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Interactive Metronome: Training to Win

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  • 1. A Rehab Revolution
  • 2. Introducing Interactive Metronome evaluation and training for athletes, students who wish to improve their timing, accuracy and academics. Appointments available with Dr. Doreo and staff (805)777-7184
  • 3. History of Interactive Metronome
    • Originally developed to assist musicians with studio recording
    • Used later to help developmentally delayed students with music training
    • Formal clinical research began in 1994
  • 4. Early Studies: Motor Skills Study
    • Special Education students
    • Improved fine and gross motor and visual motor skills
    • Results presented to the American Educational Research Association
  • 5. Stanley I. Greenspan, MD Chairman, IM Scientific Advisory Board
    • Clinical Professor Psychiatry, George Washington Medical School
    • Contributor to over 100 articles and 27 books, including Building Healthy Minds, and The Child with Special Needs
    • Child Development Expert Featured in The Washington Post, Newsweek, Time Magazine, ABC’s Nightline, NBC, and CBS
  • 6. Science Overview
    • Motor Planning and Sequencing are core functions of the brain.
    “ Motor Planning and Sequencing is a critical component of the deficit in a variety of developmental and learning disorders.”
      • - Stanley I. Greenspan, M.D.
  • 7. Large-Scale Correlation Study
    • Timing and Child Development Study Published
      • Conducted in Illinois by High/Scope Foundation
      • 585 students, 6-10 years old
    • The First Link
  • 8. AJOT Published Clinical Study
    • 3 groups of ADHD boys separated by: Control / Placebo / IM-trained
    • Statistically significant improvement in:
      • Attention
      • Motor Control and Coordination
      • Language Processing
      • Reading
      • Control of Aggression and Impulsivity
  • 9. AJOT Published Clinical Study Interaction Effect = 0.005
  • 10. Academic Fluency Study
    • Over 700 middle and high school students
    • Pre and Post subtest on nationally standardized Woodcock-Johnson III test
    • Results showed significant increases in grade equivalent (GE) performances in IM Group
  • 11. Academic Fluency Study 2.21 GE Gain in Reading Fluency 1.66 GE Gain in Math Fluency 2.21 GE gain, n=718, Woodcock Johnson, 3 rd Ed. 1.66 GE gain, n=703, Woodcock Johnson, 3 rd Ed.
  • 12. Results from Early Clinical Trials MEDIAL BRAINSTEM Neuro-Motor Pipeline BASAL GANGLIA Integrates Thought and Movement CINGULATE GYRUS Allows Shifting of Attention Cognitive Flexibility Results from a Pilot fMRI (Brain Scan) study show IM Directly Activates Multiple Parts of the “Neuronetwork”
  • 13. Key Diagnoses
    • CVA and Brain Injury
    • Amputees
    • Parkinson’s
    • General Rehabilitation
    • ADHD
    • Cognitive / Developmental Disorders
    • Academic / Sports Performance
  • 14. Who Can Benefit? Loss of Motor Control Loss of Speech/Cognition Loss of Balance and Gait ADD/ADHD Asperger's Syndrome Sensory Integration Language Processing Motor Control and Coordination Impulsive/Aggressive Enhanced Coordination Improved Focus and Attention Improved Academic Performance PERFORMANCE NEURO-SCHOLASTIC REHABILITATION PLANNING SEQUENCING
  • 15. What are the Benefits? ATTENTION / FOCUS 1 MOTOR CONTROL / COORDINATION 3 BALANCE & GAIT 4 LANGUAGE PROCESSING 5 CONTROL OF AGGRESSION / IMPULSIVITY 6 MENTAL / COGNITIVE PROCESSING 2
  • 16. Performance on IM directly correlates with performance in:
    • Attention and Concentration
    • Mental Processing
    • Motor Planning and Sequencing
    • Language Processing
    • Behavior (Aggression and Impulsivity)
    • Executive Functioning
  • 17. Performance on IM directly correlates with performance in:
    • Balance and Gait
    • Endurance
    • Strength
    • Fine/Gross Motor Skills
    • Coordination
  • 18. Jake: TBI
    • 16 year old male - TBI from MVA
    • Severe impairments:
    • Sustained attention & concentration
    • Poor memory
    • Left-right discrimination
    • Gross and fine motor coordination
    • Balance
  • 19. Jake: TBI
    • After 6 weeks of IM Training:
    • Able to attend to paper/pencil tasks for up to 50mins in preparation for school
    • Only needed minimal cues for L-R discrimination
    • Reported that he could hold conversations for longer periods of time and now able to “day dream”
  • 20. Alexandria: Sensory Integration Disorder
    • 9 year old female – Sensory Integration Disorder
    • Impairments:
    • Poor fine motor coordination
    • Balance
    • Multiple Tantrums Each Day
    • D Average in Math
  • 21. Alexandria: Sensory Integration Disorder
    • After 5 weeks of IM Training:
    • Able to ride her bicycle without training wheels for the 1 st time
    • Her attention increased dramatically
    • Earned and A and B on her next two math tests
    • Drastic decrease in frequency and duration of emotional outbursts
  • 22. Diane: ADHD & Severe Learning Disabilities
    • Her therapist reported that she was “bouncing off the walls” and tried to even tried to stand on her head in her chair during her 1 st visit
    • Following 2 weeks of training:
    • Sat and read her mom a book
    • Able to sit quietly for up to 20 minutes
  • 23. Diane: ADHD & Severe Learning Disabilities
    • Enrolled in the IM program at age 8
    • Deficits addressed:
    • Poor Attention & Concentration
    • Great difficulty processing multiple instructions
  • 24. Benefits of IM
    • Non-invasive
    • Non-pharmaceutical (not exclusive of Rx)
    • Complements existing therapy
    • Short-term
    • Measurable outcomes
    • Functional cross-over
    • Clinical differentiator
  • 25. Demonstration
  • 26. Assessment 1 second = 1,000 milliseconds 0 - 15 ms Perfect 16 - 40 ms Above Average 41 - 100 ms Average 200 100 40 15 0 15 40 100 200
  • 27. Questions and Answers
  • 28. Other Case Studies
    • Stroke
    • TBI
    • Amputee
  • 29. Lizette: Stroke
    • Initial Therapy:
    • Met all IP and OP functional goals
    • Discharged to home
    • Returned with cognitive shifting deficits
    • IM training initiated
    • Patient returned to work with improvement in concentration, speech, balance, and motor coordination.
  • 30. Edward: TBI
    • Improved Auditory Sequencing
    • Improved Concentration
    • Motor improvements particularly in his lower body
    • After only his third session he demonstrated improvements in his ability to attend for much longer periods of time without stopping or talking
    14 years old
  • 31. Veronica: Stroke
    • 37 year old female - CVA
    • Deficits addressed:
    • Poor attention & concentration
      • Unable to attend to tasks for more than 10-15 minutes without getting externally distracted
    • Decreased stamina and endurance
      • Unable to stand for more than 15-20 minutes
  • 32. Case Study 2: Stroke
    • Following 8 weeks of IM training:
    • Able to complete simulated work activity for at least 60 minutes without becoming distracted
    • Able to stand and complete household activities for at least 45 minutes
  • 33. Brenda: Amputee
    • 6 months of traditional therapy with poor outcome
    • Thousands of IM reps particularly using her feet
    • Significant improvements in motor sequencing
    • Improved gait & balance
  • 34. Brenda: Amputee
    • Disney Marathon
    • FINISH LINE!
    • January 2004
  • 35. Interactive Metronome evaluation and training available by appointment with Dr. Doreo and her staff (805)777-7184 Thousand Oaks, CA www.drdoreo.com