Tutors Effective in Stroke Rehabilitation – “It takes a lot of practice to make the brain better.”

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During a lecture to the  American Neurological Association Dr. Steven Crame is the University of California, Irvine (UCI), professor of neurology describes two therapeutic windows.   The first familiar sound to neurologists namely the clicking of the clock as they hurry to get tissue plasminogen activator on board in ischemic stroke patients. The second clock is measured in days or weeks a so called “golden” period during which combined restorative therapies and rehabilitation must be initiated to achieve maximum rehabilitation effects.
Talking about intensive active exercise practice Dr Cramer said: “It takes a lot of practice to make the brain better.”
Dr. Cramer describes  the concept of “If you sprinkle your best restorative pixie dust on the brain, you’re not going to get the same effect as if you pair it with some kind of behavioral shaping. By this he means that Nature provide the first rapid response , the inflammation and pouring in of a wealth of growth events that look very much like a developing brain.This excitable brain is bringing in the building blocks for repair and regrowth of the cells, dendrites, and synapses etc.
These building blocks are possible therapeutic targets as this spontaneous repair can be amplified and enhanced.
However Dr. Cramer predicted that far more will happen if active physical rehabilitation is added to the mix.
“When the brain is fertile to undergo repair, whatever substance you give has maximum effect if it is paired with the right kind of experience,” Dr. Cramer said.
Stroke disability is one of many events or diseases that the Tutor system can be effective in restoring  joint and limb movement.  The newly developed HandTutor and its sister devices (ArmTutor, LegTutor, 3DTutor) have become a key system in neuromuscular rehabilitation and physical and occupational therapy following brain injury including TB, cerebral palsy and Stroke. 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 intensive  training tailored to the patient’s performance. 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 during home care treatments that can be done together with telerehabilitation.
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