HandTutor Significant Part of Upper Limb Rehabilitation Program

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In an article entitled “Feasibility and efficacy of upper limb robotic rehabilitation in a subacute cervical spinal cord injury population” published in Spinal Cord , (13 September 2011)

Drs. J Zariffa, N Kapadia, J L K Kramer,etal wrote that the objectives of the study were to investigate the use of an upper limb robotic rehabilitation device (Armeo Spring, Hocoma AG, Switzerland) in a subacute cervical spinal cord injury (SCI) population.

Two Canadian inpatient rehabilitation centers were used in this study and twelve subjects (motor level C4–C6, ASIA Impairment Scale A–D) completed the training, which consisted of 16.1±4.6 sessions over 5.2±1.4 weeks. Two types of outcomes were recorded: (1) feasibility of incorporating the device into an inpatient rehabilitation program (compliance with training schedule, reduction in therapist time required and subject questionnaires) and (2) efficacy of the robotic rehabilitation for improving functional outcomes (Graded and Redefined Assessment of Strength, Sensibility and Prehension (GRASSP), action research arm test, grip dynamometry and range of motion).

By the end of the training period, the robot-assisted training was shown to require active therapist involvement for 25±11% (mean±s.d.) of the total session time. In the group of all subjects and in a subgroup composed of motor-incomplete subjects, no statistically significant differences were found between intervention and control limbs for any of the outcome measures. In a subgroup of subjects with partial hand function at baseline, the GRASSP-Sensibility component showed a statistically significant increase (6.0±1.6 (mean±s.e.m.) point increase between baseline and discharge for the intervention limbs versus 1.9±0.9 points for the control limbs).

The conclusion they drew was that the pilot results suggest that individuals with some preserved hand function after SCI may be better candidates for rehabilitation training using the Armeo Spring device.

When there is partial hand function or some preserved hand function the HandTutor has shown progress in returning normal movement to the affected joint. The HandTutor™ system is an active exercise based hand rehabilitation program that uses the accepted methods of impairment oriented training (IOT) with augmented feedback. The HandTutor™ evaluates and treats finger and hand movement dysfunction through exercises that encourage extension/ flexion of the finger(s) and wrist.

The HandTutor™ system consists of a safe comfortable glove, with position and speed sensors that precisely record finger and wrist motion, and dedicated rehabilitation software. The ergonomic gloves come in five sizes for both right and left hands. The system, used for upper limb rehabilitation from spinal cord and brain injuries and other disabilities, employs the known concept of biofeedback to give occupational and physical therapists access to an affordable user friendly hand rehabilitation package. The HandTutor™ can also be used in combination with the 3DTutor™ for arm rehabilitation. The devices are used extensively in inpatient rehabilitation programs as well as clinics and even at home through tele rehabilitation. The HandTutor™ is CE medical and FDA certified.

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