zmpczm017000.10.03 neuromove clinical presentation from painezee
DESCRIPTION
TRANSCRIPT
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What is the NeuroMove?
It is an EMG Triggered Neurological Relearning tool for Stroke and other Brain Injury Paralysis Patients
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Stroke Patients
The number 1 cause of treatable paralysis
•Traumatic Brain Injury
•Spinal Cord Injury
•Palsy and other congenital paralysis relief
Who Benefits from
the NeuroMove
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Evidenced Based Successes
-Peer Reviewed Clinical Trialswww.neuromove.com
-Patient Testimonials
-Rehab Hospitals usage protocol
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Clinical Studies
Chronic Motor Dysfunction After Stroke
Conclusion: “Two lines of evidence clearly support the use of EMG triggered NMES treatment to rehabilitate wrist and fingers extension movements of hemipareticindividuals > 1 year after stroke…
Recovering Wrist and Finger Extension by EMG Triggered Neuromuscular stimulation. By James Caraugh, Ph.D
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Clinical Studies
“Progress often far exceeded that of
previous conventional therapy. Regarding mechanisms, impaired proprioceptive feedback is considered central to stroke-disrupted sensorimotor control. EMG-triggered EMS is intended to improve brain relearning by reinstating proprioceptive feedback time-locked to each attempted movement. Clinical results were consistent with this theory.”
See all clinical studies at www.neuromove.com
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U.S. FDA Cleared-For Stroke, TBI and SCI Rehabilitation-Relaxation of Muscle Spasms & Muscle Re-education-Prevention of Retardation of disuse atrophy-Increase Local Blood Circulation-Maintaining or Increasing Range of Motion
European Heath StandardsConformité Européene - CE
-Approved for – Stroke Recovery
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NeuroMovePrescribed by Leading Rehab HospitalsJohns Hopkins, MDTawam Hospital, UAE Cleveland Clinic Kennedy Krieger Intl. Spine Institute Rehab Institute of ChicagoMayo Clinic, MNKessler, NJMoss Magee Rehab, PAQueen Elizabeth, H.K.
St. John’s Mercy, St. LouisMt. Sinai, NYMarlton Rehab, NJMontefiore, Bronx, NYLutheran Hospital, Brooklyn, NYTIRR of HoustonMission Hospital, CALethbridge Hosp. CanadaTan Tok Seng, Singapore
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What Hospitals Say
about the NeuroMove
“…treatments are focused on patients who havehad a recent stroke as well as those who havesuffered from stroke-related disabilities for years.Lutheran's "Re-train the Brain" stroke recoveryprogram many long-suffering patients canregain long lost mobility and function.”
R. Ahmad, OTR, Director
Lutheran Rehab Network, Brooklyn, NY
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Acute Rehab
Out patient Rehab
Home Care Therapy
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Re Train the Brain Tools
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Neuroplasticity Stimulating the brain plasticity by driving the
healthy neurons to take over for damaged neurons thus regaining voluntary contractions
Patient imagines movement and is rewarded through stimulated muscle contraction…
MOVEMENT!
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What makes a Successful
Brain Relearning Tool?
Patient must be Cognitive
Engages the Brain
Intensive
Concentrated Effort
Frequency
Focused Repetition
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The Re-learning Tool - NeuroMove
EMG detects targeted neurological attempts to move the muscle
Utilizing Repetitive attempts and reward to stimulate Neural re-mapping
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Patients can experience immediate results.
Gives Stroke patients real hope and motivation
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Contraindications/Precautions
Implanted electrical devices
Cardiologist approval for use with pacemakers.
Epilepsy
Cancer Lesions
Use on Muscles only
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In the Kit
Electrode Placement Guide BookInstructional CDAC Cord for recharging3-Packs of 3-ElectrodesConnecting lead wireProgram Manual
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Therapy
Session Set-up
Attach electrodes muscle group
Turn on Unit.
Set e-stim to visible yet comfortable contraction
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Any Group of Muscles
Wrist & Finger Extension - Flexion
Front & Back Elbow Flexion
Shoulder Subluxation/Abduction
Ankle Dorsiflexion
Knee Extension
Starting points
upper or lower extremities
distally or proximally
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Ankle Dorsiflexion (Drop Foot)/Flexion
Red
BlackRed
Knee Extension - Front
Red
Red
Black
Red
Red
Black
Shoulder Subluxation/Abduction
Flexible: Use on anyMuscle Group
Refer to the Guide
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Therapy Session Overview
Cycle of TherapyRELAX: NM is Setting ThresholdREADY: Patient makes ATTEMPTGOOD: Stimulation or RewardRELAX: Deliberate rest
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RELAX
The processor begins to detect EMG and set the threshold
Threshold is adjusted up or down every 15 seconds Automatically
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READY Patient makes concentrated attempts
to make muscle exertion sensors detect real attempts.
Encourage the patient to imagine or visualize movement, have them close their eyes. Engage the brain!
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RewardImagination or attempt “strikes”
the threshold and triggers physical movement…the reward.
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Cycle is Repeated
The threshold is re-set every cycle and moves up or down to continually challenge or encourage the patient.
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NeuroMove Therapy Cycle
Hands On!
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NeuroMove Patients
Post stroke and SCI treatment may begin: Once stabilized Must be cognitive Up to 30 years post stroke Use at HOME
Treatment Time 15-60 Minutes each session Once a day building to 2 or 3 times a day Expect 4 months to a year treatment plan
Can be used with: Botox Baclofen Pump
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Other ApplicationsSpinal Cord Injury
*Set SCI Mode
Other Affliction ReliefErb’s Palsy
Bell’s Palsy
Cerebral Palsy
Multiple Sclerosis
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Ancillary Benefits of NM
High Quality NMES
Programmable Parameters
Treatment of Muscle Atrophy & Re-education
Muscle Spasms
Pain Relief
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Trouble Shooting
Signals
“check electrodes”
Clean skin and wet electrodes
Check for Broken lead wires
“Poor Signal on Graph”
Restart NM between muscle groups changes
Make sure Battery Charge is Full Charge
Set Default – See Program Guide
“EMG signal too low or too high”
Check SCI versus Stroke Rehab Mode .50/.25
Set Defaults and restart
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Program Settings
Set threshold to increase
or decrease challenge (can be set
during session)
Rest Period (default – 15 sec. Set:60
seconds)
Mode: Stroke & SCI
Set Audio On or Off
Compliance Data (number of sessions
and total time used)
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Program Settings
Change Parameterso Frequency and pulse width, ramp up/off timeo stim period (default at 5 sec.)
o Range: Can only be set when SCI Mode is selected
SCI two sensitivity ranges:o 0.25-25 uV
o 0.50-50 uV (use if signal is off screen w stroke patients)
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Is this like regular biofeedback?
No - Regular EMG (electromyography) may also have a very sensitive input, but for most other applications the input signals are filtered and averaged.
Some stroke survivors have no EMG activity or a strong muscle tone with high background “noise” - regular EMG/biofeedback will not stand a chance of detecting the changes that indicate a real attempt from the brain. The NeuroMove measures peak values in the EMG and has very fast input circuitry. Instead of averaging the input it does the opposite – it looks for a pattern in the small changes that indicate a real attempt. A very effective demonstration of this is when a non-patient actually
triggers the NeuroMove just by thinking about it and imagining a
movement
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Why only one channel?
It has one channel, patient must concentrate on one movement at a time
Is it like FES is an elaborate functional stimulation only. The patient can be watching TV and doing BioNess, but the brain will not relearn new pathways
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Is it complicated to set up?
No – Encourage Home-use.
Turn on the device and turn stimulation level up slowly for a comfortable contraction of the muscle
Think very hard about moving the fingers, wrist, shoulder, foot and other muscles
After relaxing, it returns to “Ready” and is ready for the next attempt, relaxing is as important as concentrating
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Hands on Therapy Session