Cognitive Impairments Treated by Tutor System. Report on CRT

The Committee on Cognitive Rehabilitation Therapy for Traumatic Brain Injury (Tbi), in reference to a report released by the Institute of Medicine (IOM) on Oct. 11, 2011 entitled “Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence,” said “There is some evidence about potential value to cognitive rehabilitation therapy (CRT) for treating traumatic brain injury (TBI), but overall it is not sufficient in order to  develop definitive guidelines on how to apply these therapies and to determine the specific type of CRT that will work best for a particular patient.” The Brain injury association of America (BIAA)agree with IOM’s findings and also support the call for research to demonstrate cognition improving and effectiveness of different CRT interventions in brain injury patients.
Representatives from the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine and the National Research Council make up the Committee on Cognitive Rehabilitation Therapy. The committee  supports the ongoing use of CRT for TBI but are looking for improvements in the standardization, design and clinical guidelines.
A study in the FY2009 National Defense Authorization Act penned in cooperation with the BIAA and Wounded Warrior Project (WWP) also acknowledges the need for additional research and the further development of clinical guidelines. BIAA and WWP are still committed to finding ways for injured service members to gain access to cognitive rehabilitation techniques.
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The newly developed Tutor system consisting of the HandTutor, ArmTutor, LegTutor and 3DTutor has many benefits including the fact that it treats motor, sensory and cognitive impairments that result following TBI in both adults and children .

The Tutor system has become a key system in neuromuscular rehabilitation and physical therapy as wel occupational therapy. The devices are used in physiotherapy not only for brain injury but also for victims of Parkinson’s, MS, CP, stroke, SPI, Radial and Ulnar nerve injuries, development and co-ordination disorders, Brachial Plexus injuries and other disabling diseases. These innovative devices implement an impairment based program or impairment orientated (IOT) repetitive exercise practice. IOT with augmented feedback encourages and challenges the patient to do repetitive isolated and multi joint exercise practice. Repetitive and intensive practice in the mainstay of a physiotherapist and an occupational and physical therapists use of manual therapy.  motor learning through intensive active exercises. These exercises are challenging and motivating and allow for repetitive 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 at home through the use of telerehabilitation.

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