Frequently Asked Questions
Proven hand rehabilitation in hospital, primary care and home settings
MediTouch Ltd. manufacture the HandTutor rehabilitation program for hand treatment indicated for Stroke, Parkinson's disease, Cerebral Palsy, Development Co-ordination Disorders, Post hand surgery rehabilitation e.g. Tendon transfer. The program results in an improvement in hand function and is used by Occupational therapists, Physiotherapists and other physical medicine and rehabilitation professionals. The HandTutor system consists of a glove and software package that uses biofeedback to give a tailored hand exercise rehabilitation program.
About HandTutor
The HandTutor is an active exercise based hand rehabilitation program. The system is based on a safe comfortable glove with position and speed sensors together with a software package. The program uses the known concept of biofeedback to give occupational and physical therapists access to an affordable user friendly hand rehabilitation package. The HandTutor is CE medical and FDA certified.
HandTutor
With the HandTutor Meditouch has developed a system that builds on the proven rehabilitation concept that uses active repetitive exercises together with biofeedback. This allows the occupational or physical therapist to give treatment based on challenging exercises tailored to the patient's hand impairment such as range of motion, accuracy and speed of movement. Hand rehabilitation treatments can also be combined with traditional hand therapy.
The program allows the clinician to firstly evaluate the patient's hand impairment. This information is saved and documented so that a continuous report of patient progress is always available. This allows reports to be given to other rehabilitations specialists to ensure that the patients treatment schedule is optimized ensuring better treatment outcome.
The clinician can then choose and customize the game and its level of difficulty to patient's specific impairment. For example the game "Save the Earth" game can be chosen to work on speed of finger movement. The level of game difficulty can be adjusted either by the clinician or automatically controlled by the computer as the patients exercise performance leads to an improvement in their range of motion.
The patient receives motion, visual and auditory biofeedback from the system which teaches them to understand, plan and direct their hand finger and wrist movements to perform the required exercise. The package has been designed to ensure that the patient remains challenged and motivated. All the exercises can be performed at different difficulty levels that can be customized to the patients degree of hand impairment and hand movement ability. This means that the patient is always able to interact with the games. In addition the level of exercise difficulty can be adjusted either by the clinician or automatically by the software. The patient's motivation to improve on their hand exercise performance is further increased as an overall performance score is included in the sophisticated program. Overall the rehabilitation program ensures that the patient achieves controlled muscle reinforcement as the clinician can choose and tailor the appropriate exercise to the patient.
The HandTutor system incorporates server based patient record software that allows quantitative reports of the patients rehabilitation to be saved and used later in treatment reports. This allows the clinician to evaluate and justify the rehabilitation process and further tailor the rehabilitation process to the patient's hand impairment. In addition the occupation and physical therapist can use the HandTutor new technology to work on several motor impairments simultaneously.
The system is sold into specialized hospital and primary care hand clinics where it allows the clinician to offer simultaneous multiple patient treatments for a broad range of hand rehabilitation indications. The system is also used by general occupational and physiotherapy clinics that offer their patients a hgihtec treatment option for hand rehabilitation. A home use version is also available which allows the patient to further achieve accelerated rehabilitation by continuing their treatment sessions at home. Rehabilitation is therefore not limited to the hospital and primary care clinic and sessions can take place whenever the patient is motivated and available to train ensuring greater patient treatment acceptance and compliance and further improving their exercise performance.
This innovative high tech new technology allows for faster and better rehabilitation results enhancing patient quality of life.
Indications for hand rehabilitation with the HandTutor include:
* Post Ischemic or Hemorrhagic stroke
* Hand dexterity improvement following head injuries
* Hand tremor, quivering and movement Bradykinesia caused by Neurological disorders such as Parkinson's disease and Essential Tremors
* Hand Strengthening for patients suffering from Multiple Sclerosis
* Adult and Child Cerebral Palsy including spastic, ataxic and athetoid mixed cerebral palsy
* Development Co-ordination Disorders (DCD) including Dyspraxia, characterized by clumsy and physically awkward child hand movements
* Hand surgery rehabilitation following Tendon transfer or Open Reduction Internal Fixation (ORIF)
* Elbow, Radius, Ulnar fractures and soft tissue and other forearm injuries
* Brachial Plexus nerve injury
* Radial and Ulnar nerve injuries
* Hand Impairments characterized by limited active range of finger and wrist motion due to muscle weakness and muscle flaccidity
* Hand movement disorders including benign essential tremor
* Hand pain management and pain rehabilitation due to Complex Regional Pain Syndrome
Priviliges in Treatment for Patients:
- Offers intense and safe hand rehabilitation in hospital and home settings
- Complementary for rehabilitation treatment
- Motivates the patient
- By offering various exercse options, improves the treatment performance
- Provides audio and visual biofeedback
- Economical benefits of an accelerated treatment
Priviliges for Medical Professionals:
- Treatment can be adjusted to a desired angle, speed and sensitivity
- Used in researches and case studies
- Provides data regarding the improvement in rehabilitation process, documents all results through quantitative assessment and verification
- Can be combined with conventional therapy
MEDITOUCH
MediTouch established in 2004 with the aim of developing novel occupational and physical therapy rehabilitation equipment based on the proven concepts of active exercise and biofeedback.
Meditouch has developed optical and image processing technology that determines the position and speed of motion of single or multijoints. Together with occupational, physical therapy and rehabilitation clinical know how Meditouch develops rehabilitation platforms that use active exercises and biofeedback to improve lower and upper extremity function and aid in rehabilitation.
MediTouch firstly targeted hand rehabilitation indications and launched its HandTutor system with CE and FDA certification in 2008. The HandTutor is an innovative hand rehabilitation system that uses active exercise with biofeedback to give occupational and physical therapists a new high tech treatment option to improve hand function. The system in indicated for patients following stroke, Parkinson's disease and other neurology and orthopeadic patients.
MediTouch is in the prototype development stage of elbow, knee, ankle and hip braces that allow range of motion evaluation and active exercise treatment for patients suffering stroke, or recovering from Total knee, elbow and ankle Orthopedic interventions.
MediTouch is also combining EMG and TENS electrical stimulation into their rehabilitation platform.
HandTutor - Enhanced Stroke Rehabilitation
Eli Carmeli 1, Sara Peleg 2; Gadi Bartur 2; Enbal Elbo 2 ; Jean- Jacques Vatine 2,3
1 Physical Therapy Departments, Sackler Faculty of Medicine, Tel Aviv University, Israel
2Outpatient and Research Division, Reuth Medical Center, Tel Aviv, Israel
3Sackler Faculty of Medicine, Tel Aviv University, Israel;
Background: Stroke is the leading cause of adult disabilities. Although stroke affects the entire body, hand function particularly fine motor skill is the chief problem of patient. Recent evidences have demonstrated that intensive massed and repetitive practice could be necessary to brain organization and effect recovery of functional motor skills.
Objective: To assess the efficacy of post stroke hand rehabilitation using a novel feedback system called HandTutor.
Method: HandTutor is a fully computerized system designed to evaluate and rehabilitate hand function through utilizing the following key points:
1. Quantitative hand assessment of range of motion, speed and accuracy of movement
2. Customized intensive and Repetitive active practice.
3. Real time visual and auditory motion feedback.
4. Objective Follow-Up to assure patient improvement.
Subjects (n=31) 10-70 days s/p CVA, age 65±7, divided into 2 groups: Experimental group (n=16) and age-matched Control group (n=15). All subjects received 15 sessions, each session approximately 30 min; 5/wk. Experimental group received HandTutor treatment combined with traditional treatment (PT, OT). Control group recived traditional treatment of a similar duration and frequency to experimental group.
Results: After the consecutive 15 sessions, all patients were re-evaluated by Box and Block dexterity test (B&B), Fugl-Meyer (FM) impairment test, and by the computerized system which monitored and recorded each subject performance accuracy in x and y axis. The statistical analysis indicated significant improvement within the experimental group as compared to the control group in: 1) (B&B): p=0.015; 2) (FM): p=0.041; 3) performance accuracy on x axis: p<0.001; and 4) performance accuracy on y axis; p<0.001.
Conclusions: Combination of a unique intervention, based on intensive massed and repeated practice with real time motion feedback, through the use of HandTutor system, with the traditional treatment in the post stroke hand rehabilitation, proved to be significantly effective.
FREQUENTLY ASKED QUESTIONS
1. What is the HandTutor?
The HandTutor is a novel system designed to evaluate and rehabilitate sensory, motor and cognitive hand impairments. The result of using the HandTutor is an improvement in hand function.
2. Which Therapists can prescribe HandTutor treatment?
Hand Therapists including Occupational Therapists and Physical Therapists use the HandTutor system as a major tool in their rehabilitation program.
3. What are the indications of the HandTutor?
* Stroke
* Head injuries
* Parkinson's disease
* Multiple Sclerosis
* Cerebral Palsy
* Development Co-ordination Disorders
* Brachial Plexus injury
* Radial and Ulnar nerve injuries
* Post hand surgery rehabilitation e.g. Tendon transfer
* Forearm e.g. Elbow, Radius, Ulnar fractures and soft tissue injuries
* Complex Regional Pain Syndrome
4. Which age groups can be treated by the HandTutor system?
The HandTutor system has been designed to cover age groups of 7 years of age and upwards.
5. Which patients can benefit from HandTutor treatment?
Patients that have five percent of active movement relative to their passive movement can benefit from HandTutor treatment.
6. Can the HandTutor be used in the home care setting? assist in rehabilitation and re-education?
The HandTutor system is designed to be effective in both clinic and home care environments. The evaluation and treatment program is simple and intuitive to use. At the same time the treatment exercises are stimulating and challenging to keep the patient motivated.
7. What is the rehabilitation concept behind the HandTutor?
The rehabilitation concept uses a combination of challenging active repetitive exercises together with motion feedback. The result is a significant improvement in hand function and the ability to perform everyday tasks.
8. What is motion feedback?
Motion feedback is auditory and visual feedback information derived from the position of the hand. This motion feedback is quantitative and collected in real time. Motion feedback information has two roles. The first role is to allow the brain to understand the patient's current performance ability this is referred to as knowledge of performance. In addition motion feedback gives the brain input that allows the patient to understand what movement has to be performed in order to better perform the functional task. System provides feedback at the end of the exercise session that details the patients training result. This feedback is known as knowledge of results.
9. How does the HandTutor produce motion feedback?
The HandTutor system uses position sensors on the glove that can detect fine movements of the fingers and the wrist. This movement is visually displayed to the patient and the therapist through a graphical interface.
10. What is the difference between Electromyogaph (EMG) and motion feedback?
EMG detects electrical muscle activity. This electrical activity can only be detected from single surface muscles. However this electrical activity can not be directly translated into information that shows whether the patient has achieved the desired and task required body movement. In contrast, motion feedback is derived only when the patient achieves movement and can thus be used as a reliable indication to whether the task is being properly performed.
11. Can the difficulty of the HandTutor exercises be tailored to the patients functional hand ability?
The difficulty level of all the functional exercises in the HandTutor system can be tailored to the patients functional ability. This functional ability is determined by the patients motor, sensory and cognitive impairments.
12. Which patient hand impairment is evaluated by the HandTutor
The therapist can evaluate the following:
* Passive Range of Motion
* Active Range of Motion
* Velocity of finger movements
* Characterization of quality of the movement, such as tremor or smoothness
* Fine motor skills
The information is used to quantify patient performance, determine therapy goals and monitor patient progress.
13. Why is patient motion analysis and evaluation necessary to achieve treatment goals?
The quantitative hand assessment is necessary to identify the degree of hand disability. Once the therapist knows the degree of patient hand disability a customized training rehabilitation program can be formulated. The result is better hand rehabilitation. In addition, the evaluation software allows the therapist to set a baseline for hand treatment that can be referred to as evidence in order to show improvement in rehabilitation therapy.
14. Can the HandTutor system document the patient's rehabilitation process?
The HandTutor can generate reports and save detailing active and passive patient hand movements as well peed of finger and wrist movement. The reports are saved in the patient's file for easy access. These reports can be saved and printed during every step of the rehabilitation process in order to form a full documentation of the rehabilitation process.
15. Has the HandTutor system been proved effective in clinical trials?
Yes the HandTutor system has been proved effective in randomized controlled control clinical trials.
