Provider & Clinician eNews
August 20
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The Education Section

 

 

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IM Contact Information

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In this eNews:
  • New Adult Best Practice Cognitive & Motor Skills Self-Study Courses Available
  • Research News: Music Therapy Shows Potential in Stroke Rehab
  • Three-dimensional motion analysis of the effects of auditory cueing on gait pattern in patients with Parkinson’s disease: a preliminary investigation
  • Upcoming Live Courses- last month to get courses at $175 before the course cost goes up

New Adult Best Practice Cognitive & Motor Skills Self-Study Courses Available Now!

IM Adult Rehabilitation Best Practices: Cognitive Skills
Although adolescent/adult patients benefit greatly from auditory and auditory-visual IM, some continue to demonstrate deficits in visual processing, attention, and executive functions. This was the observation of a Speech-Language Pathologist (SLP) at a Level II Trauma hospital in St. Petersburg, Florida. In order to help these patients achieve further recovery, she developed several IM best practices that proved to be extremely beneficial to her patients. Spurred on by the treatment outcomes achieved by this SLP, other clinicians in her field developed and implemented additional best practices for the treatment of language processing and executive functions.

Across the U.S. in Arizona, another SLP reported integrating treatment tasks for Aphasia and Apraxia of Speech with IM, improving treatment outcomes for communication and language. This clinician has since developed best practices for using IM in skilled nursing facilities and with patients who suffer from dementia. This course contains helpful assessment and treatment strategies for the treatment of cognitive-communicative deficits in neurologically impaired adolescents/adults. Where applicable, specific treatment tasks, stimuli, and hierarchy are described in detail.

Course Meets Requirements for:

  • 4.0 Contact Hours ASHA &.AOTA

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IM Adult Rehabilitation Best Practices: Cognitive Skills
Interactive Metronome (IM) is a performance-based feedback system that was initially developed as a tool to facilitate learning, sensory processing and attention in children. Early on, researchers and clinicians realized the potential of IM to also facilitate learning and neuro-muscular control in adults, especially for patients suffering from neurological conditions. The “Golf Study” performed by Terry M. Libkuman and Hajime Otani was the first study performed on adults which showed that IM was appropriate for this age group and possibly for persons suffering from orthopedic conditions. This study showed that IM improved the shot accuracy of golfers up to 35% by improving core skills. The case of Brenda Canup is a prime example of IM’s potential place in orthopedic rehabilitation. Mrs. Canup opted for a below-the-knee amputation after struggling with a foot deformity all of her life. After surgery, she became frustrated with her lack of progress and was still ambulating with a walker. Later in her treatment, after she’d lost virtually all hope of ever ambulating with her new prosthetic limb, she started the IM program and was finally ably to make a full recovery and run the Disney Marathon. After further reports of good treatment outcomes with IM in this age group, clinician’s began to incorporate IM more and more into treatment of the adult ortho and neuro patient. IM is now a standard of care in many adult outpatient clinics, rehabilitation hospitals, nursing homes, assisted living centers, home health agencies and acute hospital settings.

Until now clinicians have adapted IM technology for adult patients based upon knowledge, research and evidence- based practices employed in the pediatric populations. It has therefore become clear that there is a need in the Interactive Metronome (IM) community to develop “Best Practice Guidelines” to provide the clinician with proven techniques that will enhance their clinical practice and understanding IM as a tool for adult rehabilitation.

This course is therefore designed to provide the certified IM user with advanced practice guidelines and techniques for the adult patient based on sound evidence and the clinical skills of advanced IM practitioners. The material for the manual is therefore provided by clinical experts their respective fields and the information will be organized into area of the body and specific diagnosis.

Course Meets Requirements for:
  • 9.0 Contact Hours OT/COTA (AOTA) = 0.9 CEUs

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Research News

Music Therapy Shows Potential in Stroke Rehab

Music therapy provided by trained music therapists may help to improve movement in stroke patients, according to a new Cochrane Systematic Review. A few small trials also suggest a wider role for music in recovery from brain injury.

Music therapists are trained in techniques that stimulate brain functions and aim to improve outcomes for patients. One common technique is rhythmic auditory stimulation (RAS), which relies on the connections between rhythm and movement. Music of a particular tempo is used to stimulate movement in the patient.

The review included seven small studies, which together involved 184 people. Four focused specifically on stroke patients, with three of these using RAS as the treatment technique. RAS therapy improved walking speed by an average of 14 meters per minute compared to standard movement therapy, and helped patients take longer steps. In one trial, RAS also improved arm movements, as measured by elbow extension angle.

“This review shows encouraging results for the effects of music therapy in stroke patients,” said lead researcher Joke Bradt, PhD, MT-BC, LCAT, of the Arts and Quality of Life Research Center at Temple University, Philadelphia. “As most of the studies we looked at used rhythm-based methods, we suggest that rhythm may be a primary factor in music therapy approaches to treating stroke.”

Other music therapy techniques, including listening to live and recorded music, were employed to try to improve speech, behaviour and pain in patients with brain injuries, and although outcomes in some cases were positive, evidence was limited.

“Several trials that we identified had less than 20 participants,” Bradt said. “It is expected that larger samples sizes will be used in future studies to enable sound recommendations for clinical practice.”

Three-dimensional motion analysis of the effects of auditory cueing on gait pattern in patients with Parkinson’s disease: a preliminary investigation
 

Journal

Neurological Sciences

Publisher

Springer Milan

ISSN

1590-1874 (Print) 1590-3478 (Online)

Issue

Volume 31, Number 4 / August, 2010

Category

Original Article

DOI

10.1007/s10072-010-0228-2

Pages

423-430

Subject Collection

Medicine

SpringerLink Date

Thursday, February 25, 2010

Alessandro Picelli1, 2, Maruo Camin1, 2, Michele Tinazzi2, 3, Antonella Vangelista2, 4, Alessandro Cosentino4, Antonio Fiaschi2, 5 and Nicola Smania1, 2, 6 

  1. Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Via L.A. Scuro, 10, 37134 Verona, Italy

  2. Department of Neurological and Visual Sciences, University of Verona, Verona, Italy

  3. Neurology Unit, “Maggiore” Hospital, Verona, Italy

  4. Rehabilitation Unit “C. Santi”, Polyfunctional Centre Don Calabria, Verona, Italy

  5. IRCCS, S. Camillo, Venice, Italy

  6. Rehabilitation Unit, “G.B. Rossi” University Hospital, Verona, Italy

Received: 10 August 2009  Accepted:20 January 2010  Published online: 25 February 2010

Abstract  
Auditory cueing enhances gait in parkinsonian patients. Our aim was to evaluate its effects on spatiotemporal (stride length, stride time, cadence, gait speed, single and double support duration) kinematic (range of amplitude of the hip, knee and ankle joint angles registered in the sagittal plane) and kinetic (maximal values of the hip and ankle joint power) gait parameters using three-dimensional motion analysis. Eight parkinsonian patients performed 12 walking tests: 3 repetitions of 4 conditions (normal walking, 90, 100, and 110% of the mean cadence at preferred pace cued walking). Subjects were asked to uniform their cadence to the cueing rhythm. In the presence of auditory cues stride length, cadence, gait speed and ratio single/double support duration increased. Range of motion of the ankle joint decreased and the maximal values within the pull-off phase of the hip joint power increased. Thus, auditory cues could improve gait modifying motor strategy in parkinsonian patients.
 

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