Apraxia and the Connection to Multiple Sclerosis

Apraxia is characterized by loss of the ability to execute or carry out learned purposeful movements,despite having the desire and the physical ability to perform the movements.  The more disability the more likely that apraxia can occur and this interferes with daily life activities. In a study just published in October 2012 attempts were made to evaluate the impact of and prevalence of  limb apraxia on manual dexterity as well as  activities of daily living (ADLs) in patients that have multiple sclerosis (MS).
Apraxia is  a ”software” problem in the brain’s motor system. Even though the nerves and muscles are working the brain cannot activate  motor routines that are pre-programmed . This can happen at a conscious or even at an unconscious level. For example, you may forget how to use a fork and knife when you are asked to do so but if you sit down at the meal table you will automatically use them. The problem is that the MS patient cannot activate the eating with silverware as a program within his brain.
The conclusions of the study showed that limb apraxia is a frequent and clinically important symptom which adds to disability in MS.  Therefore it should be evaluated and  treated, especially in patients with MS that report manual difficulties in everyday life.
One medical professional commented, “This study’s results are a surprise to me; I don’t routinely look for apraxia when I do a neurological examination on someone with MS. The researchers conclude that we should treat these apraxias. This is easier said than done, particularly in MS which is a progressive disease. In addition, they don’t acknowledge that the physical therapies that we use to treat apraxia are at best moderately effective. In reality we simply teach apraxic people to adapt to their disabilities.”
There are new physical therapy solutions that can assist MS patients slow down the progression of the disease. One such pair of products is the  HANDTUTOR and ARMTUTOR.
The TUTORs (also LEGTUTOR and 3DTUTOR) have become a key system in neuromuscular rehabilitation for MS patients as well as for those who have suffered a stroke, brain and spinal injury, Parkinson’s, CP or other limb movement limitations. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice.
The TUTORs consist of wearable gloves and braces that detect limb movement showing the patient how much active or assisted active movement they are actually doing. The rehabilitation software uses special  games to set a new target for this movement in terms of the patient’s ability to move their limb. The devices then measure the limb movement and give feedback on the success of the patient in trying to gain this new movement objective.  In this  way the TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice.
The TUTORs are now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. They can be used in the patient’s home through telerehabilitation and are fully certified by the FDA and CE.
See WWW.MEDITOUCH.CO.IL for more information.
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