LegTutor Effective in Lower Limb Physical Therapy

Pollard Leg Kick

Image by Matt Niemi via Flickr

As published in Clinical Rehabilitation September 25. 2011

Drs. JC Chen , CH Lin , YC Wei , J Hsiao , and CC Liang  of the Department of Rehabilitation Medicine, Tzu Chi Buddhist General Hospital, Hualien, Taiwan.conducted the following research:
OBJECTIVE:
To evaluate the effectiveness of thermal stimulation accompanied by either active or passive movement added to standard rehabilitation in facilitating motor and balance function of the paretic leg of acute stroke.
DESIGN:
Pilot, observer-blinded, randomized clinical trial.
SETTING:
Department of rehabilitation medicine in a general hospital.
SUBJECTS:
Thirty-six patients were enrolled within four weeks of the onset of a stroke causing moderate to severe leg paresis (Brunnstrom stage ≤III).
INTERVENTIONS:
Patients were randomly assigned to thermal (standard rehabilitation plus approximately 30-40 minutes of thermal stimulation therapy daily for six weeks) and control (standard rehabilitation only) groups.
MAIN MEASURES:
Fugl-Meyer lower extremity score, Medical Research Council scale for lower extremity, Modified Motor Assessment Scale, Postural Assessment Scale for Stroke Patients Trunk Control, Berg Balance Scale, Functional Ambulation Classification and Modified Ashworth Scale.
RESULTS:
Patients in the thermal group experienced significantly better median scores for Fugl-Meyer lower extremity (14.0; interquartile range, 10.5-15.5), Medical Research Council scale for lower extremity (6.0; 4.0-7.0), Modified Motor Assessment Scale (16.0; 12.5-18.5), Berg Balance Scale (28.0; 20.5-33.5), and Functional Ambulation Classification (2.0; 2.0-2.0) (all P < 0.05). The thermal group also had more independent walkers (15/17; 88.2%) than the control group (9/16; 56.3%) after six weeks (P = 0.06). No adverse effect occurred.
CONCLUSIONS:
Thermal stimulation accompanied by either manual facilitation or encouragement for active participation of the paretic lower limb may be an effective promising supplementary treatment for the early-phase rehabilitation of moderate to severe stroke that warrants additional study.
The LegTutor has been instrumental in physical therapy rehabilitation for a variety of issues. The Tutor system, which also includes the HandTutor, ArmTutor and 3DTutor, is being used for improvement of fine motor, sensory and cognitive impairments through intensive active exercises with augmented feedback.
The LegTutor provides a safe and comfortable leg brace with position and speed sensors that precisely record three dimensional hip and knee extension and flexion. Rehabilitation games allow the patient to exercise Range of Motion (ROM), speed and accuracy of movement. The LegTutor facilitates evaluation and treatment of the lower extremity including isolated and combined hip and knee movements.
 The Tutors are being successfully used in leading U.S. and foreign hospitals and clinics and are suitable for home use through telerehabilitation. See http://www.HandTutor.com for more information.
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