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
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
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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 Standards
Conformité Européene - CE
-Approved for – Stroke Recovery
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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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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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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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In the Kit
Electrode Placement Guide Book
Instructional CD
AC Cord for recharging
3-Packs of 3-Electrodes
Connecting lead wire
Program Manual
11
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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
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
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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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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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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 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)
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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