritis of the knee, a combination of manual physical therapy and stretching, range-of-motion, and strengthening exercises may yield improvements in functional ability as well as in subjective measures of pain, stiffness, and function and may delay or prevent the need for surgical intervention. These improvements may persist well after the conclusion of clinical treatment.” When physical exercise is indicated for a problematic knee due to osteoarthritis one of the most effective physical therapy solutions is the LEGTUTOR. The LEGTUTOR consists of a safe comfortable leg brace with position sensors that precisely record three dimensional (3D) hip and knee movements.The LEGTUTOR has a range of motion limiter that can limit the dynamic range of knee extension and flexion. Rehabilitation games allow the patient to exercise Range of Motion (ROM), speed and accuracy of movement. The LEGTUTOR facilitates evaluation and treatment of the lower extremity including isolated and combined hip and knee movements. The LEGTUTOR and its sister physical therapy products (HANDTUTOR, ARMTUTOR and 3DTUTOR) are one of the most cost effective medical devices available for what it accomplishes. Currently in use in leading U.S. and European hospitals and clinics the TUTOR system is fully certified by the FDA and CE and can be used by children as well as adults. They are also available for use in the patient’s home via telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Voluntary Exercises Better Than External Stimuli for Physical Rehabilitation

In the Journal of NeuroEngineering and Rehabilitation, July 2012 edition, Dr.Kyung-Lim Joa of the Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, South Korea published the results of a study in which rehabilitation was evaluated by using voluntary movements as well as Functional Electrical Stimulation (FES). Nineteen healthy male subjects were enrolled in the study. The study design included: a-voluntary contraction only, b-functional electrical stimulation (FES)-induced wrist extension only, and c-simultaneous voluntary and FES-induced movement. Brain activation was observed in all three modes. The activated brain regions (number of voxels) of the MI, SI, cerebellum, and SMA were LARGEST DURING VOLUNTARY CONTRACTION ALONE and smallest during FES alone. SII-activated brain regions were largest during voluntary contraction combined with FES and smallest during FES contraction alone. The brain activation extent (maximum t score) of the MI, SI, and SII was LARGEST DURING VOLUNTARY CONTRACTION ALONE and smallest during FES alone. The conclusions drawn were that voluntary contraction combined with FES may be more effective for brain activation than FES-only movements for rehabilitation therapy. In addition, voluntary effort is the most important factor in the therapeutic process. As it is this is another proof that the patient recovering from and undergoing rehabilitation for affected limbs due to Parkinson’s, CP, MS, stroke, brain or spinal injuries amongst other diseases and surgeries should be using physical therapy solutions that encourage the patient to use his own strength and efforts while exercising more than outside stimuli via robots or electrical impulses. Such physical therapy products can be found in the TUTOR system. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have been designed for just that type of intensive exercise. Consisting of comforatble and ergonomically designed gloves or braces, The TUTORs improve fine motor, sensory and cognitive impairments through intensive exercises with augmented feedback. The exercises are challenging and motivating and allow for repetitive training tailored to the patient’s own performance. In the case of the HANDTUTOR, for example, the glove has been designed to detect finger and wrist motion and has an open palmar surface to give maximum motor and sensory input. The glove comes in different sizes to allow evaluation and treatment of patients from age 5 and up. One of the most cost effective rehabilitation devices currently in use in leading U.S. and European hospitals the TUTORs are fully certified by the FDA and CE. They can also be used in the patient’s home via telerehabilitaion. See WWW.MEDITOUCH.CO.IL for more information.

First Use of Hand At Age 12

It has just been reported that Kyril, a 12 year old boy from Latvia can now do anything he wants with his right hand for the first time in his life. Kyril is one of a rare group of children that suffered from Brachial Plexus Palsy, a defect that occurs in one in 3-5,000 births that prevents normal movement of the hand. Most children learn to cope with it and 90 percent of them eventually are fine as the disability passes by 3 months of age. With Kyril it didn’t and he was sent to Israel where Dr. Mark Edelman, a pediatric orthopedist and the head of the pediatric orthopedic department at Rambam Medical Center in Haifa, operated on him and ”rearranged” his wrist and shoulder bone. In addition to that miracle Kyril was able to leave the hospital after only one day as the operation precluded the need for a plastic cast and other treatments. For others who are not so lucky and are suffering from Cerebral Palsy and other disabling diseases getting the right type of physical therapy solution is critical in order to restore normal movement in the affected limb. Such a solution can be found in the TUTOR system. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have been included in physical therapy programs at leading U.S. and European hospitals and rehabilitation facilities. These devices are ergonomically designed gloves and braces that have sensors to detect even the slightest movement on dedicated software they are connected to. The physical therapists then record and quantify this information and design a customized intensive exercise program with augmented feedback leading to enhanced rehabilitation for the patient. The TUTOR system is suitable for children as well as adults and can be used at the patient’s home through telerehabilitation. The TUTORs are fully certified by the FDA and CE. See WWW.MEDITOUCH.CO.IL for more information.

Parkinson’s Disease–Not This Population

In the northern part of Israel and in Syria there is a group of people called ”Druse”. A new study by the University of Haifa and the Carmel and Rambam Medical Centers in Israel has found that the Druse people have a much lower incidence of Parkinson’s disease (PD) than in other populations. In addition it was found that this group suffers less from Essential Tremor (ET). This despite that the Druse tend to intramarry, a fact that usually brings with it higher genetic disease rates. Funded by the Israeli Ministry of Science and Technology the researchers found that the group is a “genetic nature reserve” since they have lived in the same general area for over 1,000 years and do not marry outsiders. Amongst the statistics is the fact that in the rest of the world ET affects an average of 4% of the poulation over 40 and PD an avaerage of 1.5%. The study was conducted with 9000 Druse who were 51 or over and who live in the Galilee section of Israel. Blood samples were taken from those who suffered from any kind of tremor. Of the group only 27 had full tremors and 9 had PD. The researchers were surprised at the low at the low percentage for a group of people that practiced consanguinity (marrying cousins). Normally such a group would be more likely to get PD and ET. A previous survey, though, discovered that genetically 150 different genealogical lines made up the community. This suggested to the researchers that because of so many lines when the community was originally formed it prevented the increase in genetic diseases. For those people who are not part of the Druse population Parkinson’s disease can be very debilitating. Fortunately there are physical therapy solutions that can offer some relief for PD symptoms. At the forefront is the HANDTUTOR. The newly developed HANDTUTOR and its sister devices (LEGTUTOR, ARMTUTOR and 3DTUTOR) have become a key system in neuromuscular rehabilitation and physical therapy for Parkinson’s patients as well as those affected by brain/spinal cord injury and other upper and lower limb disabilities . These innovative devices implement an impairment based program with augmented feedback that encourages intensive practice and motor learning through active exercises. The exercises are challenging and motivating and allow for repetitive and intensive training tailored to the patient’s performance and motor, sensory and cognitive movement ability. Customized and simple but powerful rehabilitation software allows the physical and occupational therapist the ability to adjust the program and exercise difficulty to the patient’s movement level. 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 patient to be supported by the physical rehabilitation team when he 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. They are certified by the FDA and CE and are available for children as well as adults. See WWW.MEDITOUCH.CO.IL for more information.

The Risks of Mountain Bike Riding

In a microcosm study of mountain bike injuries Zachary Ashwell, a fourth year medical student who has a background in engineering, took statistics of injuries suffered by individuals who rode mountain bikes. An avid biker himself he knows the hazards and pitfalls that a rider can experience especially at Whistler Mountain Bike Park in Canada. He studied some 898 case reports from the Whistler Health Care Centre 2009 mountain bike season. The specific cases occurred between May 16 and Oct. 12 of 2009. He found that the typical injury was a 26-year-old male who suffered the injury between 1 and 4 p.m. Ashwell discovered that 86 per cent of the patients were male, that August is the worst month for injuries, that 12 per cent of the injuries suffered were considered potentially threatening to life, limb or function, and that more than 75 per cent of the bones broken in the bike park were upper body bones.The most severe injuries involved internal bleeding or internal organ injury, spinal cord injury or traumatic brain injury. Obviously the idea is to have as much safety gear as possible worn by the rider. Of 24 cases where safety equipment was noted only one was documented as not wearing armor. The other 23 were documented as wearing a variety of protective devices beyond a helmet, including knee and elbow pads, full body protective suits and neck guards. At the risk of divulging a possible business idea this writer suggests that someone should invent a kind of ”airbag garment” to protect the mountain bike rider when he falls. As stated above one of the more severe injuries that can occur to bike riders when they fall is Spinal Cord Injury (SCI) or Traumatic Brain Injury (TBI). When that occurs and the initial emergency treatment has passed the patient will need the best physical therapy solution to cope with any limb movement disability issue he has. The TUTOR system is in the forefront of such physical therapy products and has been developed to assist patients to get the most intensive exercises so that the limb can return to its former mobility stage (and the patient can again ride his bike??) The devices (HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR) are sophisticated, ergonomic and comfortable gloves and braces and have become a key system in neuromuscular rehabilitation and physical therapy for interactive rehabilitation exercise. The TUTORs are connected to exclusive software that implement an impairment based program with augmented feedback and encourage motor learning through intensive active exercises. The physical therapist records and evaluates the progress made by the patient and designs a customized exercise program for that patient. The TUTOR system, fully certified by the FDA and CE is now part of the rehabilitation program of leading U.S. and foreign hospitals and can be used in clinics in their home through the use of tele-rehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Improving Brain Function After Stroke

Dr. Robert Rennaker and Dr. Michael Kilgard of the University of Texas, Dallas recently proved how nerve stimulation when paired with specific experiences, like movements or sounds, is able to reorganize the brain and even improve its function. What they discovered could lead to new treatments for stroke, autism, tinnitus, and other disorders. The researchers looked at whether by repeatedly pairing vagus nerve stimulation with a specific movement it would change neural activity in laboratory rats’ primary motor cortex. They paired the vagus nerve stimulation with movements of the front limbs in two groups of rats. After a period of five days of this stimulation and movement pairing, the researchers examined the brain activity of the rats. Those who received the training together with the stimulation displayed large changes in the organization of the brain’s control system. Those animals receiving identical motor training without stimulation pairing didn’t exhibit any brain changes, known as plasticity. Patients suffering from strokes or other brain trauma often have rehabilitation that includes repeated movement of the affected limb in order to regain motor skills. It is surmised that repeated use of the affected limb will cause reorganization of the brain which is essential to recovery. Dr. Rennaker stated that there was a suggestion from the research that pairing vagus nerve stimulation with standard therapy could result in a more rapid and extensive brain reorganization. This would offer the potential for speeding recovery following a stroke. He further stated “Our studies in sensory and motor cortex suggest that the technique has the potential to enhance treatments for neurological conditions ranging from chronic pain to motor disorders. Future studies will investigate its effectiveness in treating cognitive impairments”. Vagus nerve stimulation has an excellent safety record in human patients that suffer from epilepsy. Therefore the technique researched provides a new method to treat brain conditions such as dyslexia and schizophrenia. Future human patients may have access to more efficient therapies that are minimally invasive and avoid long-term use of drugs if the studies are confirmed. To provide repeated movement of a stroke affected limb the TUTOR system has been in the forefront of physical therapy products. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have been developed to provide intensive and active movement of disabled legs, hands, wrists, elbows and other upper and lower limbs. The ergonomic gloves and braces that make up the TUTOR system are connected to dedicated software that allows the therapist to fully customize the exercises to the patient’s movement ability. In addition the therapist can objectively and quantitatively evaluate and report on the treatment progress. The TUTOR rehabilitation system optimizes the patient’s motor, sensory and cognitive performance and allows him to better perform everyday functional tasks to improve their quality of life. The TUTOR system is currently in use in leading U.S. and European hospital and clinics. They are fully certified by the FDA and CE and can be used at the patient’s home via telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Can Prayer Help Prevent Stroke?

Do you want to prevent having a stroke? One of the most important methods is to eliminate any risky practices you may have. Of course there are certain things we can’t change such as: genes, age and gender but we can change diet and physical activity. Adopting a diet which is low in salt and fat but high in fiber is a beginning. Vitamin B rich foods such as spinach, broccoli, carrots, salmon, herring, chicken, walnuts, almonds, sunflower seeds and whole wheat would be helpful. It is known that Vitamin B foods lower homocysteine levels and too much of this amino acid in the blood increases the risk for stroke. There are other foods that lower the risk of stroke and they include cinnamon, garlic, olive oil, onion, dark chocolates, green tea, oatmeal and strawberries. People that have diabetes should take necessary steps to prevent stroke as well. Diabetics are at risk and therefore should manage their diabetes by eating healthy and monitoring their blood pressure. Exercise is is a crucial element in stroke prevention as obesity is a stroke risk. Exercise will help take off pounds and maintain healthy weight. Cholesterol levels should be checked regularly. The state of one’s mental health can also increase stroke risk. Stress can be very damaging, if left unmanaged. It raises blood pressure, which makes the heart pump harder. One of the ways to reduce stress is with physical activity such as exercise or deep breathing. Reading and prayer or meditation can also relieve stress. Preventing high blood pressure is crucial to stroke prevention. That can be done by avoiding, or at least reducing, the consumption of high-fat foods such as: butter, red meat, eggs, shortening, certain cheeses and dairy products. Reducing the amount of salt is advisable. Sugar, caffeine and alcohol can raise blood pressure, which is a risk factor of stroke. Here are some common symptoms of stroke which, if experienced, should be brought to the attention of medical experts immediately. Sudden weakness or numbness in the face or limbs; slurred speech or drooling; numbness on one side of the body; problems with balance or walking; dizziness; confusion; or a severe headache. Unfortunately, even with the best prevention, stroke can still occur and one of the after effects can be the paralysis of a limb. When that occurs and after the patient is stabilized the emphasis will be to rehabilitate the leg or arm that is affected. Fortunately, today there are some very good physical therapy solutions such as the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. The TUTOR system has become key 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. They consist of a wearable glove or 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 to the patient in trying to gain this new movement objective. Consequently the patient understands which effort is more successful in getting him to move their affected limb again. 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 adaptable for children as well as adults and are fully certified by the FDA and CE. See WWW.MEDITOUCH.CO.IL for more information.

What (Not) to Eat After a Spinal Cord Injury

What does food have to do with spinal cord injury one might ask. However after such an injury, a person’s metabolism can often change quite a bit. Since fewer muscles are being used, people with a spinal cord injury don’t need as many calories per day as before the injury. So, if their eating habits do not change , they may be at risk for obesity and other negative health conditions. It is necessary to avoid certain types of food after a spinal cord injury in order to help a person maintain a healthy weight. Fast foods are high on the list of what to avoid after a spinal cord injury, or SCI, as they tend to put too many calories into each meal. Eating 1200 calories in one meal, as fast foods generally contain, may be half the person’s daily intake The National Guideline Clearinghouse, states that a person with a spinal cord injury requires around 10 percent fewer calories per day than the average person. If they are severely impaired or inactive they may need even less. Avoiding the excess fat and cholesterol that these foods tend to contain is necessary. According to The Spinal Cord Injury Network people with paraplegia or quadriplegia should also limit their sodium intake to no more than 500 to 1,000 mg daily. Taking more than that may cause excess fluid retention, which can make their bodies more susceptible to negative health conditions. Too much sodium can raise blood pressure,which is a risk factor for heart disease and stroke. Sodium is prevalent not only in salt but also in many sauces, condiments and pre-packaged meals. It is important to read labels of such foods before ingesting them. Just like salt, SCI patients should also avoid too much sugar as they are high in calories and give no nutrition. According to The Baylor College of Medicine such foods should make up only a small part of the daily diet for those living with SCI. Included in these foods are sodas, candy, cookies and cakes. Sweetened beverages, such as juices or tea mixes, may also contain too much sugar. Likewise alcohol consumption should be limited to one drink per day for women with SCI and two for men as a maximum. Other foods for SCI patients to avoid would be chips, fried chicken, certain oils, butter and fatty meats. So much for food intake for the SCI patient but in order to strengthen the limbs and muscles of these patients the proper exercises have to take place. One of the most cost effective physical therapy solutions can be found today in the TUTOR system. It consists of motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises. Controlled exercise practice will help to prevent the development of compensatory movement patterns. The dedicated software allows the therapist to fully customize the exercises to the patient’s movement ability. In addition the therapist can objectively and quantitatively evaluate and report on the treatment progress. The rehabilitation system optimizes the patient’s motor, sensory and cognitive performance and allows the patient to better perform everyday functional tasks to improve their quality of life. The TUTOR system (HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR) are available for children as well as adults and are fully certified by the FDA and CE. Currently in use in leading U.S. and European hospitals the TUTORs can be used in the patient’s home through telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Prehabilitation–a Definition

PREVENTION & REHABILITATION: Two words that are not usually mentioned in the same breath. They actually are at opposite ends of the spectrum. However they really can go together because as much as rehabilitation serves to heal the injured, prevention or ”prehabilitation” can prevent the injury. To explain it further there are two areas of rehabilitation: a) Prehabilitation: which is exercise therapy undertaken by athletes and others to try to reduce the risk of injury. b) Rehabilitation: is exercise therapy which is used to strengthen muscles around limbs and thereby attempt to return the use of an affected limb to its previous healthy state and also to prevent the injury from recurring. This method can be used to build up muscles and reduce injury around the shoulder, arm, leg and other upper and lower limbs of the body. Players of contact sports such as Rugby in the UK or football in the U.S., as an example, can be the beneficiaries of such prehabilitation. Using the best physical therapy solutions for prehabilitation would add to the success of prevention of severe injuries. Such physical therapy products as the TUTOR system will afford the athlete and others to accomplish the goal of muscle toning and strengthening. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have been introduced to provide intensive exercises for disabilities arising from stroke, CP, MS, brain/spinal cord injuries and other upper and lower limb injuries or diseases. The same TUTOR system can be used to exercise various muscles of the body on a regular basis to help prevent injury due to sports and other accidents. The TUTORs are ergonomically designed gloves and braces that are attached to various parts of the body and through powerful evaluation software accessed by sensors in the braces that allow the patient to perform intensive exercises. The exercises are monitored by physical therapists who then design a custom made program appropriate for that patient’s ability level. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are fully certified by the FDA and CE. They are available for children as well as adults and can be used in the patient’s home through telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

How Much Salt to Add to Your Food

As published on Wednesday, April 25, 2012 in the journal STROKE, Dr. Francesco P. Cappuccio, of the University of Warwick in the UK stated that older adults with salty diets may have an increased risk of suffering a stroke. The results were in a study of 2,700 older, mostly minority adults. They got well above the recommended sodium intake and were nearly three times as likely to suffer a stroke over 10 years as people who met guidelines recommended by the American Heart Association (AHA). As people’s sodium intake goes up, their blood pressure will likely increase as well. What is not as clear, though, is whether a salty diet may mean higher risks of heart attack and stroke later on. Unlike blood pressure, which can change quickly, stroke and heart disease are more long-range complications. So a study of the relationship between people’s sodium intake and their risk of heart problems and stroke is more difficult. At this time, the AHA suggests that people not consume more than 1,500 milligrams a day. The World Health Organization advises a limit of 2,000 milligrams. The people in this study — mainly black and Hispanic New Yorkers — consumed 3,031 milligrams of sodium per day. The findings are based on 2,657 adults who were interviewed about their health and lifestyle and then completed dietary questionnaires. They were 69 years old, on average, when the study began. During the next 10 years, there were 235 strokes in the group. Those that downed 4,000 or more milligrams of sodium each day were almost three times more likely to suffer a stroke as those who kept their daily sodium below 1,500 milligrams. Among the 558 people consumed more than 4,000 milligrams per day, there were 66 strokes. That compared with 24 strokes among the 320 people who kept within the AHA guideline. Hannah Gardener, a researcher at the University of Miami School of Medicine who led the study said “We can’t definitively draw conclusions about cause-and-effect . There can be a number of other factors to take into consideration in addition to salt intake. As an example smoking habits, exercise levels, education and health conditions like diabetes and high blood pressure need to be taken in to consideration. Although few Americans adhere to the AHA guidelines they should be followed according to Gardener. Interestingly, it’s estimated that the typical U.S. man takes in 4,000 milligrams of sodium a day, while women typically ingest 2,800 milligrams. Salt is pervasive in the food supply — from canned soups and sauces, to breads and cereals, to processed meats — and it can be challenging to cut down. Americans receive almost 80 percent of their sodium from prepared foods on supermarket shelves and in restaurants, rather than at home. Gardener further states that it is important to read product labels to know beforehand how much sodium there is in the product. Eating fruits, vegetables and whole grains, as much as possible will also alleviate the problem. The researchers suggest that responsibility should also rest on government regulations and the food industry. In England, the government has begun to regulate the processed food industry. New York City has instituted the National Salt Reduction Initiative. This move tries to coordinate local and state governments and health groups to work with the food industry to cut sodium in packaged foods and restaurants. Heinz, Kraft Foods and Starbucks, have already signed on to meet salt targets. Unfortunately, at this time and age people still take in too much sodium so strokes will still occur. When they do and the initial medical treatment is completed it behooves doctors and other medical staff and facilities to supply the best physical therapy solutions available to treat any paralysis that may exist as a result of the stroke. Such physical therapy products are the TUTOR system. Rehabilitation using the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR is instituted in the USA at major in-patient and out-patient clinics as well as at private physical therapy clinics. Many patients including stroke victims can also avail themselves of the TUTOR system through the use of tele rehabilitation when they are at home or in a location far from a qualified rehabilitation center. The TUTOR products 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 controlled exercise practice. The TUTOR system exercises multijoints within the normal movement pattern which prevents the development of undesired and compensatory joint movement. It therefore ensures better performance of functional tasks. This is important in stroke, brain, spinal cord (SCI) and Cerebral Palsy rehabilitation in addition to other neurological and orthopedic injury and disease. Additional features of the TUTOR 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.MEDITOUCH.CO.IL for more imformation.

What to Expect From Stroke Rehabilitation.

Dr. Komaroff is a physician and professor at Harvard Medical School and gives the following advice Rehabilitation helps return abilities impaired by a stroke. How much progress one makes and how quickly it occurs will depend on how severe the stroke was and the part of the brain that was affected. Strokes can affect muscle strength, senses (like pain), one’s ability to speak and to understand speech, vision, emotions, thinking and level of consciousness. Some people only suffer mild unilateral weakness with nothing else wrong. Other people lie in a coma. New techniques have been learned in recent years that sometimes lead to recovery that at one time were not possible. Rehabilitation may occur in the hospital, a rehab facility or at home. One or more specialists may be involved. These may include a physiatrist, rehab nurse, physical or occupational therapist, speech-language pathologist or a recreational therapist. The strategies used will depend on the patient’s goals for therapy. Some common goals include rebuilding strength, relearning to walk, improving speech and recovering memory. On the other hand rehab can also help a person adapt to a permanent disability, if necessary. Physical rehab may include walking up or down stairs, walking on a treadmill and using hand or leg weights. Even if the patient can’t bear weight on his legs exercise may still be possible. This may have to be done while partially supported by a harness. Many patients exercise in a swimming pool, where water can support some of the weight. The therapist may also stimulate natural movements in the arms and legs. This can help restore neurological pathways at the same time as it strengthens muscles and improves circulation. Regaining skills for regular everyday living is another important goal. The patient will learn practical techniques to make washing, dressing, driving and other routine activities more manageable. The therapist may teach speech and language skills and may include exercises to improve comprehension, speaking, reading and writing. It may also help restore the ability to swallow safely which is often impaired by a stroke. Then there is cognitive rehab that teaches strategies to compensate for problems with learning, memory, and awareness. Rehab usually takes time and hard work. patients sometimes get discouraged but rehab can make the crucial difference between regaining previous ability to function or remaining impaired. Some patients make little progress after a month of work, every day, with rehabilitation therapy. Then, they suddenly seem to make considerable progress. They should not give up. Stroke rehab really can make a difference. Finding and using the best physical therapy solutions often includes products like the TUTOR system. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have been developed to assist in exercising stroke affected limbs. 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. The 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 TUTORs are now part of the rehabilitation program of leading U.S. and European 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 offering tele-rehabilitation. The TUTORs are fully certified by the FDA and CE. See WWW.MEDITOUCH.CO.IL for more information.