New Stroke Treatment Uses Electrodes

In a lecture given in October 2012 for the National Institute of Neurological Disorders and Stroke, Bethesda, MD Nanosymposium,  L.G. Cohen discusses how, “Brain Stimulation Methods May Improve Recovery from Stroke”.

About one third of all stroke patients are disabled for the long term and have mobility problems. The treatment of choice has been exercise and physical therapy. Studies have shown that with those methods the brain is reorganized and brain tissue forms new connections into deeper brain regions.

 Research is ongoing by Cohen and others to investigate how this stimulation can enhance compensatory changes. In a method called ”transcranial direct current stimulation” (tDCS), electrodes are placed over the scalp and send electrical currents directly to the brain. There have been some preliminary studies showing that such treatment can make small improvements in mobility.

In addition to these new methods stroke patients can avail themselves of state of the art physical therapy products such as the ARMTUTOR and HANDTUTOR. The TUTOR system (which includes a LEGTUTOR and 3DTUTOR) has  become a key system in neuromuscular rehabilitation for stroke victims and also those recovering from brain and spinal injuries, Parkinson’s, MS, CP and 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 glove 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 rehabilitation 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 are available for adults and children from the age of 5 and are fully certified by the FDA and CE. They are also used in the patient’s home via telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

Parkinson’s Disease Explained

Parkinson’s disease (PD) is a  motor system disorder, which is the result of the loss of dopamine-producing brain cells. The  primary symptoms  are tremor; rigidity; bradykinesia and coordination.  Patients may have difficulty talking, walking,  or completing other  tasks. PD usually affects people  aged of 50 or over. Sometimes the disease progresses more quickly in one person than for another.  In time the shaking, or tremor, which affects the most PD patients may begin to interfere with their daily activities.  There are other symptoms such as: depression, emotional changes, difficulty in swallowing, chewing,  speaking, urinary problems or constipation, skin problems and disruptive sleep . The diagnosis is based on medical history and a neurological examination and can be difficult to diagnose accurately.    Brain scans or laboratory tests are used in order to rule out other diseases.

 There is no known cure for PD at this time, but a variety of medications provide  relief from the symptoms.   Levodopa and Carbidopa are two that have had some success.   Although Levodopa helps at least three-quarters of patients, not all symptoms respond equally to the drug. Bradykinesia and rigidity respond best but tremors may be only partially reduced.  Balance and some other symptoms may not be alleviated at all.  Anticholinergics can help control rigidity and tremors.  There are other drugs that help including   Amantadine, which also appears to reduce symptoms.

Sometimes surgery may be indicated if the disease doesn’t respond to drugs. This surgery is called deep brain stimulation (DBS) and has  been approved by the U.S. Food and Drug Administration. In DBS, electrodes are implanted into the brain which are externally programmed. DBS can reduce the need for certain drugs, which can then decrease  involuntary movements called dyskinesia that are a side effect of Levodopa.The surgery can also help to alleviate fluctuations of symptoms by reducing tremors, gait problems and slowness of movements.

PD is both chronic and progressive.   Some people become severely disabled while others experience only minor motor disruptions. Tremor is the major symptom for some patients and a minor complaint for others.  It is impossible to know which symptoms will affect an individual patient or the intensity of the symptoms.

There are various research projects being undertaken through the National Institutes of Health (NIH) which also supports  research via grants to  medical institutions across the U.S.  There are research projects using animals to study the progression of the disease and hopefully to find new medications. Scientists are looking into causes like environmental factors, defective genes and toxins that may cause the disease. Others are trying to develop drugs that may be able to delay, prevent or even reverse the disease.

Parkinson’s patients have also been helped by state of the art physical therapy solutions to alleviate some of the debilitating symptoms of their movement disabilities. One such physical therapy product is the TUTOR system.

The ARMTUTOR™ and HANDTUTOR systems have been developed to allow for functional rehabilitation of the upper extremity including the shoulder, elbow, wrist and fingers. The system consists of an ergonomic wearable glove or arm brace together with dedicated rehabilitation software. The ARMTUTOR™ and HANDTUTOR  allow the physical and occupational therapist to report on and evaluate the patient’s functional rehabilitation progress. This allows the PT and OT to prescribe the correct customized and motivating intensive exercise practice to the manual rehabilitation therapy.

Intensive repetition of movement is achieved through  challenging games set to the patient’s  ability. The system provides detailed exercise performance instructions and precise feedback on the patient’s efforts. 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. Telerehabilitation allows the recovering patient to continue his physical therapy at home. The system is used by many leading rehabilitation centers worldwide and has full FDA and CE certification. See WWW.MEDITOUCH.CO.IL for more information.

Child Developmental Coordination Disorder–Its Causes and Treatment

Developmental coordination disorder (DCD) is when children don’t develop normally using voluntary muscles.

DCD has also been called ”clumsy child syndrome”,  a disorder of motor function, and even congenital maladroitness. We notice the disorder when the child doesn’t seem to be walking properly or dressing himself.

Although these children often develop normally in all other ways they have difficulty with both large and small muscles. This may involve closing buttons, forming letters when they write or throwing or catching balls.  This can cause social problems even on the playground as they will be considered different by their peers. They may also feel discouraged from progressing even though they have normal intelligence.

Symptoms vary from child to child. In some it could be an inability to tie shoe laces and in another it could be improperly forming printed letters or catching a ball. The disorder manifests itself in relation to the child’s age and IQ. Generally there are 5 types of symptoms.

–an at-rest muscle tone that is below normal

–general unsteadiness and slight shaking

–inability to produce written symbols

–inability to move smoothly because of problems putting together the subunits of the whole movement

–muscle tone that is consistently above normal

Some children may have more than one symptom.

The causes of DCD are unknown however there are some theories given. These include poor prenatal nutrition, low birth weight or prematurity. There is no hard evidence for these reasons, though.

Estimates show that perhaps 6% of children between 5 and 11 have DCD and that males may be more diagnosed although males and females each probably have the disorder equally. There seems to be a link between DCD and speech language disorders although it isn’t known why.

Usually parents or teachers are the first to notice the disorder because the child is having learning problems, falling frequently or lagging behind peers. A doctor’s examination is usually advised to rule out any neurological problem or a psychiatrist may be consulted to eliminate a learning disability.

Since different symptoms occur in different children it is imperative to determine that the child is abnormally ”clumsy” in comparison to his peers of a similar age and intelligence level. There has to be a negative consequence to the child’s clumsiness in order to have a diagnosis of DCD. These consequences would be those that affect his day to day progress in school, play or other necessary activities. The correct diagnosis needs to be made to determine that it is not connected with muscular dystrophy or retardation. Some people feel that there has to be a minimum IQ of 70 to label it DCD.

There have been no known treatments until now that work for all cases of DCD. Working with an occupational therapist, placing the child in a special education class in order to improve motor coordination and to improve academic problems or in a physical education class to improve motor skills may be very helpful.

Individual therapy can be very important to the child that has DCD as to neglect the problem can cause additional issues involving social relationships and low self esteem.

No one knows how to prevent developmental coordination disorder, although some have suggested a healthy diet during pregnancy and regular prenatal care.

Recently there has been a development in physical therapy solutions that can help a child from the age of 5 and up to overcome symptoms of DCD. Called the TUTOR system these products provide an intensive exercise program that is both challenging and enjoyable to use. The HANDTUTOR, and ARMTUTOR specifically can provide a way to strengthen the muscles needed to learn better coordination.

The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation and physical therapy for interactive rehabilitation exercise. These innovative devices implement an impairment based program with augmented feedback and encourage motor learning through intensive active exercises. These exercises are challenging and motivating and allow for repetitive training tailored to the patient’s performance. This training is customized by the occupational and physical therapist to ensure that the patient stays motivated to do intensive repetitive manual therapy and exercise practice.

 The HandTutor, LegTutor, ArmTutor and 3DTutor is now  part of the rehabilitation program of leading U.S. and foreign hospitals with the Tutors being used in clinics and in patients homes through telerehabilitation. Fully certified by the FDA and CE more information is available at WWW.MEDITOUCH.CO.IL

Hope for Multiple Sclerosis Patients

Multiple Sclerosis (MS) is a disease affecting the Central Nervous System (CNS). Specifically it affects one or more parts of the brain, spinal cordor optic nerve. The original dysfunction is at a cellular level where the neurons that are sent around the brain and body cannot do their job properly because the Myelin sheath protecting their pathways is partially or completely eroded and the underlying fiber is damaged.  Immune cells have attacked the Myelin sheath and therefore the nerve cell cannot transmit signals. Scientists are not sure why, how or from where these cells come.

The symptoms prevalent in an MS patient vary. Not all symptoms occur to every MS patient and several symptoms can be associated with other medical issues aside from MS. However the following are just some of the symptoms that can be attributed to MS.  Loss of balance; limb weakness which makes walking difficult; an onset of paralysis;  footdrop where the foot drags during walking; proprioceptive dysfunction which is a loss of awareness of body parts and cognitive dysfunction.

As unfortunate as these symptoms are there are therapies that can alleviate many, if not all, of them. Using state of the art physical therapy solutions, such as the TUTOR system, experience has shown, that an MS patient can be made more comfortable by arresting the symptoms and improving his general health.

The recently developed HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have become a key system in neuromuscular rehabilitation and physical therapy for interactive rehabilitation exercises. These innovative devices implement an impairment based program with augmented feedback and encourage motor learning through intensive active exercises. These exercises are challenging and motivating and allow for repetitive training tailored to the patient’s performance. This training is customized by the occupational and physical therapist to ensure that the patient stays motivated to do intensive repetitive manual therapy and exercise practice.

The TUTORs look at motor, sensory and cognitive impairments and they customize treatment for them. By using the LEGTUTOR, for example, the patient controls proprioception as he becomes aware that his leg or lower limb is the one that is functioning. Cognitive dysfunction is  alleviated by the use of these physical therapy products as the patient can first, remember a movement then plan how it is going to be used and finally implementing it.. All of the TUTORs can be used in the same way to accomplish the similar goals.

The TUTORs are being used to provide intensive exercises not only for MS patients but also for those who have had a stroke, a brain or spinal cord injury, Parkinson’s disease or other upper and lower limb surgery or disability.The TUTORs are now  part of the rehabilitation program of leading U.S. and foreign hospitals where they are used in clinics and in the patient’s home through telerehabilitation. The TUTORs are fully certified by the FDA and CE and available for adults and children from the age of 5 and up.

See WWW.MEDITOUCH.CO.IL for further information.

Is There a Connection Between Conscientiousness and Injury?

There seems to be a direct correlation between the world of sport and the human spirit. Since the need to reproduce is a part of human nature  it is natural to have a drive to increase fitness and thereby protect one’s ability to reproduce. This manifests itself in a physiological way as well as in a psychological way. It exists in many individuals but the degree varies. People who are high risk takers have a lower level of self preservation.

Personality indicators usually consist of five areas. Extraversion, Neuroticism, Agreeableness, Openess and Conscientiousness. This article will concentrate on the latter trait.

Conscientiousness consists of persistance, organization, motivation and behavior that is goal directed. The opposite character may be the one that is lazy and sloppy. So do conscientious people have more or less sports injuries than those who are not that fastidious? Studies have shown that conscientiousness is not the only factor in a personality affecting injury. Over-activity, emotional instability, impulsiveness  and aggressiveness in children are additional factors that can affect injury occurrence. Conscientiousness consists of four main traits. Orderliness, hard work, self control and conformity. All these determine the degree of conscientiousness that the individual has.

Self control is probably the most important and relevant of the traits. This individual will keep his belongings in order and neat and clean. He will do his various tasks on time and he will work towards his intended goals. These can be called General Conscientiousness. Such individuals will prevent injuries by stretching before and after exercises, wear  helmets, switch off electrical appliances, apply sunscreen, check smoke alarm batteries etc. Theseinjury prevention behaviors are tied in to an individuals self control and hard work.

In a research study it was found that children who grow up with more parental supervision have more injury prevention traits than those that have less supervision i.e. that conscientiousness may not be genetic but rather may depend on nature and nurture. An additional study found that children who grew up with a lower level of conscientiousness experienced more injuries than those whose level was higher. Goal setting and following rules and regulations can definitely be traced to a lower injury rate. A further study showed a correlation between a high level of conscientiousness and a lower rate of automobile accidents.

When injury occurs and, unfortunately, causes a limb to be semi paralyzed or disabled the most effective physical therapy products should be used. Such a product is the HANDTUTOR, LEGTUTOR or ARMTUTOR.

These physical therapy products have been developed to allow for functional rehabilitation of the upper or lower extremities including the shoulder, elbow, wrist, leg, knee or hip. The system consists of an ergonomic wearable glove or brace together with dedicated rehabilitation software. The TUTOR system allows the physical and occupational therapists to report on and evaluate the patient’s functional rehabilitation progress and allows them  to prescribe the correct customized and motivating intensive exercise practice to the manual rehabilitation therapy.

Intensive repetition of movement is achieved through  challenging games set to the patient’s  ability. The system provides detailed exercise performance instructions and precise feedback of the patient’s efforts. 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. Telerehabilitation allows the recovering patient to continue his physical therapy at home. The TUTOR system is used by many leading rehabilitation centers worldwide and has full FDA and CE certification. See WWW.MEDITOUCH.CO.IL for more information.

Ballet Dancing–Ouch!

In a sports medicine journal published in Australia it was pointed out that in order to manage classical ballet dancers with overuse injuries it is necessary to understand the art form, have precise knowledge of anatomy and awareness of certain conditions.

“Turnout” (a rotation of the leg that comes from the hips, causing the foot and knee to turn outward, away from the center of the body and thereby  allows for greater extension of the leg, especially when raising it to the side and rear)  is essential to classical ballet technique and is the basis on which all ballet movement follows, however it is frequently the cause of overuse injuries.

Common presenting conditions caused by turnout are second metatarsal stress fractures,tendinitis  and posterior ankle impingement syndromes. Ballet dancers also have persistent shin pain  due to chronic compartment syndrome and stress fracture of the  anterior tibia. They also suffer from constant knee, hip and back pain.

In order to speed  recovery of dancers, it is vital for the sports medicine team to cooperate. This allows the dancer to benefit from accurate diagnosis, technique correction, getting the full range of manual therapies to soft and joint tissue, appropriate strengthening therapy and maintenance of dance fitness during the time they are out of class with (Pilates and other) exercises as well as  nutrition advice. Most of the overuse ballet conditions do well with a combination of conservative therapies.

Intensive exercise therapy is also available through the use of the LEGTUTOR. Part of the TUTOR system (which also includes the HANDTUTOR, ARMTUTOR and 3DTUTOR) the LEGTUTOR consists of a safe comfortable leg brace with position and speed sensors that precisely record three dimensional hip and knee movements. The LEGTUTOR has a range of motion limiter that can limit the dynamic range of 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.

Originally devised for the treatment of Parkinson’s disease, brain or spinal cord injury, CP, MS, stroke or other upper or lower limb disabilities the TUTOR system is currently treating patients at leading U.S. and European hospitals and clinics. The TUTORS are available for use by adults and children from the age of 5 and are fully certified by the FDA  and CE. They are also available for ”at home” patients through telerehabilitation.

See WWW.MEDITOUCH.CO.IL for further information.

What Kind of Pain am I Having Now? ITB Syndrome and Relief

One of the lesser known but yet common leg problems encountered by runners is ”Iliotibial Band Syndrome” or ITB syndrome. Theiliotibial band is the ligament that runs down the outside of the thigh from the hip to the shin.When that gets inflamed it hurts. Consider the following story:

Laura K. had been running regularly for several years before the pain hit. Just two days after finishing her first marathon, Laura went off with her  running group for an easy 5-mile run. However after 2 miles, the outside of her leg began to hurt — big-time. “My leg just blew out. I stopped running and could hardly walk,” she recalls. “I barely made it home in pain.”

Laura, a writer from  Ohio, was suffering from iliotibial band syndrome, one of the most common overuse injuries to occur to runners. Many runners mistakenly think they have aknee injury because the most notable symptom is  typically swelling and pain on the outside of the knee.

But it’s not the knee, it’s the ligament that runs down the outside of the thigh from the hip to the shin. “When the band comes near the knee, it  narrows, and rubbing can occur between the bone and the band. This causes the inflammation,” according to Freddie H. Fu, M.D., a Pittsburgh, Pa. orthopedic surgeon and also the chairman  of the Pittsburgh Marathon.

The cause of ITB syndrome is any activity that repeatedly makes the leg  turn inward. This can include running too many track workouts in the same direction, wearing worn-out shoes, running too many miles, running downhill or on banked surfaces. Seasoned runners can be affected just as much as beginners.

One sports medicine podiatrist claims that 40% of his ITB patients have been running for more than 5 years. Fifty percent of them  run between 20 and 40 miles per week.

 Perhaps because of the way women’s hips tilt, ITB is more common with them according to Dr. Fu.

There has been a recent increase among all runners  possibly because there are more people preparing for marathons. Many of them are willing to run with pain and not let up.

Knowing that you have ITB is relatively easy. If you feel pain on the outside of your knee when you bend it at a 45 degree angle you probably have incurred the syndrome. Then it would be necessary to get an MRI to confirm that there is a partial thickening of the band.

Knowing when to stop running or doing any exercise is important but equally vital is strengthening the ligaments and muscles of the body prior to engaging in such activities. One of the most effective methods of  muscle strengthening is to use known physical therapy products such as the TUTOR system. Despite the fact that this product was created to treat the physical disabilities of patients suffering from Parkinson’s disease, stroke, brain/spinal cord injury or other upper or lower limb surgeries, the TUTORs can have a dual purpose. Consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR the object of their innovation is to provide intensive exercises to affected limbs. The TUTORs are comfortable ergonomically designed gloves and braces together with powerful dedicated rehabilitation software. The system consists of motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises. The dedicated software allows the physical/occupational therapist to objectively and quantitatively evaluate the patient’s progress.

The TUTORs are fully certified by the FDA and CE and are currently in use in leading U.S. and European rehabilitation hospitals and clinics. Designed to be used by adults and children from the age of 5 and up the TUTOR system can also be used at home through telerehabilitation.

See WWW.MEDITOUCH.CO.IL for further information.

Telerehabilitation Success

Telerehabilitation is by now not such a new concept in the physical therapyworld. What is new, though,  is how it has expanded to provide much needed rehabilitation for severly ill and disabledindividuals no matter where in the world they live or where their doctors andtherapists are located. Many patientswho have suffered strokes, brain orspinal cord injuries, Parkinson’s, CP, MS or other upper or lower limb surgeries or diseases who need to or prefer to remain at their home rather than in a clinic or rehab center can take advantage of systems like the TUTORs. Developed in 2004 with just the HANDTUTOR and later expanded to include the ARMTUTOR, LEGTUTOR and 3DTUTOR this system has become one of the leading physical therapy solutions to so many disabled patients.

Consisting of ergonomically designed gloves and braces and motivating and challenging games developed on exclusive software the TUTORs allow the patient to practice isolated and/or interjoint coordination exercises. These exercises help to prevent the development of compensatory movement patterns. The software allows the therapist to fully customize the exercises to the patient’s ability. For one such amazing success story go to this link.

Telerehabilitation technology offers hope away from the clinic | mHIMSS

For further information about the TUTOR system see WWW.MEDITOUCH.CO.IL

Does Spending More Money Improve Patient Back and Neck Pain Conditions?

According to the Journal of the American Medical Association (JAMA)  spine-related expenditures have increased but without any evidence of improvement in patient conditions.  However, according to the American Physical Therapy Association (APTA), patients who receive physical therapy for musculoskeletal disorders, including back and neck pain, have reported positive outcomes at lower costs than using surgery or drugs.  Roger Karsten, President of Dynamic Physical Therapy in Cadillac, Michigan states that ”Consumers, patients should understand that physical therapy offers a low-cost, high-value alternative to drugs and surgery when  musculoskeletal pain is present”.

Back and neck conditions can be treated more effectively by hands-on physical therapy by mobilizing the spine. Many patients that have chronic and disabling lower back pain account for more expenses and worker’s compensation costs so if surgery and a chronic condition can be prevented it will save a vast amount of money.

Physical therapists are health care professionals who use treatment techniques to promote the ability to move, restore function, reduce pain,  and prevent disability” says Karsten.   Developing fitness and wellness oriented programs for healthier and more active lifestyles is also necessary.”

Using state of the art physical therapy solutions is vital in accomplishing these goals. One of the latest developments in physical therapy products is the TUTOR system. Consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR, these products were originally designed for patients with disabled limbs resulting from Parkinson’s, stroke, CP, MS, brain and spinal cord injuries and other upper or lower limb surgeries or diseases. However the TUTORs  can also be used both as a preventative for severe injuries as well as for more minor medical issues where the limb needs strengthening. The TUTORs are gloves or braces that are strategically located and then with sensors connect to exclusive computerized exercise games. Physical therapists record and evaluate patient progress on these games and then design a customized intensive exercise program for that patient. The TUTORs are now successfully being used in rehabilitation hospitals and clinics worldwide and can also be utilized in the patient’s home through telerehabilitation. Fully certified by the FDA and CE the TUTORs are available for adults and children from the age of 5 and up. See WWW.MEDITOUCH.CO.IL for further information.