The following discussion was posted on January 15, 2012 for the Cerebral Palsy International Research Foundation.
Constraint-induced movement therapy (CIMT), has been used in the adult stroke population for years but recently, this type of therapy has come to the attention of therapists who work with children who suffer from hemiplegia (weakness on one side of the body because of an injury to the brain)., CIMT focuses on regaining movement on the affected side of the body by restraining the non-affected arm, thereby forcing the child to learn to move the affected arm more effectively and efficiently.
There is increasing evidence that this therapy may result in positive structural changes in the brain, which prompted Brady and Garcia (Dev Disabil Res Rev 2009), to comment that CIMT is an example of an emerging shift in rehabilitation of CNS injury, from an emphasis on compensatory skills to a hope for partial restoration. Research reports have generally shown a favorable response to CIMT, although questions remain about what is the critical level of intensity of therapy necessary for a positive effect i.e. how much or how many repetitions and how frequently? Just like with any new therapy, another important question is whether it is better to what is already available and being used, perhaps at less expense.The Tutors are one of the most cost effective physical rehabilitation systems.
A recent article by Wallen and colleagues where they compared a modified form of CIMT with intensive occupational therapy on normal daily activities and upper limb outcomes in children with hemiplegic CP concluded that modified constraint-induced therapy is no more effective than intensive occupational therapy.(Dev Med Child Neurol 2011).
Whether Wallen or the study by Brady and Garcia is correct the TUTOR system (HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR) is in the forefront of physical rehabilitation for children from the age of 4 or 5 receiving their therapy and is an adjoin to both traditional occupational therapy and CIMT. The HANDTUTOR and its sister devices have been developed to teach children how to reuse their joints after hand and wrist injuries such as trauma or after hand surgery e.g. tendon transfer. In addition stroke, brain and spinal cord injuries, CP, MS, Complex Regional Pain Syndrome and a host of other serious debilitating diseases that affect hand and wrist and arm movement ability 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. It does this 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 to excel and thereby to improve their range of motion and general use of the hand or wrist.
The TUTORS also 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.