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What is the NeuroMove?
It is an EMG Triggered
Neurological Relearning tool for
Stroke and other Brain Injury
Paralysis Patients
3
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
4
Evidenced Based Successes
-Peer Reviewed Clinical Trials
www.neuromove.com
-Patient Testimonials
-Rehab Hospitals usage protocol
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
6
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
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
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
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
10
Acute Rehab
Out patient Rehab
Home Care Therapy
11
Re Train the Brain Tools
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!
13
What makes a Successful
Brain Relearning Tool?
Patient must be Cognitive
Engages the Brain
Intensive
Concentrated Effort
Frequency
Focused Repetition
14
The Re-learning Tool - NeuroMove
EMG detects targeted neurological
attempts to move the muscle
Utilizing Repetitive attempts and
reward to stimulate Neural re-
mapping
15
Patients can experience
immediate results.
Gives Stroke patients real
hope and motivation
16
Contraindications/Precautions
 Implanted electrical devices
 Cardiologist approval for use with
pacemakers.
 Epilepsy
 Cancer Lesions
 Use on Muscles only
17
In the Kit
Electrode Placement Guide Book
Instructional CD
AC Cord for recharging
3-Packs of 3-Electrodes
Connecting lead wire
Program Manual
11
18
Therapy
Session Set-up
 Attach electrodes muscle
group
 Turn on Unit.
 Set e-stim to visible yet
comfortable contraction
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
20
Ankle Dorsiflexion (Drop Foot)/Flexion
Red
Black
Red
Knee Extension - Front
Red
Red
Black
Red
Red
Black
Shoulder Subluxation/Abduction
Flexible: Use on any
Muscle Group
Refer to the Guide
21
Therapy Session Overview
Cycle of Therapy
RELAX: NM is Setting Threshold
READY: Patient makes ATTEMPT
GOOD: Stimulation or Reward
RELAX: Deliberate rest
22
RELAX
The processor begins to detect EMG and set the
threshold
Threshold is adjusted up or down every 15
seconds Automatically
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
eyes. Engage the brain!
24
Reward
Imagination or attempt “strikes”
the threshold and triggers
physical movement…the reward.
25
Cycle is Repeated
The threshold is re-set every cycle and
moves up or down to continually
challenge or encourage the patient.
26
NeuroMove Therapy Cycle
Hands On!
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
28
Other Applications
Spinal Cord Injury
 *Set SCI Mode
Other Affliction Relief
Erb’s Palsy
Bell’s Palsy
Cerebral Palsy
Multiple Sclerosis
29
Ancillary Benefits of NM
 High Quality NMES
 Programmable Parameters
 Treatment of Muscle Atrophy
& Re-education
 Muscle Spasms
 Pain Relief
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
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)
32
Program Settings
Change Parameters
o Frequency and pulse width, ramp up/off time
o 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)
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
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
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
36
Hands on Therapy Session

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Zmpczm0170001003 ZMPCZM017000.10.03 Neuromove clinical presentation from PainEzee

  • 1. 1
  • 2. 2 What is the NeuroMove? It is an EMG Triggered Neurological Relearning tool for Stroke and other Brain Injury Paralysis Patients
  • 3. 3 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
  • 4. 4 Evidenced Based Successes -Peer Reviewed Clinical Trials www.neuromove.com -Patient Testimonials -Rehab Hospitals usage protocol
  • 5. 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
  • 6. 6 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
  • 7. 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
  • 8. 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
  • 9. 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
  • 10. 10 Acute Rehab Out patient Rehab Home Care Therapy
  • 11. 11 Re Train the Brain Tools
  • 12. 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!
  • 13. 13 What makes a Successful Brain Relearning Tool? Patient must be Cognitive Engages the Brain Intensive Concentrated Effort Frequency Focused Repetition
  • 14. 14 The Re-learning Tool - NeuroMove EMG detects targeted neurological attempts to move the muscle Utilizing Repetitive attempts and reward to stimulate Neural re- mapping
  • 15. 15 Patients can experience immediate results. Gives Stroke patients real hope and motivation
  • 16. 16 Contraindications/Precautions  Implanted electrical devices  Cardiologist approval for use with pacemakers.  Epilepsy  Cancer Lesions  Use on Muscles only
  • 17. 17 In the Kit Electrode Placement Guide Book Instructional CD AC Cord for recharging 3-Packs of 3-Electrodes Connecting lead wire Program Manual 11
  • 18. 18 Therapy Session Set-up  Attach electrodes muscle group  Turn on Unit.  Set e-stim to visible yet comfortable contraction
  • 19. 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
  • 20. 20 Ankle Dorsiflexion (Drop Foot)/Flexion Red Black Red Knee Extension - Front Red Red Black Red Red Black Shoulder Subluxation/Abduction Flexible: Use on any Muscle Group Refer to the Guide
  • 21. 21 Therapy Session Overview Cycle of Therapy RELAX: NM is Setting Threshold READY: Patient makes ATTEMPT GOOD: Stimulation or Reward RELAX: Deliberate rest
  • 22. 22 RELAX The processor begins to detect EMG and set the threshold Threshold is adjusted up or down every 15 seconds Automatically
  • 23. 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 eyes. Engage the brain!
  • 24. 24 Reward Imagination or attempt “strikes” the threshold and triggers physical movement…the reward.
  • 25. 25 Cycle is Repeated The threshold is re-set every cycle and moves up or down to continually challenge or encourage the patient.
  • 27. 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
  • 28. 28 Other Applications Spinal Cord Injury  *Set SCI Mode Other Affliction Relief Erb’s Palsy Bell’s Palsy Cerebral Palsy Multiple Sclerosis
  • 29. 29 Ancillary Benefits of NM  High Quality NMES  Programmable Parameters  Treatment of Muscle Atrophy & Re-education  Muscle Spasms  Pain Relief
  • 30. 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
  • 31. 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)
  • 32. 32 Program Settings Change Parameters o Frequency and pulse width, ramp up/off time o 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)
  • 33. 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
  • 34. 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
  • 35. 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