Telerehabilitation-an Important Tool in Post Stroke Physiotherapy

Telerehabilitation allows the rehabilitative process  to continue remotely after being discharged from acute care. It can include complex tasks known to create rich conditions for neural charge. Researchers based in Minnesota performed a study to explore the feasibility of  telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke. They also wanted to compare complex versus simple movements in the ankle to promote brain reorganization and behavioral change  Their results are published in  ”Physical Therapy”, February 2012., Author Huiqiong Deng, MD, MS, from  the University of Minnesota, Minneapolis, and his team conducted the pilot randomized controlled trial that included training done in the participant’s home. Testing was done in different research labs involving multi-camera gait analysis and functional magnetic resonance imaging (fMRI)., In the study there were 16 participants with chronic stroke and impaired ankle dorsiflexion who were randomly assigned to receive 4 weeks of telerehabilitation of the paretic ankle. Participants received either computerized complex movement training (track group) or simple movement training (move group). Behavioral changes were measured with the 10-m walk test and gait analysis using a motion capture system. Brain reorganization was measured with ankle tracking during fMRI., The results showed that dorsiflexion during gait was significantly larger in the track group compared to the move group. Although the volume, percent volume, and intensity of cortical activation failed to show significant changes during the fMRI, the frequency count of the number of participants showing an increase versus a decrease in these values and from pretest to posttest, measurement was significantly differentin the two test groups.  The track group decreased and the move group increased., The researchers conclusion was that the results suggested that telerehabilitation that emphasizes complex task training with the paretic limb, is workable and can be effective in promoting further dorsiflexion in people that have chronic stroke., Telerehabilitation has been one of the features and advantages of the TUTOR system. While recovering stroke patients will begin  their physiotherapy in a hospital or clinic setting the TUTOR system has been designed to allow continuation of the therapy at home. The advantage is also available for those patients who live a distance from a PT clinic or are otherwise homebound., Occupational and physical therapists use the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR –  known as the TUTOR system – as a manual therapy tool to help them with their rehabilitative work., The TUTOR system has shown much success in rehabilitation of joint movement. The newly developed TUTORS consist of ergonomic wearable devices. The HANDTUTOR is a glove for hand therapy and the ARMTUTOR is an arm brace for elbow and shoulder rehabilitation. The LEGTUTOR is a leg brace for leg and hip. The system is indicated for patients who have suffered TBI, a stroke, SCI, CP, MS, Parkinson’s disease and other mobility restraining illnesses. It is used by occupational therapists and physiotherapists in rehabilitation centers, private clinics and the home where it can be supported by telerehabilitation. It is designed for those who have head, trunk, upper and lower extremity movement dysfunction., The accompanying software system consists of motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises.  The dedicated rehabilitation software allows the physical and occupational therapist to fully customize the exercises to the patient’s movement ability. In addition, the OT and PT can make objective follow up and reports on their patient’s progress. Rehabilitation aims to optimize 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 TUTORS are certified by the FDA and CE See WWW.HANDTUTOR.COM for more information.

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