In the December edition of stroke http://bit.ly/h21GuE Dr. Asplund from Riks-Stroke, Department of Medicine, University Hospital, Umeå, Sweden looks at Patient Dissatisfaction With Acute Stroke Care. The group highlight the potential for reducing patient dissatisfaction by structural measures, such as access to care in a stroke unit, patient involvement in discharge planning, and systematic follow-up after discharge.
However the strongest predictor of dissatisfaction with acute care was poor functional outcome. IF the patient is dependent on caregivers for daily living this leads to a depressed mood state and poor self-perceived health.
Our experiences with the HandTutor system in the community setting show that providing the patient with an ergonomic glove and easy to use rehabilitation software motivates both the patient and their caregiver to do intensive exercise practice. The home care therapy sessions can be supported by physical and occupational therapists offering tele-rehabilitation which again gives the patient the feeling that the patient and care giver are not alone and there is still progress to be made in their physical rehabilitation.
Thursday, 16 December 2010
Wednesday, 15 December 2010
Signs and symptoms to predict movement ability outcome
In the December edition of PM&R Dr. Ramasamya and his UK group from the Academic Department of Military Surgery and Trauma, Birmingham and colleagues from Royal National Orthopaedic Hospital, Stanmore, University Hospital, Middlesborough and Defence Medical Rehabilitation Centre discuss Peripheral nerve injury following combat extremity trauma—does plantar sensation return? The report can be found at http://bit.ly/hB7oHK.
They conclude that as 95% of salvaged limbs with a documented insensate foot at initial presentation showed a return of plantar sensation then initial plantar sensation is not prognostic of long-term plantar sensory status and should not be a component of a limb-salvage decision algorithm.
Therapists and doctors should focus on signs and symptoms rather than initial diagnosis as an outcome prediction. The HandTutor system can be used for all patients that have hand movement dysfunction regardless of diagnosis. The system focuses on the sign and symptoms which are the amount and quality of patient’s active movement ability. This information provides the therapist and patient with real time feedback on movement ability and improvement.
They conclude that as 95% of salvaged limbs with a documented insensate foot at initial presentation showed a return of plantar sensation then initial plantar sensation is not prognostic of long-term plantar sensory status and should not be a component of a limb-salvage decision algorithm.
Therapists and doctors should focus on signs and symptoms rather than initial diagnosis as an outcome prediction. The HandTutor system can be used for all patients that have hand movement dysfunction regardless of diagnosis. The system focuses on the sign and symptoms which are the amount and quality of patient’s active movement ability. This information provides the therapist and patient with real time feedback on movement ability and improvement.
Shortage of trained PT's projected
In the December edition of PM&R DR. Zimbelman and her team from Cleveland Medical Centre USA look at Physical Therapy Workforce in the United States: Forecasting Nationwide Shortages http://bit.ly/hTf5ax . The group reports that On the basis of current trends, demand for PT services will outpace the supply of PTs within the United States.
In regards to neuromuscular rehabilitation, industry has to further develop intense and engaging upper-extremity rehabilitation tools that motivate the patient to intensively practice therapy tasks with less dependence of the therapist. The increased use cost-effective systems that can be used by the patient alone or with caregiver support will reduce the demand on PT’s, the healthcare system and healthcare budget.
The HandTutor system is used by patients in the home care environment with quantitative exercise performance data being stored so that it can be reviewed by the therapist. In addition the therapist can take part in the patients treatment from a remote location by using readily available web based tools.
In regards to neuromuscular rehabilitation, industry has to further develop intense and engaging upper-extremity rehabilitation tools that motivate the patient to intensively practice therapy tasks with less dependence of the therapist. The increased use cost-effective systems that can be used by the patient alone or with caregiver support will reduce the demand on PT’s, the healthcare system and healthcare budget.
The HandTutor system is used by patients in the home care environment with quantitative exercise performance data being stored so that it can be reviewed by the therapist. In addition the therapist can take part in the patients treatment from a remote location by using readily available web based tools.
Tuesday, 14 December 2010
An informative open access article that discusses poor motor skill ability and ADHD found at: http://bit.ly/fyjpAk
The paper quotes references to support:
1. Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders, affecting approximately 3-9% of all school-aged children.
2. ADHD is characterized by a chronic developmentally inappropriate pattern of hyperactivity, inattention and impulsivity, which impairs academic performance, social interaction, and family function.
3. A high percentage of children with ADHD (30-50%) continuing to experience symptoms into adulthood.
4. Poor motor performance skills, are prevalent in children with ADHD, characterized by: excessive overflow movements, poor timing, force control, balance leading to poor ADL ability; e.g. tying shoes, poor handwriting, etc.
5. 50% of children with ADHD display motor coordination problems consistent with developmental coordination disorder (DCD).
6. The typical feature of DCD involves a marked impairment in the performance of motor skills that is not due to general intellectual, sensory, or motor neurological impairment. www.HandTutor.com
The paper quotes references to support:
1. Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders, affecting approximately 3-9% of all school-aged children.
2. ADHD is characterized by a chronic developmentally inappropriate pattern of hyperactivity, inattention and impulsivity, which impairs academic performance, social interaction, and family function.
3. A high percentage of children with ADHD (30-50%) continuing to experience symptoms into adulthood.
4. Poor motor performance skills, are prevalent in children with ADHD, characterized by: excessive overflow movements, poor timing, force control, balance leading to poor ADL ability; e.g. tying shoes, poor handwriting, etc.
5. 50% of children with ADHD display motor coordination problems consistent with developmental coordination disorder (DCD).
6. The typical feature of DCD involves a marked impairment in the performance of motor skills that is not due to general intellectual, sensory, or motor neurological impairment. www.HandTutor.com
Wednesday, 14 April 2010
Living life to the full around the world: 21st century treatment proves successful for adults living with cerebral palsy
The OT/ PT can use Neuromuscular stimulation and robot-assisted rehabiliation to improve finger/ wrist movement ability. Equally important is isolated and combined finger and wrist intensive exercises provided by the HandTutor in the form of customized rehabilitation games with biofeedback.
An important component in achieving optimal rehabilitation outcome is intensive active movement practice. Traditional Occupational and Physical therapy provides the patient task orientated training (TOT). TOT is intensive repetition of everyday functional tasks or Active daily living tasks. Intrinsic motor and sensory feedback from the result of the tasks will allow correction in the planning, initialization and performance of the task and assist in rehabilitation.
The MediTouch HandTutor is a rehabilitation glove and software which offers impairment oriented training and augmented feedback. The HandTutor provides repetitive customized isolated or inter joint coordinated finger and wrist hand exercises and rehabilitates fine movements of the hand and wrist. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and Orthopedic conditions.
Research with the HandTutor confirms that Task oriented training should be combined with Impairment oriented (IOT) training to achieve enhanced functional recovery. The HandTutor is used in hospitals and community hand therapy clinics as well as through tele rehabilitation. Examples of patients that are treated include Stroke, TBI, spinal cord injury CP, Orthopedic hand and arm surgery, development co-ordination disorders in children etc. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and orthopedic conditions.
An important component in achieving optimal rehabilitation outcome is intensive active movement practice. Traditional Occupational and Physical therapy provides the patient task orientated training (TOT). TOT is intensive repetition of everyday functional tasks or Active daily living tasks. Intrinsic motor and sensory feedback from the result of the tasks will allow correction in the planning, initialization and performance of the task and assist in rehabilitation.
The MediTouch HandTutor is a rehabilitation glove and software which offers impairment oriented training and augmented feedback. The HandTutor provides repetitive customized isolated or inter joint coordinated finger and wrist hand exercises and rehabilitates fine movements of the hand and wrist. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and Orthopedic conditions.
Research with the HandTutor confirms that Task oriented training should be combined with Impairment oriented (IOT) training to achieve enhanced functional recovery. The HandTutor is used in hospitals and community hand therapy clinics as well as through tele rehabilitation. Examples of patients that are treated include Stroke, TBI, spinal cord injury CP, Orthopedic hand and arm surgery, development co-ordination disorders in children etc. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and orthopedic conditions.
Sunday, 11 April 2010
Tuesday, 2 March 2010
Neuromuscular stimulation, robot-assisted rehabilitation task specific training and the HandTutor
The Occupational/ Physical therapist has in his hand therapy repertoire several techniques to maintain and improve the patient's finger and wrist movement ability including Neuromuscular stimulation and robot-assisted rehabilitation. Additionally an important component in achieving optimal rehabilitation outcome is intensive active movement practice together with task orientated training. It is widely accepted that a combination of impairment oriented training with task specific training is essential for enhancing functional recovery. The HandTutor is impairment oriented training and provides customized games and biofeedback to motivate and challenge the patient to do intensive active finger and wrist exercises and to achieve maximal functional recovery.
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