HandTutor used with mental practice to improve hand movement ability

Mental practice or movement imagination is a training method where the patient imagines a movement without actually moving the limb that has movement dysfunction. Recently researchers have proposed the use of mental practice to facilitate motor recovery in stroke patients and other patients with motor disorders. Mental practice is the imagined rehearsal of a movement with the specific intent of improving that movement and it is suggested that during mental practice the motor control structures in the brain are activated in more or less the same way as during the actual performance of movements. This mechanism of improving limb movement has been reinforced by neuroimaging studies taken during motor imagery and show that the same brain areas are active as during actual movement. In addition, studies with healthy individuals have shown that motor imagery and actual action share some striking similarities. When someone is asked to perform a movement, for example, “walk along this line”, and to imagine the same movement, the time to complete the actual walking movement is similar to the time needed for completing the imagined walking movement.

HandTutor system answers the 2009 American Heart Association (AHA) Policy Statement on stroke systems of care

In 2009 the American Heart Association issued a AHA Policy Statement that appears in Stroke magazine http://stroke.ahajournals.org/cgi/content/full/40/7/2635 discussing recommendations for the implementation of telemedicine within stroke systems of care. In regards to sub acute stroke treatment, the report states that many small hospitals do not have specialists with training and expertise to treat patients in medical sub specialties, including physical, occupational and speech therapy, and rehabilitation medicine.
Stroke rehabilitation involves coordinated interventions from a multidisciplinary team in order to achieve the best potential functional outcome. and should be provided by an appropriately trained and staffed that follows established practice guidelines. Impaired recovery outcomes has been noted in patients with geographically and or financially limited access to appropriate rehabilitation services. The report concludes that telemedicine for rehabilitation (telerehabilitation) may be a practical and valuable approach to delivering post stroke care when limited resources, manpower shortages, long distances, or limited patient mobility prevent or limit access to indicated rehabilitation therapies.
In a recent statement by Steven L. Wolf, PhD, professor of rehabilitation medicine at Emory University School of Medicine millions of Americans face challenges in accessing health care, with rural residents experiencing more limitations of activity caused by chronic conditions such as stroke than urban residents. Additionally, insurance carriers often do not cover lengthy rehabilitation programs for stroke survivors, causing many patients to lose the proven benefits of aggressive therapy following a stroke.
Prof Wolf also states that “A tremendous amount of research has led to advances in stroke therapy through the identification of the importance of task practice and intensity of therapy. However, we know that many patients, in particular those living in rural and under served areas, do not receive quality post-stroke rehabilitation.

The EU policy states all European stroke patients should have access to a continuum of care, including organized acute stroke units, appropriate rehabilitation, and secondary prevention measures and the 2006 World Health Organization Helsingborg Declaration on European Stroke Strategies declared that tele-rehabilitation is a vital element to achieving this goal.
The HandTutor system is being used for stroke and other brain and spinal cord injury, cerebral palsy, brachial plexus injury patients, with the patient undergoing intensive exercise practice at home with tele-monitoring from a remote location ensuring patient compliance and maximum motivation.

Community-based upper-extremity rehabilitation improves motor function and performance of functional activities in chronic stroke

In the Arch Physical Medical Rehabilitation http://1.usa.gov/hAQpOz Dr. Pang and his colleagues from School of Rehabilitation Sciences, University of British Columbia, Rehabilitation Research Laboratory, GF Strong Centre, Vancouver, BC, Canada assess the effects of a community-based exercise program on motor recovery and functional abilities of the paretic upper extremity in persons with chronic stroke. The patients underwent an exercise program designed to improve upper-extremity function (1h/session, 3 sessions/wk for 19wk). The group found that community-based exercise program can improve upper-extremity function in persons with chronic stroke.
The HandTutor and ArmTutor system is proven to improve upper extremity function in pateints with arm movement dysfunction in both rehabiliation clinic and the home.

In the March issue of Topics in Stroke Rehabilitation http://bit.ly/h03MW7 Dr. Gregory and his team from Department of Physical Medicine and Rehabilitation and the Department of Neurology, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina USA compare patient preferences for Stroke Rehabilitation. The group conclude that patients prefer the initial rehabilitation therapy setting to be at home. Providers should inquire about patient preference and provide information about treatment options to help inform decision making.
The group also state that early aggressive rehabilitation therapies maximize functional recovery.
The HandTutor, ArmTutor and LegTutor systems provide the patient with user friendly upper and lower extremity dedicated rehabilitation devices that allow for intensive exercise practice and maximize functional recovery both in acute, sub acute, outpatient and home care settings.

Home based computer-assisted upper limb exercise for young children with cerebral palsy

In the March edition of Journal of Rehabilitation Medicine http://bit.ly/fBCSi6 Dr. Weightman and his colleagues form the Academic Unit of Rehabilitation Medicine, University of leeds reported improvements in self-reported function and quality of arm movements observed following the use of a home based arm rehabiliaiton system. The system was used to augment home-based arm exercise in an engaging way for children with cerebral palsy.

The HandTutor and ArmTutor systems is used to give tele-rehabilitation worl wide to children with arm and hand movement impairments and to supplement tradition occupational and physical therapy.

The language system of the brain is functionally interwoven with perceptual and motor systems.

In the February edition of Nature Reviews Neurology http://bit.ly/iglaQ5 Dr Berthier Professor of Neurology and Director, Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Spain and Dr. Pulvermüller Programme Leader, Cognitive Neuroscience of Language, Medical Research Council Cognition and Brain Sciences Unit; Fellow, Wolfson College, Cambridge University, Cambridge, United Kingdom discuss neuroscience insights and therapy to improve neurorehabilitation of poststroke Aphasia.
They state that the treatment of aphasias—acquired language disorders—caused by stroke and other neurological conditions has benefitted from insights from neuroscience and neuropsychology. Massed practice and exploitation of residual neurological capacities can aid neurorehabilitation of patients with poststroke aphasia, and progress in basic neuroscience research indicates that the language system of the human brain is functionally interwoven with perceptual and motor systems. Intensive speech and language therapies, including constraint-induced aphasia therapy, that activate both the linguistic and concordant motor circuits utilize the knowledge gained from these advances in neuroscience research and can lead to surprisingly rapid improvements in language performance, even in patients with chronic aphasia.
The HandTutor, ArmTutor and LegTutor systems provide motivation to the patient to do repetitive virtual functional task practice or massed active exercise practice which is proven to improve sensory, motor and cognitive movement ability and aid in the function of active daily living tasks which increases patient independence post stroke.