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.

HandTutor eHealth Telemedicine and Tele-Rehabilitation Report

A recent report published by the eHealth Telemedicine community ICT discusses applications in tele-rehabilitation. The report can be found at: http://bit.ly/eeuJgP

The report summarizes tele-rehabilitation as the delivery of rehabilitation services to distant locations, through the use of Information and Communications Technologies (ICT). The report states that the main drive for the introduction of tele-rehabilitation is the need to give specialized therapy to a geographically dispersed population in addition to the need to reduce costs while maintaining or increasing the quality of service. In addition patients that need physically rehabilitation will most probably have mobility issues that make transport to a specialized rehab centre difficult and expensive.

Tele-rehabilitation sessions are more flexible in terms of the timing and frequency of sessions and allow for more follow up on patient compliance and performance when compared to out patient clinic appointments. In addition rehabilitation programs done in the patients home environment have been proven to give better outcomes than equivalent rehabilitation programs conducted in the clinic environment. Up until recently tele-rehabilitation has had two main disadvantages namely, the lack of physical contact between physician and patient and lack of technologies tools that can quantitatively evaluate and treat the patient’s movement dysfunction.

The HandTutor system consists of a glove and software that uses motion feedback sensors to evaluate and treat the patients speed, range and accuracy of hand movements in real time. The dedicated rehabilitation software allows the patient and therapist to monitor and customize the exercise training in real time using readily available remote monitoring and audio and video internet tools to allow for inexpensive virtual physician contact. It is currently being used by patients with hand movement dysfunction in their home environment and is supported by therapists through tele-rehabilitation. http://bit.ly/f6i542

HandTutor system effective in upper extremity hemiparesis patients

In the February edition of Neurorehabilitation and Neural Repair http://bit.ly/grWa4B Dr. Whitall and his group from School of Medicine, University of Maryland, Baltimore, Maryland, USA, Baltimore Veterans Affairs Medical Center Geriatrics Research, Baltimore, Maryland, USA, Johns Hopkins University, Baltimore, Maryland, USA and University Hospital of Zurich, Zurich, Switzerland show that Bilateral arm training with rhythmic auditory cueing( BATRAC) is not superior to dose–matched therapeutic exercises (DMTE). However both rehabilitation programs durably improve motor function for individuals with chronic upper–extremity hemiparesis and with varied deficit severity.
The HandTutor system encourages upper extremity active exercise practice and has been proven effective in the treatment of chronic upper–extremity hemiparesis patients.