Cognitive Rehabilitation and the Tutor System Work Together


Image by jonclegg via Flickr

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).


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