Pinless Navigation for Knee Surgery–Less Pain

Published in “Daily News and Analysis” (DNA) on Aug 9, 2012 by one of their correspondents, it was announced that Dr Vijay Allahbadia, consultant joint replacement surgeon at  Hinduja Healthcare, Mumbai, India established a new  procedure for  knee replacement surgery, which normally includes getting holes drilled into your knee and then having pins inserted into them. This is both complicated and painful during recovery. However, a new technological innovation-the pinless navigation system-will make the surgery a safer and a less painful option.

Using  infrared cameras and tracking software to conduct the knee  surgeries without using the traditional pins the system will hopefully set a trend in future knee replacements. Dr Vijay Allahbadia states that the surgery is less invasive and is a shorter surgical procedure than the traditional one.

Because extensive training is needed  there are very few orthopedic surgeons that can perform this surgery. In Mumbai Dr. Allahbadia is the only one.

Normally, following the initial recovery period of knee replacement surgery, there is a longer period of  rehabilitation. One of the most recent and cost effective physical therapy solutions is found in the LEGTUTOR.

  The LEGTUTOR is an ergonomic wearable leg brace with dedicated rehabilitation software.  The LEGTUTOR 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. This means that the LEGTUTOR system allows the physical therapist to prescribe a leg rehabilitation program customized to the patient’s knee and hip movement ability at their own stage of rehabilitation. The LEGTUTOR uses biofeedback to keep the patient motivated to do the exercise practice with those that were designed in the form of challenging games. They are suitable for a wide variety of other neurological and orthopedic injuries and diseases as well as post trauma and orthopedic surgery.

 The LEGTUTOR is also used by physical and occupational therapists in combination with the HANDTUTOR, LEGTUTOR and 3DTUTOR for upper and lower extremity rehabilitation. The TUTORs are used in rehabilitation therapy as well after brain or spinal cord injuries, Parkinson’s disease, MS, CP, Radial, Ulnar nerve and Brachial Plexus injuries. The TUTOR system is used by many leading rehabilitation centers worldwide and has full FDA and CE certification. It is designed for children and adults and can be used at home through telerehabilitation. See WWW.HANDTUTOR.COM for more information.

A Researchers Suggestion Already Answered

Dr. Ananda Hochstenbach-Waelen etal from Adelante Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg,  Hoensbroek, Holland published  their findings of research in the September 2012 edition of “Journal of Neuro Engineering and Rehabilitation” wherein they  discuss ”Embracing change: practical and theoretical  considerations for successful rehabilitation for upper limb training of stroke patients”.

 Dr. Ananda Hochstenbach-Waelen feels that rehabilitation technology is the tool of the future for upper limb training for stroke patients because of an increasing demand and because there is limited implementation of this technology.

Dr. Ananda Hochstenbach-Waelen did a search of PubMed and IEEE databases and discussed the issue with therapists to identify criteria and conditions to implement such skills training for stroke patients. The steps they recommended were that the technology should be tailored to the patient’s needs and goals; that there should be increasing levels of difficulty in the exercises; that the hardware and software should allow for quick familiarization and adjustability to individual patients; that the system should make itself adaptable to the patient and that the technology should provide instructions and feedback to the patient’s progression.

Apparently overlooked by the researchers is the fact that such technology already exists in the form of the widely acclaimed HANDTUTOR and ARMTUTOR. The HANDTUTOR and ARMTUTOR together with their sister devices (LEGTUTOR and 3DTUTOR) are ergonomic wearable devices that together with powerful dedicated software are  physical therapy products that have been created to serve as the exercise vehicle for stroke patients as well as for Parkinson’s, CP, MS, brain/spinal cord, Radial and Ulnar nerve and Brachial Plexus injuries as well as  other head, trunk or upper and lower limb movement dysfunction.

The TUTOR system consists of motivating and challenging games that allow the patient to practice increasing levels of difficulty and isolated and/or interjoint coordination exercises as well as  to experience repetition of the task related movements. Controlled exercise practice will help to prevent the development of compensatory movement patterns. The dedicated software allows the physical therapist to fully customize the exercises to the patient’s movement ability. In addition the therapist can objectively and quantitavely evaluate, offer feedback and provide documentation so as to report on the treatment progress In this way the therapist can tailor the program to the patient’s personal goals. The rehabilitation system optimizes the patient’s motor, sensory and cognitive performance and allows the patient to better perform everyday functional tasks to improve his quality of life. The TUTOR system has been designed to allow for quick familiarity and easy adaptibility on the part of the patient.

Already in use in leading U.S. and European hospitals and clinics the TUTOR system is fully certified by the FDA and CE and is available for children as well as adults and can also be used at the patient’s home through telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information about this most cost effective physical therapy solution.

Mountain Bike Injuries

In a microcosm study of mountain bike injuries Zachary Ashwell, a fourth year medical student who has a background in engineering, took statistics of injuries suffered by individuals who rode mountain bikes. An avid biker himself he knows the hazards and pitfalls that a rider can experience especially at Whistler Mountain Bike Park in Canada.

He  studied some 898  case reports from the Whistler Health Care Centre 2009 mountain bike season. The specific cases occurred between May 16 and Oct. 12 of 2009.

He found that the typical injury was  a 26-year-old male who suffered the injury between 1 and 4 p.m.

 Ashwell discovered that 86 per cent of the  patients were male, that August is the worst month for injuries, that 12 per cent of the injuries suffered  were considered potentially threatening to life, limb or function, and that more than 75 per cent of the bones broken in the bike park were upper body bones.The  most severe injuries involved internal bleeding or internal organ injury, spinal cord injury or traumatic brain injury.

Obviously the idea is to have as much safety gear as possible worn by the rider. Of 24 cases where safety equipment was noted  only one was documented as not wearing armor. The other 23 were documented as wearing a variety of protective devices beyond a helmet, including knee and elbow pads, full body protective suits and neck guards. At the risk of divulging a possible business idea this writer suggests that someone should invent a kind of ”airbag garment” to protect the mountain bike rider when he falls.

As stated above one of the more severe injuries that can occur to bike riders when they fall is Spinal Cord Injury (SCI) or Traumatic Brain Injury (TBI). However as stated above the most common injury is orthopedic fractures mainly upper  limb or extremity including hand arm, elbow and shoulder.

When that occurs and the initial emergency treatment and possibly orthopedic surgery has passed the patient will need the best physical therapy solution to cope with any limb movement disability issue he has. The TUTOR system is in the forefront of such physical therapy products and has been developed to assist patients to get the most intensive exercises so that the limb can return to its former mobility stage (and the patient can again ride his bike??)

 The  devices (HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR) are sophisticated, ergonomic and comfortable gloves and braces and have become a key system in neuromuscular rehabilitation and physical therapy for interactive rehabilitation exercise. The TUTORs are connected to exclusive software that implement an impairment based program with augmented feedback and encourage motor learning through intensive active exercises. The physical therapist records and evaluates the progress made by the patient and designs a customized exercise program for that patient.  The TUTOR system, fully certified by the FDA and CE is now  part of the rehabilitation program of leading U.S. and foreign hospitals and can be used in clinics in their home through the use of tele-rehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Prehabilitation–a Definition

PREVENTION & REHABILITATION: Two words that are not usually mentioned in the same breath. They actually are at opposite ends of the spectrum. However they really can go together because as much as rehabilitation serves to heal the injured, prevention or ”prehabilitation” can prevent the injury.

To explain it further  there are two areas of rehabilitation:

a) Prehabilitation: which is  exercise therapy undertaken by athletes and others to try to  reduce the risk of injury.

b) Rehabilitation:  is exercise therapy which is used to strengthen muscles around limbs and thereby attempt to return the use of an affected limb to its previous healthy state and also to prevent the injury from recurring. This method can be used to build up muscles and reduce injury around the shoulder, arm, leg and other upper and lower limbs of the body. Players of contact sports such as Rugby in the UK or football in the U.S., as an example, can be the beneficiaries of such prehabilitation.

Using the best physical therapy solutions for prehabilitation would add to the success of prevention of severe injuries. Such physical therapy products as the TUTOR system afford the athlete and others to accomplish controled exercise practice allowing for muscle toning and strengthening. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have been introduced to provide intensive exercises for disabilities arising from stroke, CP, MS, brain/spinal cord injuries and other upper and lower limb injuries or diseases or orthopedic injury and disease. The TUTORs are ergonomically designed gloves and braces that are attached to various parts of the body and through powerful evaluation software accessed by sensors in the braces that allow the patient to perform intensive exercises. The exercises are monitored by physical therapists who then design a custom made program appropriate for that patient’s ability level.

The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are fully certified by the FDA and CE. They are available for children as well as adults and can be used in the patient’s home through telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Acquired Brain Injury–What is it and What Can Be Done?

Many people suffer from brain injury which usually is caused by a traumatic event such as an accident or fall. However there is also what is called Acquired Brain Injury which can be a result of a stroke, tumor or infectious disease.

It was announced on July 10 that in London a campaign has begun by the United Kingdom Brain Injury Forum (UKBIF) that will highlight the need for easier and earlier access to rehabilitation for ABI patients. The aim of the campaign is to improve existing services and to do more for these unfortunate individuals.

It is known that the effects of ABI include physical, emotional, sensory and cognitive problems. Also that the effects can be temporary, permanent, light or severe. Sometimes the disabilities are not obvious. Results may include relationship breakdowns, loss of employment and change of personality.

In the UK alone approximately 150,000 people per year have some kind of brain injury and  the costs for ABI care was more than 1 billion pounds Sterling just in hospital costs in 2007. Community care and rehabilitation cost another 4 billion pounds. One factor that is known  about brain injury is that early rehabilitation may help to reduce length of hospital stays. Because of these facts it is important that all costs for future care are available and that the highest standard of care and rehabilitation be administered.

One of the latest physical therapy solutions is the TUTOR system. It is very cost effective and therefore can keep the costs of rehabilitation down while affording the patient the best of care. The TUTORs which include the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are ergonomically designed gloves and braces that are strategically placed on the affected part of the body and then through exclusive software the patient can exercise his affected limb. Physical and occupational therapists monitor this activity and record and evaluate the patient’s progress and then design a custom made exercise program for the patient at his ability level. The TUTORs are available for adults as well as children, are fully certified by the FDA and CE and can be used at home through the use of telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Diabetes Drug for Brain Injury Discovery

On June 24, 2012 it was reported that a new diabetes drug-called Exendin-4 which has been approved by the FDA significantly minimizes damage in Traumatic Brain Injury (TBI) in laboratory animals. The project was commissioned by  the U.S. Air Force. The principal researchers are Prof. Chaim Pick of Tel Aviv University’s Sackler Faculty of Medicine and Dr. Niguel Greig of the U. S. National Institute of Aging.

Although the death toll in people who suffer from TBI is relatively low, it can have severe, lifelong consequences for brain function. As a result of TBI a patient can have impaired mental abilities and dramatic personality changes. This aside from the high financial cost of treatment.

Originally Exendin-4 was designed to control sugar levels in the body but it has shown to be effective in alleviating symptoms of Alzheimer’s disease and it was found that if administered shortly after the original incident it can minmize damage in TBI. Together with collaborators, Dr. Vardit Rubovitch, Lital Rachmany-Raber and Prof. Shaul Schreiber and Dr. David Tweedie of the U.S. Institute the study and results have been published in the journal Experimental Neurology.

The research has been going on for several years and consisted of the effects of injuries when hitting the windshield in a car accident as well as work for the U.S. military in relation to trauma sustained when someone is exposed to an explosion or terrorist attack. In the experiments it was shown that mice that were exposed to blasts but that received Exendin-4 had significant reduction of brain damage caused by the explosion. An improved outcome  was also associated when the mice sustained TBI by blunt force if given the drug . The plan now is to find the right dosage and delivery system and to find other drugs to complement Exendin-4 to increase its efficiency.

TBI can have debilitating effects on limb movement and when that occurs the best physical therapy solutions are needed to provide exercises for the patient. The most cost effective physical therapy poducts are incorporated into  the TUTOR system. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are comfortable ergonomically designed gloves and braces that are placed on strategic locations of the body. They have position and speed sensors that precisely record finger and wrist movement. Rehabilitation games allow the patient to exercise range of motion, speed and accuracy of movement including opposition and pinch movement practice. The software gives the physical therapist objective and quantitative information which then allows an exclusive exercise treatment plan to be designed.

The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are also used by patients that have impaired limb mobility due to stroke, Parkinson’s, CP,MS, spinal cord injury and other upper and lower surgeries. Currently in use in leading U.S. and European hospitals and clinics the TUTOR system is FDA and CE certified and is available for children as well as adults. The patient is also able to use the TUTORs from home, if necessary, through the use of telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

What Exactly is a Brain Concussion and What Treatment is Helpful?

There are so  many occurrences of brain concussion especially amongst young athletes that it behooves everyone, especially those involved in sports, to be aware of what happens, how to prevent it and what the treatments are for it.

What is concussion and what causes concussion?

What is referred to as ”mild traumatic brain injury” or concussion, can be defined as a temporary loss of brain function due to a trauma to the head.  With concussion, function may be interrupted but there is no structural damage to the brain.

The brain ”floats” in cerebrospinal fluid and is encased in the skull. These protections allow it to withstand many minor injuries that occur daily. However, if  there is sufficient force that causes the brain to bounce against the  bones of the skull, then there is potential for injury. It is the movement of the brain against the inside of the skull that can cause the brain to be irritated and thereby interrupt its function. This movement can come from a direct blow to the head or face, and also from other body trauma that can cause the head to shake. Temporary loss of consciousness due to the injury probably means that a concussion has taken place however there are  concussions  that occur without the patient being knocked out. To be sure there are studies of football players where the majority aren’t even aware that they had sustained a head injury.

Types of concussion?

Traditionally,  the severity of concussion was based on the loss of consciousness and its duration together with  the presence of amnesia. It was presumed that there was a correlation between those two events and the amount of potential brain damage.

According to The International Conference of Concussion in Sports concussion be divided into two groups: simple and complex.

Simple concussion: In a simple concussion,  the symptoms gradually resolve, and the patient returns to normal function in seven to 10 days.

Complex concussion: In complex concussions, symptoms remain and thought processes are affected. Patients who have repeated concussions would fall into the complex category.

The Mayo Clinic recommends the following preventions.

1-Sports players should wear appropriate protective gear during games and other recreational activities. The equipment should fit well, be maintained and worn correctly. Players should follow rules and play responsibly and in a sportsmanlike way. Cyclists of any kind of vehicle should wear protective headgear.

2-Buckle your car seat belt. The belt can prevent an injury to the head in case of an accident.

3-Make your home safe.  Since falls around the home are the leading cause of head injury for infants, toddlers and older adults it’s  important to keep the home well lit and  floors free of objects — meaning anything that might cause someone to trip and fall..

4-Protect your children. To help lower the risk of head injuries to  children, it’s a good idea to place padding around countertops and edges of tables. If there are very young children in the house, block off stairways and install window guards. Don’t let  children play sports that are not at their age level.

5-Use caution in and around swimming areas. Don’t dive into a pool that is less than 9 feet (3 meters) deep.  Follow posted safety rules at water parks and public pools.

6-Wear sensible shoes. Wear shoes that are easy to walk  in. Don’t wear high heels, sandals with thin straps, or shoes that are either too slippery or too sticky.

Concussion Treatment

When there is bleeding under the scalp, but outside the skull, it creates a “goose egg” or large bruise, called a hematoma, at the site of the head injury. Generally this hematoma will go away on its own with time.

The use of ice immediately after the trauma may help decrease its size however do not apply ice directly to the skin. Rather  use a washcloth as a barrier and  wrap the ice in it. One can also use a bag of frozen vegetables wrapped in cloth, as this conforms nicely to the shape of the head.

Ice should be applied for 20-30 minutes at a time and repeated  every two to four hours.  After 48 hours there is little benefit to icing.

Resting is important to allow the brain to heal.

The patient should be seen by a professional health expert as soon as possible.

According to the  American Academy of Neurology  any athlete suspected of having a concussion should be removed from play until   evaluation by a physician. If a concussion is suspected , the Centers for Disease Control recommends implementing a 3-step plan:

1-The player should immediately stop playing and not return until the doctor approves.

 2-Do not try to judge the severity of the injury yourself but rather have a professional do it.

3-Inform the athlete’s family about the possible concussion and give them vital information about  concussions.

If a second concussion  occurs before the brain has recovered from the first one it can slow recovery or even increase the likelihood of having long-term problems. In some cases, repeat concussions can result in edema (brain swelling), brain damage, and even death.

If, unfortunately, brain damage occurs and it results in paresis of one or more limbs then after the acute stage it is important to use the best physical therapy solution available. One of the most cost effective and efficient physical therapy products available is the TUTOR system. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are products that are used to allow intensive exercise therapy to the brain injured patient.

The newly developed HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have become a key system in neuromuscular rehabilitation and physical therapy for interactive rehabilitation exercise. These innovative products 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. The training is  customized by the occupational and physical therapists to ensure that the patient stays motivated to do intensive repetitive manual therapy and exercise practice.   The TUTOR system is now  part of the rehabilitation program of leading U.S. and foreign hospitals where they are used  in rehabilitation clinics and in the patient’s home through the use of telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Yoga and Other Rehabilitation Systems for Stroke Patients

J.V. Bastille, PT, MS, RYT a physical therapist and certified Integrative Yoga Therapy teacher registered with the Yoga Alliance, Boudreau Physical Therapy Associates, Keene, N.H. and

K.M. Gill-Body, PT, DPT, MS, NCS, an Adjunct Clinical Associate Professor, Graduate Programs in Physical Therapy, MGH Institute of Health Professions, Boston, Mass, and Clinical Associate, Massachusetts General Hospital, Boston

write in Physical  Therapy, the journal of the American Physical Therapy Association about

Yoga as based on an exercise program specifically for people With chronic poststroke hemiparesis

 It is known that many people who have had a stroke have impaired health status because their level of activity is reduced. The advantages of yoga are that it offers a gentle alternative exercise program that can be  adapted for people who have had a stroke.

Four people with chronic poststroke hemiparesis participated in this single-case study. The results suggest that yoga may be beneficial to people who have had a stroke.

While yoga definitely has its advantages stroke victims can make use of other complementary therapies to augment further rehabilitation to affected limbs. One such physical therapy solution is the TUTOR system. Consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR these physical therapy products enable the stroke patient as well as those recovering from brain and spinal cord injuries, MS, CP, Parkinson’s and other upper and lower limb surgeries to get intensive exercise programs through the use of a sophisticated and innovative rehabilitation program. The TUTORs are comfortable ergonomic gloves and braces that are strategically placed on the body. These products have sensors that activate challenging and motivating computer games  allowing the patient to practice isolated and/or interjoint coordinating exercises. The dedicated software allows the therapist to fully customize the program to the patient’s ability. The rehabilitation system optimizes the patient’s motor, sensory and cognitive performance thereby allowing him to better perform every day functional tasks to improve his quality of life.

Currently in use in leading rehabilitation hospitals and clinics in the U.S. and Europe the TUTORs are also available through telerehabilitaion when the patient is discharged from acute care or lives too far away from an appropriate clinic. The TUTORs are fully certified by the FDA and CE and can be used by children as well as adults. See WWW.MEDITOUCH.CO.IL for more information.

Physical Rehabilitation Facility Closing and Its Alternative Solution

It was announced on May 30,2012 that Rutland Regional Medical Center’s inpatient rehabilitation unit in Vermont would be closing its doors. Many current and former patients have protested and urged the facility to remain open. They maintain that they received excellent care there and would consider it a tragedy if that help couldn’t be provided to others in need. “Without the superior care I received there back in the summer of 1998, I would not be living life as comfortable as I am now”, said one of its former patients.

When a vital institution such as a rehabilitation center is forced to close its doors for financial or other reasons many people suffer–patients as well as  the professional and lay staff.

In the case of the cancellation of physical rehabilitative services it is important to know that alternative physical therapy solutions exist. Specifically the system being used more and more these days is called TELEREHABILITATION, aka telemedicine, telehealth and other similar terminology. In the field of physical rehabilitation one system stands out above the others. Known as the TUTORs this  system is used usually by patients who are in or who have been discharged from an inpatient rehabilitation facility or who live at too great a distance from a facility. They can receive a good deal of their physical therapy needs through the use of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR. These physical therapy products are designed to allow the patient to receive intensive exercise programs monitored and regulated by physical and occupational therapists who may be miles away. The TUTORs consist of comfortable ergonomic gloves or braces strategically located on various parts of the body and powerful dedicated rehabilitation software in the form of challenging games. These games allow the patient to practice isolated and/or interjoint coordination exercises. This controlled exercise practice will prevent the development of compensatory movement patterns. The dedicated software allows the therapist to fully customize the exercises to the patient’s movement ability.The TUTORs are designed for patients who have experienced limited joint or limb movement ability due to a stroke, brain or spinal cord injury, Parkinson’s disease, MS, CP and other upper and lower extremity difficulties.

Currently in use in leading U.S. and European hospitals and clinics the TUTORs are available for children as young as 4 and are fully certified by the FDA and CE. See WWW.MEDITOUCH.CO.IL for further information.

When Physical Therapy Ends

 

 Diana Kohnle suggests on

Wednesday, May 16, 2012 in

 MedlinePlus Pages  ”Don’t neglect exercise”

• – Don’t become a couch potato when your doctor’s prescription for physical therapy is over.

The American Council on Exercise shows how to transition from physical therapy to a regular exercise program:

• Make a commitment to stay  active and fit;  don’t slip into a sedentary lifestyle.
• Discuss with your  therapist questions about safe follow-up exercises.
• Start  slow and easy, and follow your physical therapist‘s instructions.
• Watch out for warning signs not to overdo it.

Rehabilitation means that after a serious injury, illness or surgery, you may recover slowly. It will be necessary to regain your strength, relearn skills or find new ways of doing things that you did before.

Rehabilitation includes:

• Physical therapy to help your strength, mobility and fitness
• Occupational therapy to help you with your daily activities
• Speech-language therapy to help with understanding, speaking,  writing, reading  and swallowing
• Treatment of pain

The type and goals of therapy   may be different for different people. An older person who has had a stroke may simply want rehabilitation to be able to bathe or dress   without help. A younger person who has had a heart attack may go throughcardiac rehabilitation in order to try to return to work and to do normal activities. Someone with a lung disease may get pulmonary rehabilitation in order to be able to breathe better and improve his quality of life.

When physical therapy solutions are still needed the TUTOR system can be of great help. The TUTORs (HANDTUTOR, ARMTUTOR, LEGTUTOR nd 3DTUTOR) are used extensively by patients recovering from stroke, Parkinson’s disease, head/spinal cord injuries, CP,MS and other upper or lower limb surgeries. These physical therapy products are the vehicle that give intensive exercise programs to rehabilitate affected limbs. The HANDTUTOR is an ergonomic  glove and the ARMTUTOR, LEGTUTOR and 3DTUTOR are braces that fit comfortably on the patient’s arm or leg. They are connected to a computer that is fitted with exclusive and powerful software. The exercises consist of challenging games that provide the exercises. Physical/occupational therapists then record and evaluate the exercises designing a tailor made program for that patient.

Currently in use in leading U.S. and European hospitals and clinics the TUTOR system is also available for children and adults and can be used at home through the use of telerehabilitation. The TUTORs are certified by the FDA and CE. See WWW.MEDITOUCH.CO.IL for more information.