Modified Constraint-Induced Movement Therapy Maximized With the Hand and ArmTutor

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Drs. M.McCall, S.McEwen, A.Colantonio, D.Streiner etal of the Graduate Department of Rehabilitation Sciences, University of Toronto, Ontario, Canada report on a research suggesting that constraint-induced movement therapy (CIMT) reduces impairment. The group investigated the efficacy of a modified CIMT protocol on participation, activity, and impairment in adults older than 65 subacute stroke. Outcome measure: Canadian Occupational Performance Measure showed some improvements at the level of impairment and activity. The group concluded that CIMT has a role in stroke rehabilitation in elderly people.
Enter–the Tutor system. Following neurological damage, Constraint induced movement therapy (CIMT) is a therapy used for physical and occupational rehabilitation of the upper limb including arm and hand. )  It is common post stroke for patients not to use their weaker or impaired arm this can lead to learned non-use or even neglect of the weaker arm. Following a structured treatment program, CIMT aims to increase the amount of use and quality of movement of the weaker arm by forcing its use.
CIMT forces the use of repetitive task-oriented training which is practice of short tasks with the impaired arm for several hours a day. The course is usually run over a 2-3 wk period.The impaired arm is restrained to force use of the weaker arm.
The person is also asked to try to use the weaker arm outside of the treatment program whilst doing functional tasks at home. In addition the restraining mitt is provided together with a series of home practice. Research has shown that intensive and repetitive use of the weaker arm will improve the quality of movement. Intensive exercise practice is also where the HandTutor and ArmTutor play an integral part of rehabilitation therapy.
The Tutor system consists of ergonomic wearable devices including the HandTutor for finger and wrist exercise and hand therapy together with the ArmTutor for elbow and shoulder exercise. The Tutor system uses powerful dedicated rehabilitation software which motivates the patient to do the intensive repetitive practice. The system is indicated for patients in rehabilitation centers, private clinics and the home where it can be supported by telerehabilitation.  Practice with the HandTutor and ArmTutor is well tolerated and can be done for longer than the 2-3 week CIMT course.
The Tutor system (including the LegTutor and 3DTutor for lower limb/ extremity exercise practice). Patients do intensive exercise practice using motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises. The system is part of the therapy program for CP, MS, stroke, Parkinson’s disease, Radial and Ulnar nerve, brain and spinal cord injury patients.  Controlled exercise practice will help to prevent the development of compensatory movement patterns and assists in Constraint Induced movement therapy. The dedicated software allows the occupational and physical therapist to fully customize the exercises to the patient’s movement ability. In addition the therapist can objectively and quantitatively evaluate and report on the treatment progress. The rehabilitation system optimizes the patient’s motor, sensory and cognitive performance and allows the patient to better perform everyday functional tasks to improve their quality of life. The HandTutor, ArmTutor, LegTutor and 3DTutor are FDA and CE certified and is designed for children as well as adults.

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