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ZMPCZM017000.10.03 Neuromove clinical presentation.
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ZMPCZM017000.10.03 Neuromove clinical presentation.


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  • 1. 1
  • 2. What is the NeuroMove? It is an EMG Triggered Neurological Relearning tool for Stroke and other Brain Injury Paralysis Patients 2
  • 3. Who Benefits from the NeuroMove Stroke Patients The number 1 cause of treatable paralysis •Traumatic Brain Injury •Spinal Cord Injury •Palsy and other congenital paralysis relief 3
  • 4. Evidenced Based Successes -Peer Reviewed Clinical Trials -Patient Testimonials -Rehab Hospitals usage protocol 4
  • 5. 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 hemiparetic individuals > 1 year after stroke… Recovering Wrist and Finger Extension by EMG Triggered Neuromuscular stimulation. By James Caraugh, Ph.D 5
  • 6. Clinical Studies “Progress often far exceeded that of previous conventional therapy. Regarding mechanisms, impaired proprioceptive feedback is considered central to strokedisrupted sensorimotor control. EMGtriggered 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 6
  • 7. 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 Standards Conformité Européene - CE -Approved for – Stroke Recovery 7
  • 8. NeuroMove Prescribed by Leading Rehab Hospitals Johns Hopkins, MD Tawam Hospital, UAE Cleveland Clinic Kennedy Krieger Intl. Spine Institute Rehab Institute of Chicago Mayo Clinic, MN Kessler, NJ Moss Magee Rehab, PA Queen Elizabeth, H.K. St. John’s Mercy, St. Louis Mt. Sinai, NY Marlton Rehab, NJ Montefiore, Bronx, NY Lutheran Hospital, Brooklyn, NY TIRR of Houston Mission Hospital, CA Lethbridge Hosp. Canada Tan Tok Seng, Singapore 8
  • 9. What Hospitals Say about the NeuroMove “…treatments are focused on patients who have had a recent stroke as well as those who have suffered from stroke-related disabilities for years. Lutheran's "Re-train the Brain" stroke recovery program many long-suffering patients can regain long lost mobility and function.” R. Ahmad, OTR, Director Lutheran Rehab Network, Brooklyn, NY 9
  • 10. Acute Rehab Out patient Rehab Home Care Therapy 10
  • 11. Re Train the Brain Tools 11
  • 12. 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! 12
  • 13. What makes a Successful Brain Relearning Tool? Patient must be Cognitive Engages the Brain Intensive Concentrated Effort Frequency Focused Repetition 13
  • 14. The Re-learning Tool - NeuroMove EMG detects targeted neurological attempts to move the muscle Utilizing Repetitive attempts and reward to stimulate Neural remapping 14
  • 15. Patients can experience immediate results. Gives Stroke patients real hope and motivation 15
  • 16. Contraindications/Precautions Implanted electrical devices  Cardiologist approval for use with pacemakers.  Epilepsy  Cancer Lesions  Use on Muscles only  16
  • 17. In the Kit Electrode Placement Guide Book Instructional CD AC Cord for recharging 3-Packs of 3-Electrodes Connecting lead wire Program Manual 17
  • 18. Therapy Session Set-up  Attach electrodes muscle group  Turn on Unit.  Set e-stim to visible yet comfortable contraction 18
  • 19. 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 19
  • 20. Ankle Dorsiflexion (Drop Foot)/Flexion Shoulder Subluxation/Abduction Red Red Red Black Black Red Knee Extension - Front Black Red Refer to the Guide Red Flexible: Use on any Muscle Group 20
  • 21. Therapy Session Overview Cycle of Therapy RELAX: NM is Setting Threshold READY: Patient makes ATTEMPT GOOD: Stimulation or Reward RELAX: Deliberate rest 21
  • 22. RELAX The processor begins to detect EMG and set the threshold Threshold seconds is adjusted up or down every 15 Automatically 22
  • 23. 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 23 eyes. Engage the brain!
  • 24. Reward Imagination or attempt “strikes” the threshold and triggers physical movement…the reward. 24
  • 25. Cycle is Repeated The threshold is re-set every cycle and moves up or down to continually challenge or encourage the patient. 25
  • 26. NeuroMove Therapy Cycle Hands On! 26
  • 27. 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 27
  • 28. Other Applications Spinal  Cord Injury *Set SCI Mode Other Affliction Relief Erb’s Palsy Bell’s Palsy Cerebral Palsy Multiple Sclerosis 28
  • 29. Ancillary Benefits of NM  High Quality NMES Programmable Parameters  Treatment of Muscle Atrophy & Re-education  Muscle Spasms  Pain Relief  29
  • 30. 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 30
  • 31. 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) 31
  • 32. Program Settings Change Parameters o Frequency and pulse width, ramp up/off time stim period (default at 5 sec.) o Range: o 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) 32
  • 33. 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 33
  • 34. 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 34
  • 35. 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 35
  • 36. Hands on Therapy Session 36