The document describes the NeuroMove, an EMG-triggered neuromuscular relearning tool for stroke and brain injury paralysis patients. It works by detecting a patient's attempted movements through EMG sensors and rewarding their brain's attempts with brief muscle stimulation. The summary discusses how it has been shown to help regain function in clinical studies for stroke, TBI, and SCI patients through reinstating proprioceptive feedback. It is prescribed for both inpatient and at-home rehabilitation.

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
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4. Evidenced Based Successes
-Peer Reviewed Clinical Trials
www.neuromove.com
-Patient Testimonials
-Rehab Hospitals usage protocol
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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
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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 www.neuromove.com
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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
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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
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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
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10. Acute
Rehab
Out patient Rehab
Home Care Therapy
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11. Re Train the Brain Tools
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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!
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13. What makes a Successful
Brain Relearning Tool?
Patient must be Cognitive
Engages the Brain
Intensive
Concentrated Effort
Frequency
Focused Repetition
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14. The Re-learning Tool - NeuroMove
EMG detects targeted neurological
attempts to move the muscle
Utilizing Repetitive attempts and
reward to stimulate Neural remapping
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15. Patients
can experience
immediate results.
Gives
Stroke patients real
hope and motivation
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16. Contraindications/Precautions
Implanted electrical devices
 Cardiologist approval for use with
pacemakers.
 Epilepsy
 Cancer Lesions
 Use on Muscles only

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17. In the Kit
Electrode Placement Guide Book
Instructional CD
AC Cord for recharging
3-Packs of 3-Electrodes
Connecting lead wire
Program Manual
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18. Therapy
Session Set-up

Attach electrodes muscle
group

Turn on Unit.

Set e-stim to visible yet
comfortable contraction
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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
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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
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21. Therapy Session Overview
Cycle of Therapy
RELAX:
NM is Setting Threshold
READY:
Patient makes ATTEMPT
GOOD:
Stimulation or Reward
RELAX:
Deliberate rest
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22. RELAX
The processor begins to detect EMG and set the
threshold
Threshold
seconds
is adjusted up or down every 15
Automatically
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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
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eyes. Engage the brain!

24. Reward
Imagination or attempt “strikes”
the threshold and triggers
physical movement…the reward.
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25. 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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26. NeuroMove Therapy Cycle
Hands On!
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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
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28. Other Applications
Spinal

Cord Injury
*Set SCI Mode
Other Affliction Relief
Erb’s
Palsy
Bell’s Palsy
Cerebral Palsy
Multiple Sclerosis
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29. Ancillary Benefits of NM

High Quality NMES
Programmable Parameters
 Treatment of Muscle Atrophy
& Re-education
 Muscle Spasms
 Pain Relief

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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
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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)
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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)
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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
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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
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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
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36. Hands on Therapy Session
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