Upper Limb Complex Regional Pain Syndrome Treated by the Arm Tutor

Ryan W. Patterson, MD, MPH et al writing in the Journal of Hand Sugery (JHS) discusses
Complex Regional Pain Syndrome of the Upper Extremity”
The diagnosis and management of complex regional pain syndrome is often challenging. Early diagnosis and intervention improve outcomes in most patients; however, some patients will progress regardless of intervention. Multidisciplinary management facilitates care in complex cases. The onset of signs and symptoms may be obvious or insidious; temporal delay is a frequent occurrence. Difficulty sleeping, pain unresponsive to narcotics, swelling, stiffness, and hypersensitivity are harbingers of onset. Multimodal treatment with hand therapy, sympatholytic drugs, and stress loading may be augmented with anesthesia blocks. If the dystrophic symptoms are controllable by medications and a nociceptive focus or nerve derangement is correctable, surgery is an appropriate alternative. Chronic sequelae of contracture may also be addressed surgically in patients with controllable sympathetically maintained pain.
The ArmTutor™, HandTutor and 3DTutor system has been developed to allow for functional rehabilitation of the upper extremity. The Tutors consist of an ergonomic wearable arm brace and dedicated rehabilitation software. The ArmTutor™ system allows for a range of biomechanical evaluation including speed, passive and active range of motion and motion analysis of the upper extremity. Quantitative biomechanical data allow for objective evaluation and rehabilitation treatment follow up. The ArmTutor™ rehabilitation concept is based on performing controlled exercise rehabilitation practice at a patient customized level with real time accurate feedback on the patient’s performance.  The exercises are designed in the form of challenging games that are suitable for a wide variety of neurological and orthopedic injury and disease. The games challenge the patient to perform the exercise task to their best ability and to continue exercise practice.
The ArmTutor™ allows for isolated and a combination of elbow and three directional shoulder treatment. The system provides detailed exercise performance instructions and precise feedback on the patients exercise performance. Controlled exercise of multijoints within the normal movement pattern prevents the development of undesired and compensatory joint movement and ensures better performance of functional tasks.
The ArmTutor™ system together with its sister devices (HandTutor, LegTutor, 3DTutor) is used by many leading rehabilitation centers worldwide and has full FDA and CE certification. See http://www.HandTutor.com for more information.

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