LegTutor Shows Success in Post Knee Surgery Therapy

Dr.Giles R. Scuderi, in an online publication, August 2011, reported that between May 2001 and June 2004, 388 total knee arthroplasty cases were enrolled in a prospective, randomized, multicenter investigational device exemption trial. Patients received either the investigational high-flexion mobile-bearing knee or a fixed-bearing control. At 2 to 4 years of follow-up, results in 293 patients with degenerative joint disease were compared using Knee Society Assessment and Function scores, radiographic results, complications analysis, and survival estimates. The mobile-bearing and fixed-bearing groups demonstrated similar, significant improvement over preoperative assessments in Knee Scores, maximum flexion, and range of motion. One mobile-bearing arthroplasty required revision. Radiographic results were unremarkable, and implant-related complications were rare in both groups. At this early follow-up, the investigational high-flexion mobile-bearing knee and its fixed-bearing counterpart demonstrated comparable, effective performance.
Post knee surgery physical therapy received a major boost with the advent of the LegTutor. This is a new device that improves fine motor, sensory and cognitive impairments through intensive active exercises with augmented feedback. The repetitive training is tailored to patient performance and allows the therapist to customize the most suitable rehabilitation program to the patient’s ability. The LegTutor together with its sisters the HandTutor, ArmTutor and 3DTutor are currently in use in major U.S. and foreign hospitals. Used in private clinics and even at home with tele rehabilitation the Tutors are successful for children as well as adults.

Newly developed Tutor system uses telerehabilitation

As published in J Telemed Telecare. 2011 Aug 15, 2011 Drs. D. Hailey and R. Roine et al of the School of Information Systems and Technology, University of Wollongong, Australia.
systematically reviewed the evidence on the effectiveness of telerehabilitation (TR) applications. The review included reports on rehabilitation for any disability, other than mental health conditions, and drug or alcohol addiction. All forms of telecommunications technology for TR and all types of study design were considered. Study quality was assessed using an approach that considered both study performance and study design. Judgements were made on whether each TR application had been successful, whether reported outcomes were clinically significant, and whether further data were needed to establish the application as suitable for routine use. Sixty-one scientifically credible studies that reported patient outcomes or administrative changes were identified through computerized literature searches on five databases. Twelve clinical categories were covered by the studies. Those dealing with cardiac or neurological rehabilitation were the most numerous. Thirty-one of the studies (51%) were of high or good quality. Study results showed that 71% of the TR applications were successful, 18% were unsuccessful and for 11% the status was unclear. The reported outcomes for 51% of the applications appeared to be clinically significant. Poorer-quality studies tended to have worse outcomes than those from high- or good-quality studies. We judged that further study was required for 62% of the TR applications and desirable for 23%. TR shows promise in many fields, but compelling evidence of benefit and of impact onroutine rehabilitation programmes is still limited. There is a need for more detailed, better-quality studies and for studies on the use of TR in routine care.
The HandTutor, ArmTutor, LegTutor and 3DTutor improve movement of the hand, wrist, elbow, knee, ankle, foot and other joints of the body following traumatic injuries. The devices have been effective for post stroke victims as well as for those suffering from Cerebral Palsy, spinal cord and brain injuries, Apraxia, MS, Parkinsons and other movement disabilities. The Tutors provide Intensive active exercises that reduce the rate of deterioration. The Tutors implement a rehabilitation program with augmented feedback that allows the therapist to evaluate and record the patient’s motor and cognitive impairments. Already being used in leading U.S. and foreign hospitals and clinics the system is available for children and adults and can be implemented using telerehabilitation.

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Dr. Kiyohisa Ogawa writing in the Journal of Trauma-Injury Infection & Critical Care, 17 August 2011 explains that the majority of type I coracoid fractures set out in Ogawa’s classification constitute double disruption of the superior shoulder suspensory complex (SSSC) as proposed by Goss, frequently resulting in healing delay and adverse functional consequences. However, there are few reports alluding to strategies or concrete treatment methods of such injuries. The purpose of this report is to introduce our surgical strategy for treating the type I coracoid fracture with concurrent injuries and to describe our treatment method with their outcomes.
The methods used: Thirty-six patients, who had acute type I coracoid fractures surgically treated and were followed up for 1 year or longer, constituted the present study population. Reduction and stabilization were undertaken beginning with the most medial unstable injury of SSSC and proceeding to the lateral ones. The respective coracoid fractures were finally reduced and fixed. In the follow-up, patients were directly examined and evaluated using the ratios of the Constant score for the injured side to that for the normal side.
The results were: There were a total of 80 ipsilateral injuries of SSSC, including the coracoid fractures, and double disruption accounted for 94% of the patients. Of these, 62 injuries were surgically treated. No complications associated with surgery were observed. Bone union was achieved in all fractures; no patients required an additional operation. The Constant score ratio at the follow-up was 93% +/- 7.4% on average.
The conclusionwas : Although the majority of cases with type I coracoid fractures suffered double disruptions of SSSC, satisfactory results have been obtained with surgical treatment focusing on the assured reconstruction of a firm scapuloclavicular union.
Following shoulder surgery as well as other traumas the ArmTutor has proven to be a success in improving fine motor, sensory and cognitive impairments through intensive active exercises. Repetitive training tailored to the patient’s performance includes augmented feedback leading to enhanced functional rehabilitation. The ArmTutor and its sister devices the HandTutor, LegTutor and 3DTutor are being used in leading U.S. and foreign hospitals and clinics. The system is adaptable to both children and adults and allows for tele rehabilitation for patients at home.

HandTutor Successful in Post Surgery Therapy

Dr. J.Singh et al. writing in
Indian Journal of Orthopaedics, 08/23/2011http://upload.wikimedia.org/wikipedia/commons/6/63/2006_Italy_voting_hand.jpg
states that conservative treatment is an inexpensive method, particularly suitable for stable fractures, and in patients who are poor candidates for surgery. Surgical modalities have a distinct advantage of stable fixation, but with added risk of digital stiffness. Percutaneous pinning is a reliable, most commonly used surgical modality and technically easier. Both conservative and surgical modalities have good efficacy when used judiciously. When indicated for physical therapy following surgery the HandTutor together with its sisters ArmTutor, LegTutor and 3dTutor have proven successful in rehabilitating finger and wrist mobility. The new devices use dedicated software and can record the patient’s motor and cognitive impairments which the therapist can then assist the patient in improving the range of motion, the accuracy and speed of movement as well as the cognitive function of the affected joint. The HandTutor comes in varying sizes and thus is suitable for children as well as adults. Hospitals, clinics and, with tele rehabilitation, the patient’s own home are the settings for this innovative system.

ArmTutor Assists in Enhanced Rehabilitation following Arthrodesis Surgery

In a study of Poliomyelitis in children which can cause paralysis of shoulder girdle muscles leading to a flail shoulder, Joshua D. Miller, MD et al, in the Journal of Pediatric Orthopaedics:, September 2011 - Volume 31 - Issue 6 - p 679–682, stated that shoulder arthrodesis is indicated as a possible treatment for these children in order to stabilize the shoulder. This retrospective study reviewed all shoulder arthrodesis surgeries owing to complications of polio performed at a major medical institution between 1981 and 1996 to assess position of fusion, radiographic evidence of fusion, complications, and patient satisfaction., Methods: A review of medical records identified 11 patients undergoing 13 shoulder arthrodesis procedures, with a mean age of 14.7 years at the time of the procedure. Internal fixation was achieved with large cancellous screws in 8 patients and a Dynamic Compression Plate (DCP) plate in 5 procedures. Average follow-up period was 41 months. Eight patients were placed into a spica cast and 5 used a sling postoperatively., The results showed that shoulder arthrodesis surgery in this cohort resulted in an average position of fusion with 42.3 degrees of abduction, 23.8 degrees of flexion, and 26.2 degrees of internal rotation. Twelve of the 13 procedures assessed for radiographic union demonstrated fusion. The most common complications were malrotation and nonunion. Of the 13 procedures, 2 underwent humeral osteotomies for malrotation, and 1 with 6.5 mm cancellous screws required revision with a DCP plate owing to nonunion. Six patients underwent hardware removal, 3 of which were specifically owing to complaints of painful hardware. At final follow-up, no patient reported pain and all expressed satisfaction with their results and improved shoulder function after repair.His conclusion was that this study is the largest series of shoulder arthrodesis surgeries for treatment of patients with a flail shoulder from polio to date, providing a more thorough analysis of its efficacy as an indicated treatment., The ArmTutor together with its sister devices (HandTutor, LegTutor, 3DTutor) has proven very effective in improving range of motion of shoulders and elbows following surgery, disease or trauma. The innovative device is an electronic brace connected to a computer with dedicated software. It allows for repetitive exercises to the affected joint with augmented feedback. Currently used in leading U.S. and foreign hospitals the system can be administered by a physical therapist or the patient himself. It is available for children as well as adults and can be used together with tele rehabilitation.

ArmTutor Assists in Enhanced Rehabilitation Following Elbow Fractures

ArmTutor Assists in Enhanced Rehabilitation Following Elbow Fractures

Posted August 21, 2011 by handtutorblog in Hand Tutor. Tagged: armtutor, Elbow, joint rehabilitation, Physical therapy, Upper limb. Leave a Comment | Edit
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According to Dr. P. Harding at the Department of Physiotherapy, The Alfred Hospital in Melbourne, Australia and published in Cochrane Database Syst Rev. 2011 http://1.usa.gov/nes7Ge, there is a lack of robust evidence to inform on the timing of mobilization, and specifically on the use of early mobilization, after non-surgical or surgical treatment for adults with elbow fractures. There is a need for high quality, well-reported, adequately powered, randomized controlled trials that compare early versus delayed mobilization in people with commonly occurring elbow fractures, treated with or without surgery. Trials should use validated upper limb function scales, and assessment should be both short-term and long-term (at least one year). The ArmTutor has been developed to afford the patient intensive computer assisted training to regain full mobility of the elbow and limb. The sensor fitted device, one of several (HandTutor, LegTutor and 3DTutor) is placed on the arm and and connected to a computer with dedicated rehabilitation software that encourages intensive exercises to enhance a full range of mobility.

HandTutor proven successful for self management, joint protection and exercises in hand osteoarthritis

In the July issue of BMC Musculoskeletal Disorders http://www.ncbi.nlm.nih.gov/pubmed/21745357 Dr. Dziedzic and his group from Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, United Kingdom discuss their plan to assess self management, joint protection and exercises in hand osteoarthritis: a randomized controlled trial with cost effectiveness analyses.

The main analysis will be on an intention to treat basis and will assess the clinical and cost effectiveness of joint protection and hand exercises for managing hand osteoarthritis (OA). The findings will improve the cost–effective evidence based management of hand OA.

Methods

Participants aged 50 years and over registered at three general practices in North Staffordshire and Cheshire will be mailed a health survey questionnaire (estimated mailing sample n=9,500). Those fulfilling the eligibility criteria on the health survey questionnaire will be invited to attend a clinical assessment to assess for the presence of hand or thumb base OA using the ACR criteria. Eligible participants will be randomised to one of four groups: leaflet and advice; joint protection (looking after your joints); hand exercises; or joint protection and hand exercises combined (estimated n=252). Results The primary outcome measure will be the OARSI/OMERACT responder criteria combining hand pain and disability (measured using the AUSCAN) and global improvement, 6 months post–randomisation. Secondary outcomes will also be collected for example pain, functional limitation and quality of life. Outcomes will be collected at baseline and 3, 6 and 12 months post–randomisation. The main analysis will be on an intention to treat basis and will assess the clinical and cost effectiveness of joint protection and hand exercises for managing hand OA.

The HandTutor is an motion capture glove which together with dedicated rehabilitation software motivates patients to do intensive finger(s) and wrist exercises. It is important that patients suffering form joint degenerative diseases continue to do active exercises in order to reduce the rate of movement and musculoskeletal degeneration. The ArmTutor which allows for customized shoulder and elbow exercises and the LegTutor that allows for customized knee and hip exercises have also been proven to reduce the rate of joint movement degeneration in OA.

The HandTutor, ArmTutor, LegTutor and 3DTutor are used in many clinics in the USA and worldwide with patients are also using these devices in private outpatient clinics and the home environment. Home bound patients can use tele rehabilitation that is supported by physical and occupational therapists.