How the Tutor System helps Elderly Stroke Victims

A study of rehabilitation outcomes for elderly stroke patients was conducted by Samantha G. M. Yap, MBBS, MRCP, FAMS and Karen S. G. Chua, MBBS, MRCP, FRCP (Edin), FAMS.
The objective of the study was to identify and characterize injury variables as well as outcomes in persons with traumatic brain injury (TBI) who are 55 years and older and admitted to a rehabilitation unit. Fifty two individuals over a 4-year period were included in the study. It was discovered that the most common reason for injury was falls (61.5%).
The conclusions showed that most patients in this group had severe brain injury, which may have been due to a higher incidence of intracerebral hematoma. It also showed that older patients with TBI do benefit from physical rehabilitation with significant functional gains and a high rate of return to home and to community.
The Tutor system is the medical device of choice in stroke rehabilitation for the elderly as well as similar patients of younger ages. Consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR these devices have been developed to teach children and adults how to reuse their affected 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.
The unique and successful devices use a dedicated software that utilize 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 motivate the patient 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.

Post Stroke Physical Therapy Includes Tutor System

Until just recently, scientists usually thought that when a section of the brain was damaged, its function was lost forever. If stroke patients couldn’t use a weak or paralyzed arm they were taught to dress and bathe with their good arm. But now, sophisticated imaging tests of the brain have revealed that when nerve cells die, their functions are taken over by other cells.
This concept is known as neuroplasticity and has altered stroke rehabilitation considerably. “Now, we know that if you want to get motor recovery on the affected side, you have to use the affected side intensively and repetitively,” says Richard Zorowitz, MD, chief of physical medicine and rehabilitation of Johns Hopkins Bayview Medical Center in Baltimore. “By doing that it stimulates the brain to make new connections.”
Neuroplasticity is the principle behind new techniques such as mirror therapy as well as several other new technologies. They include electrical stimulation of the damaged limbs and robots that help patients repeatedly move those limbs.
Additionally and at a more cost effective price the TUTOR system (HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR) has shown to be very successful in returning normal limb function to stroke victims.
The newly developed devices have become a key system in neuromuscular rehabilitation for stroke victims and those recovering from brain and spinal 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 movement showing the patient how much active or assisted active movement they are actually doing.
The rehabilitation software uses special rehabilitation games to set a new target for this movement in terms of the patients ability to move their limb. The devices then measure the limb movement and give feedback on the success of the patient in trying to gain this new movement objective. In this way the patient is given movement feedback that allows the patient to understand which effort is more successful in allowing them to move their affected limb again. 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.

Bobath or CIMT Therapies, Both Enhanced By the Tutor System

Burcu Ersoz Huseyinsinoglu and Yakup Krespi of the Stroke Unit, Florence Nightingale Hospital, Istanbul, Turkey and Arzu Razak Ozdincler of the Istanbul University School of Physical Therapy and Rehabilitation, Istanbul, Turkey conducted a study involving a comparison between the Bobath concept and the constraint-induced movement (CIMT) therapy concept for rehabilitating stroke patients.
Their objective was to compare the effects of therapies on arm functional recovery among stroke patients with a high level of function on the affected side.
A total of 24 patients were used. The Bobath group was treated for 1 hour whereas the CIMT group received training for 3 hours per day during 10 consecutive weekdays.
The conclusions they drew from the study were that there was no basic difference between the two methods as far as improving functional ability, speed and quality of movement in the paretic arm among stroke patients with a high level of function. Constraint-induced movement therapy seemed to be a bit more efficient than the Bobath Concept in general.
When it comes to these methods the tool of choice is the HAND and ARM TUTOR.
The ARMTUTOR™ and HANDTUTOR devices have been developed to allow for functional rehabilitation of the upper extremity including the shoulder, elbow and wrist. The system consists of an ergonomic wearable glove and arm brace together with dedicated rehabilitation software. The ARMTUTOR™ and HANDTUTOR allow the physical and occupational therapists to report on and evaluate the patient’s functional rehabilitation progress. This allows the OT and PT to prescribe the right customized and motivating intensive exercise practice which is the cornerstone to manual rehabilitation therapy. Intensive repetition of movement is achieved through challenging games set to the patient’s movement ability. The system provides detailed exercise performance instructions and precise feedback on the patient’s exercise performance. 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.
Tele rehabilitation allows the recovering patient to continue his physical therapy at home. All the TUTOR devices are FDA and CE certified. See WWW.HANDTUTOR.COM for more information.

Tutor System Emulates Famous Theory

Developed in the late 80s and early 90s, Winfried Hacker and his associates created a theory that today is applied in industry and science involving human action.
Hacker’s Action theory defines a task-oriented view of human behaviors. The main purpose is to describe how a person completes a task. There are certain repeated patterns during completion of each task.
There are also 3 levels of patterns throughout the completion of a task:
i) Motive-activity
ii) Goal-action
iii) Instrumental conditions-operations.
In this approach, accomplishment of a top-level activity depends on accomplishment of lower level actions followed by operations. Motives are inspirations causing a set of goals, and actions for these goals consist of various operations. Operations can be directly and subjectively observed and recorded.
The newly developed TUTOR system for use in physical rehabilitation following stroke, brain/spinal cord injury, Cerebral Palsy, Multiple Sclerosis and a host of other upper and lower limb disabilities apparently uses the Hacker Action Theory throughout its operation. The TUTORs, consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are wearable braces or gloves that connect to dedicated software designed to encourage self movement (not robotic) by the patients. The customized software consists of a series of games that the patient has to attempt to complete–”Instrumental Conditions Operations” (iii as above).
Each game has a specific goal that allows the patient to accomplish further movement of his affected limb–”Goal Action” (ii as above).
The motivation for all these actions is to get the patient to recover his normal movement ability or as close to it as possible following the disabling event–”Motive Activity” (1 as above).
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. This 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 HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. and foreign hospitals and are being used in clinics and in the patient’s home through the use of tele-rehabilitation. See WWW.HANDTUTOR.COM
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program of leading U.S. and foreign hospitals and are being used in clinics and in the patient’s home through the use of tele-rehabilitation. See WWW.HANDTUTOR.COM

Newest Rehab Centers Need to Include Tutor System

Philip Lim, writing for GMAONLINE on February 4, 2012 reports about the progress achieved in stroke rehabilitation.
A Singaporean retiree Soon Eng Sam, 70, suffered a stroke that paralysed the left side of his body.
He was bedridden for three months and had regained some limb functions on the affected side with conventional physical therapy. He now hopes to hasten his recovery with the help of new devices designed to make rehabilitation fun.
Soon is one of the lucky patients to use the Centre for Advanced Rehabilitation Therapeutics (CART) which is described as one of the most advanced facilities of its kind in Asia.
There is a race against time as more and more people are approaching the ”golden age” making a center like this more and more important.
It is estimated that in about 20 years twenty percent of the population will be 65 or older. Now it is only 9.3 percent of the population.
Chan Kay Fei, head of Rehabilitation Medicine at the government-run Tan Tock Seng Hospital feels that technology will be more and more vital and therapists will not be able to meet all the needs of the aging population.
Enter–new medical devices.
One of the most innovative systems to be developed in recent times is the TUTOR system.
Rehabilitation using the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR is included in the USA at major rehabiliaiton in-patient and out-patient clinics as well as at private physical therapy clinics. Many patients including those suffering from a stroke or cerebral palsy as well as those who have had a TBI or Spinal cord injury can also avail themselves of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR through the use of tele rehabilitation in addition to clinics and hospitals. These devices have been developed to allow for functional rehabilitation of the whole body including the upper and lower extremity. The system consists of ergonomic wearable devices and dedicated rehabilitation software that provide patient instructions and feedback to encourage intensive massed controlled exercise practice. In this way, the Tutor system allows for controlled exercise of multijoints within the normal movement pattern which prevents the development of undesired and compensatory joint movement and therefore ensures better performance of functional tasks. This is important in the rehabilitation process for stroke, brain, spinal cord (SCI) and Cerebral Palsy in addition to other neurological and orthopedic injury and disease. Additional features of theTUTOR system include quantitative evaluation and objective follow up that is important in the physiotherapists treatment of the stroke patient.
The TUTORS are FDA and CE certified and are available for children as well as adults. See WWW.HANDTUTOR.COM for further information.

Telerehabilitation-an Important Tool in Post Stroke Physiotherapy

Telerehabilitation allows the rehabilitative process to continue remotely after being discharged from acute care. It can include complex tasks known to create rich conditions for neural charge. Researchers based in Minnesota performed a study to explore the feasibility of telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke. They also wanted to compare complex versus simple movements in the ankle to promote brain reorganization and behavioral change Their results are published in ”Physical Therapy”, February 2012.
Author Huiqiong Deng, MD, MS, from the University of Minnesota, Minneapolis, and his team conducted the pilot randomized controlled trial that included training done in the participant’s home. Testing was done in different research labs involving multi-camera gait analysis and functional magnetic resonance imaging (fMRI).
In the study there were 16 participants with chronic stroke and impaired ankle dorsiflexion who were randomly assigned to receive 4 weeks of telerehabilitation of the paretic ankle. Participants received either computerized complex movement training (track group) or simple movement training (move group). Behavioral changes were measured with the 10-m walk test and gait analysis using a motion capture system. Brain reorganization was measured with ankle tracking during fMRI.
The results showed that dorsiflexion during gait was significantly larger in the track group compared to the move group. Although the volume, percent volume, and intensity of cortical activation failed to show significant changes during the fMRI, the frequency count of the number of participants showing an increase versus a decrease in these values and from pretest to posttest, measurement was significantly differentin the two test groups. The track group decreased and the move group increased.
The researchers conclusion was that the results suggested that telerehabilitation that emphasizes complex task training with the paretic limb, is workable and can be effective in promoting further dorsiflexion in people that have chronic stroke.
Telerehabilitation has been one of the features and advantages of the TUTOR system. While recovering stroke patients will begin their physiotherapy in a hospital or clinic setting the TUTOR system has been designed to allow continuation of the therapy at home. The advantage is also available for those patients who live a distance from a PT clinic or are otherwise homebound.
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. 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 FDA and CE See WWW.HANDTUTOR.COM for more information.

Tutor System Knows No Discrimination

A study by Susan D. Horn, PhD etal written for the ”Archives of Physical Medicine and Rehabilitation” in November 2010 about black-white differences in patient characteristics, treatments and outcomes for inpatient stroke rehabilitation describes racial differences in patient characteristics, physical therapy (PT), nontherapy ancillaries, occupational therapy (OT), as well as functional outcomes at discharge in rehabilitation after stroke.
Dr. Horn used six inpatient rehabilitation facilities.There were black and white patients subdivided in case-mix subgroups for moderate strokes and severe strokes
The results identified significant black-white differences in multiple patient characteristics and intensity of rehabilitation care. White subjects took longer from the stroke itself until rehabilitation admission and were more ambulatory before the stroke. Black subjects usually had more diabetes. In patients who had a moderate stroke, black subjects were younger, were more likely female, and had more hypertension and obesity with body mass index. For patients that had severe stroke, black subjects were less sick and had higher admission FIM scores. White subjects received more time per day of OT, although black subjects had longer median PT and OT time in a session.
Dr. Horn’s conclusions were that reasons for differences in rehabilitation for black and white subjects should be investigated further to understand clinicians’ choice of treatments by race.
In a world of vast differences in population categories it is refreshing to know that even in physical rehabilitation everyone is entitled to the best of care. The TUTOR system (HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR) is one such set of medical devices that knows no bounds in achieving excellent results. Created for children as well as adults and for women and men and of all races the TUTOR system is one of the most affordable and successful devices to be used in physiotherapy and rehabilitation clinics.
The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation for stroke victims and those recovering from brain and spinal 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, 3DTUTOR consist of wearable glove and braces that detect limb movement showing the patient how much active or assisted active movement they are actually doing. The rehabilitation software uses special rehabilitation games to set a new target for this movement in terms of the patients ability to move their limbs. The devices then measure the limb movement and give feedback on the success of the patient in trying to gain this new movement objective. In this way the patient is given movement feedback that allows him to understand which effort is more successful in allowing them to move their affected limb again. The Tutor system provides exercises that are challenging and motivating and allows 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.