Q: Can IM be used with extremely low-functioning patients?

A: Yes, in cases like theses hands-on assistance can be provided. Hands-on assistance is provided and may be required throughout the entire IM treatment program. A near drowning victim was confined to a wheelchair with spasticity and paralysis. He could not access the head switch to navigate wheelchair or access his alternative communication device. The patient performed IM with hands-on assist. At first 50 beats go by before the patient could hit the trigger, now he is down to 15 beats between hits. The patient improved from doing nothing to navigating his own wheelchair with the head switch, using alternative communication device and doing calculus in an on-line program/ He has won a Chair Scholarship to University of Florida. See also Minimally conscious patients.

M

Marketing

Q: Can you suggest any marketing strategies?

A: Some marketing strategies include:

1. Being listed on the IM Locator Board. Note: You must own or rent the equipment to be listed. You can update your Locator Information by visiting the Provider Login section of the website, Scroll down the Login Home Page and click on the link that says: "Click Here to Update your IM Treatment Types Offered "
2. Distributing IM brochures to potential clients. These can be purchased through IM Corp.
3. Creating Advertisements for local publications. Access the IM logo and sample Ads on the Provider Login.
4. Getting media coverage (live & print) from local sources. Visit Provider Login for Templates.
5. Conduct a "Lunch & Learn" to educate the community about your services. Target parents, physician groups and support groups (Stroke, TBI, Autism, etc) to attend.
6. Create your own website. You can use Google to find examples of providers who use and advertise their IM services.

Metronome

Q: Can you get same outcomes with a standard metronome?

A: A standard metronome may encourage rhythmic movement, but does not provide feedback for timing. When patients receive sensory feedback, they stay engaged longer, try harder and are encouraged to perform better. As their timing improves, a variety of neurological domains are affected. These include sensory, motor, cognitive, language, and social. IM provides feedback to improve timing and rhythm.

Military Veterans

Q: Is IM used within the Military or with Veterans?

A: IM is in use today in the US Army and in selected VA Hospitals to treat soldiers with amputations and blast injuries. In addition, the Army and the VA are currently conducting IM research with their patients.

Minimally conscious patients

Q: Can IM be used with minimally conscious patients? Does it help?

A: Yes, IM can be used with minimally conscious patients. For example, an OT used IM with a patient 8 months into a minimally conscious state with dramatic outcomes. Her patient is now in a rehab center, awake, doing ADLs, and participating in various therapies. She attributes her success to the Interactive Metronome.

Music & dance training

Q: Can IM be used in conjunction with music & dance instruction?

A: Yes, IM was originally invented for use with professional recording artists and used successfully with them.

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Norms

Q: Are there norms for the elderly population?

A: The IM Indicator Table shows norms from age 6 – 60+.  IM is currently in the process of collecting data on elderly adults in conjunction with LifeCare Centers of America, who use the Interactive Metronome.

Q: What scores can be compared to the Indicator Table? How were IM norms obtained?

A: IM norms are based upon the Adjusted Average for the LFA. These scores represent exceptional, average, and deviant ranges of timing. We’ve learned through clinical research and clinical application, that every movement and thought is governed by mental timing. Theoretically, no matter what the task is, the patient’s timing should fall within the normal range for his/her age.  Whether you are tapping your hand on your leg or whether you are tapping your hand on a wall, the timing of your taps should fall within the normal range for your age. So, you can compare timing performance of IM treatment tasks (1-13) or ones you create on your own to the Indicator Table. These norms were obtained by normal subjects, ages 6 – 60+, who performed the LFA.

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Protocols

Q: Are there any protocols to follow?

A: IM is a treatment tool that must be individualized for each patient to achieve optimal outcomes. Protocols can be helpful in some instances if used in a flexible manner or if they follow a decision-tree format. At this time, IM is not developed any protocols, just sample treatment plans (12 Session Plan, 15 Session Plan.

Q: What are the 12-15 session IM treatment protocols? Are they still used?

A: The 12-15 session protocols are actually just sample treatment plans.  They include a disclaimer that states:

"Please note this treatment plan is an example and not intended for use as a protocol. In addition, all exercises are modifiable to meet individual patient needs. For more insight into modifying IM treatment plans, visit the “Best Practices” Section of the Provider only website."

As a practical matter, IM is a treatment tool, not the treatment per se. You should always assess/monitor your patient’s response to the IM task and settings to see if they need further adjustment or are facilitating progress. The six phases of IM treatment are not new. They were included in each rendition of the IM certification manual. We are now emphasizing the 6 treatment phases instead of the sample treatment plans because treatment outcomes are more favorable with an individualized approach.

Provider milliseconds (ms) scores

Q: What should the providers ms scores be before using with patients?

A: As low as possible, 20 ms range is ideal.
 

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