HandTutor Shows Improvement in Cognitive Impairments

By Elaine Sanchez for the American Forces Press Service


SAN ANTONIO, Jan. 12, 2012 – A military study is aiming to aid troops with mild TBI. Experts at the San Antonio Military Medical Center here have launched a military study aimed at improving results for active and non active service members suffering from traumatic brain injury.

The Study of Cognitive Rehabilitation Effectiveness, aka the SCORE trial, is examining cognitive rehabilitation therapy’s value as a treatment for veterans with mild TBI.

The Defense and Veterans Affairs departments joined on this study to determine the best treatment for combat and non combat troops who are experiencing mild TBI symptoms — such as difficulties with attention, concentration, judgment and memory. according to Douglas B. Cooper, the study’s clinical neuropsychologist for the Traumatic Brain Injury Service.

The goal of the trial is to determine if cognitive rehabilitation therapy improves chronic mild TBI symptoms and, if so, which interventions work best.

Cognitive rehabilitation, Cooper explained, includes a variety of interventions that help the patient with brain injuries to reduce, manage or cope with cognitive deficits. It’s mostly used to treat patients with brain injuries, whether they are from concussions, penetrating brain injuries or strokes.

Cooper said his team will look at each treatment to see which interventions have proven most successful and for whom.

The HANDTUTOR system implements an impairment based rehabilitation program with augmented feedback and encourages motor learning. Improvement in motor and cognitive impairments combined with traduitional functional exercise speeds up functional recovery.

The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation and physical and occupational therapy. These innovative devices implement an impairment based exercise program with augmented feedback and encourage motor learning through intensive active exercises. Manual therapy is the provision of exercise practice by an occupational and physical therapist. As the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR allow the PT and OT to customize the exercises, the patient is given motivating tasks through computer games with biofeedback that give them the correct dose of manual therapy. This means that the TBI, Parkinson’s, stroke or CP patient is given exercises that are challenging and motivating and allow for repetitive training tailored to the patient’s performance.

Even patients with severe movement dysfunction can benefit from intensive exercise practice as the TUTOR system picks up even small angles of joint movement. The TUTOR system also allows the OT and PT to make objective reports and evaluations on the patient’s movement ability so his progress can be maintained and shown to both himself and his family. This is also a strong motivation to carry on training and improve movement and functional everyday living ability. The HANDTUTOR and ARMTUTOR are a major part of the rehabilitation program of leading U.S. and foreign hospitals. The TUTORS are also used in clinics and at home care supported by telerehabilitation. See WWW.HANDTUTOR.COM for more information.

New Indian Tribe Clinic and the Tutor System

Dr. Heechin Chae, chief of the Traumatic Brain Injury Department at Fort Belvoir Community Hospital in Virginia has been chosen to establish a traumatic brain injury (TBI) clinic with The Pocasset Pokanoket Tribe.
Dr. Chae has had some successful outcomes as medical director at Spaulding Rehabilitation Hospital in Boston, Massachusetts since 2008. Dr. Chae often treats caregivers and families of soldiers, veterans, as well as athletes.
Beginning in southeastern Massachusetts, the Pocassets intend to open post acute rehabilitation therapy clinics for TBI patients,with new and innovative interdisciplinary low tech, high touch, high repetition approaches to rehabilitation. The clinics will care for 100 patients and be located near and around major population centers.
It has been suggested that Dr. Chae include the newly developed TUTOR system into the list of therapeutic tools used in the treatment programs.
Occupational and physical therapists use the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR – -known as the TUTOR system as a manual therapy tool to help them with their rehabilitative work.
The TUTOR system has shown much success in rehabilitation of joint movement. The newly developed TUTORS consist of ergonomic wearable devices. The HANDTUTOR is a glove for hand therapy and the ARMTUTOR is an arm brace for elbow and shoulder rehabilitation. The LEGTUTOR is a leg brace for leg and hip treatment. The system is indicated for patients who have suffered TBI, a stroke, SCI, CP, MS, Parkinson’s disease and other mobility restraining illnesses. It is used by occupational therapists and physiotherapists in rehabilitation centers, private clinics and the home where it can be supported by telerehabilitation. It is designed for those who have head, trunk, upper and lower extremity movement dysfunction.
The accompanying software system consists of motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises. The dedicated rehabilitation software allows the physical and occupational therapist to fully customize the exercises to the patient’s movement ability. In addition, the OT and PT can make objective follow up and reports on their patient’s progress. Rehabilitation aims to optimize 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 TUTORS are certified by the FDAand CE. See WWW.HANDTUTOR.COM for more information.

Tutors Contribute to Quality of Life Improvement for Parkinson’s Patients

Matilde Leonardi of the Neurology, Public Health, and Disability Unit, Scientific Directorate. Neurological Institute “Carlo Besta” IRCCS Foundation. Milan, Italy, et al, conducted a study to determine the degree of quality of life issues faced by patients who suffer from Parkinson’s disease published online September 1, 2011. .
Patients with Parkinson’s disease who suffer from a variety of motor and nonmotor symptoms reported reduced quality of life and increased disability. The aims of the study were to assess the impact of Parkinson’s disease on disability and quality of life and to evaluate them.
The 96 person study used the World Health Organization Disability Assessment Schedule.
Parkinson’s disease is strongly associated with reduced quality of life, increased disability and NMS prevalence.
The TUTOR system has been in the forefront of physical rehabilitation tools for Parkinson’s disease patient recovery.
The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation and physical and occupational therapy. These innovative devices implement an impairment based exercise program with augmented feedback and encourage motor learning through intensive active exercises. Manual therapy is the provision of exercise practice by an occupational and physical therapist. As the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR allow the PT and OT to customize the exercises, the patient is given motivating tasks through computer games with biofeedback that give him the correct dose of manual therapy. This means that the Parkinson’s, stroke, CP or TBI patient is given exercises that are challenging and motivating and allow for repetitive training tailored to the patient’s performance.
Even patients with severe movement dysfunction can benefit from intensive exercise practice as the TUTOR system picks up even small angles of joint movement. The TUTOR system also allows the OT and PT to make objective reports and evaluations on the patient’s movement ability so his progress can be maintained and shown to both himself and his family. This is also a strong motivation to carry on training and improve movement and functional everyday living ability and thereby improved quality of life.
The HANDTUTOR and ARMTUTOR are a major part of the rehabilitation program of leading U.S. and foreign hospitals. The TUTORS are also used in clinics and at home care supported by telerehabilitation. See WWW.HANDTUTOR.COM for more information.

Tutors Effective Tool for TBI Rehabilitation.

A leading cause of death and disability among persons in the United States is Traumatic Brain Injury (TBI). Yearly, an estimated one and a half million Americans sustain a TBI. 50,000 people die, 230,000 people are hospitalized and survive, and approximately 80,000-90,000 people experience the onset of long-term disability resulting from these injuries.
In patient hospitalization rates have declined since more improvements are made in treatment and the patients can be treated in outpatient units instead. The large amount of TBI in the United States requires public health measures to prevent these injuries and to improve their consequences. Surveillance systems run by the state can provide reliable data on injury causes and risk factors, identify trends in TBI incidence, enable the development of cause-specific prevention strategies focused on populations with the greatest risk, and monitor how effective these programs are. State follow-up registries, built on surveillance systems, can provide more information regarding the frequency and nature of disabilities associated with TBI. This information can help states and communities design, implement, and evaluate cost-effective programs for people living with TBI and for their families, addressing acute care, rehabilitation, and vocational, community support and school .
During the physical rehabilitation process the TUTORS (HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR) play an important role for TBI patients.
The newly developed HANDTUTOR, for example, have become a key system in neuromuscular rehabilitation for TBI and stroke victims and those recovering from spinal cord 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. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR consist of wearable glove and braces that detect limb movements showing the patient how much active or assisted active movement they are actually accomplishing. The rehabilitation software uses special rehabilitation games to set a new target 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 this new objective. In this way the patient is given feedback that allows the patient to understand which effort is more successful in allowing them to move their affected limb again. Subsequently 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 of leading U.S. German, Italian, French, UK and other foreign hospitals. See WWW.HANDTUTOR.COM for more information.

The Tutor System and Traumatic Brain Injury

According to the Brain Injury Association of America 1.7 million people suffer a TBI each year in the U.S. Of these,between 75% and 90% are categorized as Mild Traumatic Brain Injury (MTBI).
• MTBIs cost the nation nearly $17 billion each year.
• Research indicates that up to 15% of patients diagnosed
with MTBI may have persistent, disabling problems.
The TUTOR System has been in the forefront of rehabilitation for Brain Injury patients.
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.
The newly developed HANDTUTOR and its sister devices have become a key system in neuromuscular rehabilitation and physical therapy for brain injury patients. 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 and sensory and cognitive movement ability. Customized, 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 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. Telerehabilitation features allow the HANDTUTOR, LEGTUTOR, ARMTUTOR and the 3DTUTOR to be supported by the physical rehabilitation team when the patient 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.
See WWW.HANDTUTOR.COM for more information.

HandTutor Important Tool in Physiotherapy by Telerehabilitation

Fereshteh Ghasemi of Payame Noor University,Tehran, Iran discusses the topic of
Telerehabilitation or E-rehabilitation. It is the delivery of rehabilitation services over telecom
networks. According to the World Health Organization (WHO), there are about 650 million people with
disabilities worldwide; these statistics drive the need for a more applicable Telehealthcare Systems. This
research aims to provide a design description of a novel multilateral telerehabilitation system for patients with
diminished hand function that need minimum interaction between patient and therapist. The proposed
configuration consists of the Central Intelligent System (CIS) including multi-function modules in a
homepage for patients in a physiotherapy office, and a Hand Rehabilitation System including a Robot, Motion
Analysis Module or the HANDTUTOR in the patient’s home. This system works with a
diagnostic feedback from a Hand Rehabilitation System to the Central Intelligent System (CIS). The patient affixes
sensors on his hand and proceeds with daily activity. Data transmitted by WSN will be analyzed by the Motion
Analysis Module in order to diagnose the latest degree of recovery. Information is fed back automatically
to the CIS through the network. An appropriate program corresponding to the information will be
prepared by CIS and transmitted into the robot. After doing exercises by the system, joint angles are measured
and sent to the CIS again to diagnose the level of patient recovery. Cost of care using this configuration is
reduced significantly.
In the case of the HANDTUTOR no robots are used because they inhibit the patient from using his own power to develop normal mobility. The telerehabilitation system allows a live OT or PT to monitor the therapy sessions via the HANDTUTOR system as the patient maneuvers through the dedicated software on his computer.
The HANDTUTOR and its sister devices ( ARMTUTOR, LEGTUTOR and 3DTUTOR) have been developed to teach children and adults how to reuse their joints after hand and wrist injuries such as trauma or stroke, brain and spinal cord injuries, CP, MS, Complex Regional Pain Syndrome and a host of other serious debilitating diseases that affect hand, wrist and arm movement ability. These can be treated with the HANDTUTOR and the ARMTUTOR. The unique and successful devices use a dedicated software that utilizes games to enhance and improve the patient’s functional movement ability by motivating the patient to do intensive movement practice which is the key element in an occupational and physical therapist’s treatment of movement impairments. The games, such as, Car Race, Snowball, Catch The Ball, Sky Defender and others captivate and motivate the child and even the adult to excel and thereby to improve their range of motion and general use of the hand or wrist. The TUTORS use tele rehabilitation for those patients that are home bound or who have recovered sufficiently to get their treatment at home. Leading U.S. and foreign hospitals and outpatient clinics now use the devices which can treat adults as well. See WWW.HANDTUTOR.COM for more information.

Juvenile CIMT Intervention is Complemented by the ArmTutor in Rehabilitation

Children with unilateral cerebral palsy (CP) often demonstrate limited reach, grasp, and manipulation in the involved upper extremity. These limitations affect their functional activities, including social play, object play, educational activities and self-care. Most children with unilateral CP learn to perform tasks primarily using their noninvolved arm with minimal to almost no use of the involved arm.
Constraint-induced movement therapy (CIMT) is a short-term, intensive intervention that involves constraint of the noninvolved arm and intensive movement practice of the involved arm. Developed in the 1980s it has been successfully used with adults and children. Most protocols for pediatrics consider the child’s age and interests, are specifically adapted to the child’s leve and type of impairment, and usually include an educational component for caregivers to maintain practice of newly gained skills.
After numerous trials depending on age, schedules and other factors the results of a comprehensive study found that pediatric CIMT is a useful intervention producing clinically significant improvements in upper-extremity function of young children with unilateral CP.
When the child is at least 4 years old the ARMTUTOR is an important device used in C.I.M.T. rehabilitation therapy for children with CP caused upper extremity limitations.
The newly developed ARMTUTOR can play an integral part in the C.I.M.T. process. The ARMTUTOR provides the physiotherapist and occupational therapist the ability to customize manual therapy for the arm, shoulder, elbow and wrist. Together with its sister devices (HANDTUTOR,LEGTUTOR, 3DTUTOR) it has been developed to allow for functional rehabilitation of the upper extremity. The ARMTUITOR system consists of an ergonomic wearable arm brace and dedicated rehabilitation software. The ARMTUTOR system allows for the occupational and physical therapists to implement biomechanical evaluations which include speed, passive/active range of motion and motion analysis of the upper extremity. This, to best customize the shoulder and elbow exercises provided by the ARMTUTOR. In addition, quantitative biomechanical data allows for objective evaluation and rehabilitation treatment follow up by the occupational and physical therapist. The ARMTUTOR rehabilitation concept is based on performing controlled and motivating exercise rehabilitation practice at a patient customized level with real time accurate feedback on the patient’s performance. The exercises are designed in the form of challenging games that are suitable for a wide variety of orthopedic injury and disease.The games, which children love, challenge the patient to perform the exercise task to their best ability.
The ARMTUTOR provides detailed exercise performance instructions and precise feedback on the patients performance. This encourages motivation. 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.
The ARMTUTOR system is being used by many leading rehabilitation centers worldwide and has full FDA and CE certification. See WWW.HANDTUTOR.COM