Pazit Levinger et al conducted a study published in Springer Link in October 2011.
Posts Tagged ‘CE’
John M. Grohol, Psy.D. reviewed the following information on October 13, 2011 for PSYCH CENTRAL
According to a government report, solid evidence is still lacking to show that that specific goal-oriented treatments are effective for traumatic brain injury, or TBI, however results are promising.
Statistics show that an estimated 1.7 million people in the United States sustain a traumatic brain injury or TBI and between 2000 to 2010, the number of military personnel with TBI nearly tripled from 11,000 to > 30,700.
Traumatic brain injury is caused from a bump or blow to the head or from external forces that result in the brain moving within the head examples include whiplash or exposure to blasts. The results caused include cognitive, physical, and/or psychosocial problems.
One of the treatments for TBI is cognitive rehabilitation therapy (CRT). CRT is a goal oriented approach that helps patients increase their ability to process and interpret information. CRT involves a variety of treatments provided by health professionals including occupational and physical therapists. When the TBI causes joint movement impairment the Tutor system consisting of the HandTutor, ArmTutor, LegTutor and 3DTutor has become invaluable.
Because TBI is considered the “signature wound” of modern conflict the U.S. Department of Defense has asked the Institute of Medicine (IOM) which is the health division of the National Academy of Sciences, to conduct research to determine the effectiveness of cognitive rehabilitation therapy for TBI treatment.
According to said Dr. Ira Shoulson – the head of the IOM committee that studied the problem and a neurologist at Georgetown University. The USA’s experience in Afghanistan and Iraq show that traumatic brain injury results in long-term challenges in physical as well as emotional rehabilitation and then reintegration to everyday life. Effective health care infrastructure and evidence-based treatment and rehabilitation policies needs to be implemented in order that we cope with TBI patients impairments.
The goal of cognitive rehabilitation therapy (CRT) is to help an individual who suffers from the physical and mental impairments caused by brain injury to improve his or her ability to move through daily life and recover or compensate for damaged cognitive or physical functions. A restorative approach will helps the patient reestablish cognitive function, while a compensatory approaches will help the individual adapt to an ongoing impairment.
When the disability is specifically physical the HandTutor, ArmTutor, LegTutor and 3DTutor have played an important role in interactive rehabilitation exercises.
The Tutor system including the HandTutor, ArmTutor, LegTutor and 3DTutor have become a key system in neuromuscular rehabilitation and physical therapy improving functional outcomes for upper and lower limb disabilities due to TBI. 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 and physical movement ability. The system also includes objective quantitative evaluations that provide the therapist information to customize the most suitable rehabilitation program to the patient’s ability. Currently part of the rehabilitation program of leading U.S. and foreign hospitals the Tutors are also used in clinics and at home through the use of tele rehabilitation (TR).
LYA WODRASKA writing in The Salt Lake Tribune on October 11, 2011 reports that any hope remaining that quarterback Jordan Wynn will return this year ended Monday when the Utah Utes announced Wynn, who injured his left shoulder in the Utes’ thirty one to fourteen loss to Washington, must have shoulder surgery to repair the damage.
This will be the second surgery in less than a year for the junior, who had surgery in December on his right shoulder.
Wynn finishes this year 66-for-116 for 727 yards and six touchdowns with two interceptions. We saw that Wynn struggled throwing long due to the lingering effects from the December surgery and he now faces another long recovery following the repair to his nonthrowing arm.
Jordan will have to do intensive rehabilitation to come back as he is eligible for a redshirt season.
The ArmTutor can assist Mr. Wynn in regaining full use of his shoulder.
The ArmTutor™ system has been developed to allow for functional rehabilitation of the upper extremity. The system consists of an ergonomic wearable arm brace and dedicated rehabilitation software. The ArmTutor™ rehabilitation concept is based on performing controlled exercise rehabilitation practice at a patient customized level with real time accurate feedback on the patient’s performance. So early in recovery from shoulder surgery the occupational and physical therapist will work on improving range of motion and accuracy and speed of movements as well as muscle strength. The exercises are designed in the form of challenging games that are suitable for a wide variety of neurological and orthopedic injury and disease.
The games challenge the patient to perform the exercise task to their best ability and to continue exercise practice.
The ArmTutor™ allows for isolated and a combination of elbow and three directional shoulder treatment. The system provides detailed exercise performance instructions and precise feedback on the patients 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.
The ArmTutor™system with its sister devices (HandTutor, LegTutor and 3DTutor) is used by many leading rehabilitation centers worldwide and has full FDA and CE certification.
Biofeedback takes three forms. Thermal biofeedback measures skin temperature. Neurofeedback measures brain activity and electromyography (EMG) measures muscle activity. Measurements captured by the electrodes are displayed on a monitor. A therapist explains this data to the patient. Initially by trial and error, the patient alters his behavior and the resultant readings are displayed on a screen. These changing readings provide visible evidence of how a patient’s reactions are influencing his symptoms or improving his bodily functions. In time patients learn to control their symptoms without needing the monitor.
During Stroke treatments EMG measurements of muscle activity that are not enough to effectuate movement are captured by the electrodes and displayed on a monitor. A therapist explains this data to the patient. The patient is asked to try his best to move his affected limb and is shown which technique results in the most muscle activity. EMG feedback can be used in physiotherapy and occupational therapy to help patients reeducate their limbs in movement by showing them how to control their muscle activity in order to teach them how to grip and release objects in a stroke-impaired hand.
As reported in a 2009 review in the Biofeedback Matters newsletter: Physiotherapy alone may improve grip but teaching brain injury including stroke patients to relax and release objects was harder. This is because the reflexes that control muscle activity in Stroke patients’ brains and muscles is damaged and overactive this causes continued muscle tension or spasticity when a patient desires to release an object. According to Dr. Richard Harvey of Chicago’s Rehabilitation Institute EMG Biofeedback can help to teach patients improved motor control but it cannot help patients rehabilitate a functional tasks.
The research summary shows the following examples of the effectiveness of biofeedback improving functional outcomes in stroke patients: A 1989 study from the Stroke Research Unit, Nottingham UK showed that stroke patients receiving EMG biofeedback regained more arm function than control group patients with patients with more extreme movement impairment showing the most benefit. A 1994 study from the stroke rehabilitation center in Rome showed similar benefits in biofeedback improving lower extremity leg strength. Unfortunately, many of the studies demonstrating benefits for stroke patients have been criticized for their small sample size and imprecise terminology. Dr. Robert Teasell at St. Joseph’s Health Care, London, Ontario rehabilitation hospital reviewed studies between the 1960s and 2003 he concluded that biofeedback did appear more effective than conventional therapies but larger studies are still needed. The American Stroke Association in 2006, confirmed and updated this information by saying that up until 2006 these studies have not been done. The Tutor system established in 2004 with the aim of developing novel occupational and physical rehabilitation equipment based on the proven concepts of active exercise and biofeedback. 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 theyare 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. In this way the Tutor system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice. The HandTutor ArmTutor, LegTutor, 3DTutor is now part of the rehabilitation program of leading U.S. German, Italian, French and UK and other foreign hospitals. http://www.handtutor.com
Zak Koeske writing in the Fairlawn Patch on October 9, 2011 reported about TBI survivor Jane Concato who discusses her own experience dealing with brain injury.About seven years ago Jane Concato rose out of bedearly in the morning in her Westwood home and headed downstairs however she slipped and her fall changed her life forever.Concato’s husband, Joe, heard the fall and immediately arose to see what had happened. He found found his wife unconscious, squeezed up against the front door. Jane’s fall fractured her skull and bruised both her right and left temporal lobes leaving her in a coma at Hackensack Hospital for 3 weeks. Thus began Jane and her families life dalin with the effects of brain injury. Jane’s family were told by doctors to prepare for Jane not being able to learn to walk and talk again and just be prepared.Concata came out of a coma and underwent physcial and occupational rehabilitation therapy at Kessler rehabilitation centre in New jersey.Concato like many people didn’t know much about TBI traumatic brain injury pre fall. .The Brain Injury Association of New Jersey said that 12,000 – 15,000 of the 1.4 million Americans who suffer traumatic brain injuries annually are from New Jersey. BIANJ also estimates that 175,000 New Jersey residents live with the effects of TBI.During recovery for TBI patients are heavily involved in physiotherapy. One of the newest methods to enable them to improve functional outcomes in their rehabilitation is through the use of the Tutor system.The Tutor system, consisting of the HandTutor, ArmTutor, LegTutor and 3DTutor, has been developed to allow for functional rehabilitation of the whole body including the upper and lower extremity. The system consists of ergonomic wearable devices including a glove and arm and leg brace. These devices use dedicated rehabilitation software that provide patient instructions and feedback to encourage intensive massed controlled exercise practice which is the basic principle behing physical and occupational therapy manual exercise practice. 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 ensures better performance of functional tasks. Additional features of the Tutor system include quantitative evaluation, objective follow up and tele-rehabilitation.The new medical devices are available for children as well as adults and through the use of telerehabilitation and are FDA and CE certified.