R
Repetitions
Q:
How many repetitions should the patient have completed
by the end of their IM treatment?
A:
We recommend that you do not
base
discharge upon repetitions. Base it upon whether the
patient has achieved functional goals and what you are
observing in the IM sessions.
Research
Q: Where can I find IM research?
A: Visit
www.interactivemetronome.com to see a list of our
published research and research in progress.
Q:
Is all of the IM research funded by IM?
A:
No. All research is not funding by Interactive
Metronome.
Q:
Are IM studies randomized and controlled?
A:
Yes,
most of studies are randomized and controlled.
Q:
How
can we better understand mental timing? Where can I
find references?
A:
Visit the
Provider Login section of the website for
information and links to websites to stay current.
Links include:
Q:
Is there
any
IM research on the adult population?
A: We have many
studies underway for the adult population, including:
- Drexel University:
Durability & Generalization
- University of
Rochester: Visual Attention
- University of
Cincinnati: Hemiplegic Arm
- Medical College of
Georgia: Parkinson's Disease
- Veterans
Administration: Cognitive, Behavioral & Motor Skills
(unimpaired & veterans with blast injuries)
- Walter Reed Army
Medical Center: PTSD, Sleep, Cognition
Research Supporting IM
Q:
IM research aside, is there any other research
supporting the use of IM in rehabilitation?
A:
Yes.
You can download a bibliography of supporting temporal
processing research by visiting
http://www.interactivemetronome.com/IMPublic/Upload
Files/documents/Course_2008_SupportingResearchBibliography.pdf. Contact
Amy Vega, IM Clinical Education Director, for
updates as this bibliography is ever-expanding. To keep
current with information and research on temporal
processing, visit Dr. Kevin McGrew’s
Tick
Tock Brain Talk blogspot. He regularly posts new
research to this site and it’s cousin
The Brain Clock Evolving Web of Knowledge.
S
Marketing
Schizophrenia
Q:
What is the effect of IM on schizophrenia? Is there any
research to support this?
A:
Mental timing (AKA temporal processing) has been
identified as deficient in certain populations,
including those individuals with ADD/ADHD, Parkinson's,
Tourette's, Huntington's, Dyslexia, and Schizophrenia.
We have heard a couple of IM providers express interest
in trying it with this population. At this point, we
don’t have any further information on IM's affect on
schizophrenia.
Schools
Q:
Is IM used in the schools? How do you fit it in around
core curriculum?
A:
There are many private and public schools around the
U.S. that are using IM to help struggling students
and/or boost reading and math achievement scores. A
recent pilot study in an Arkansas elementary school
showed that just 15 minutes of IM 3 times per week with
mostly hands-on assistance and modeling, resulted in
statistically significant gains in sensory modulation,
phonological awareness and processing, social skills,
reading, language, and visual-motor integration. The
providers presented the outcomes of their pilot study at
the 2007 IM Professional Conf.
Contact
Amy Vega, IM Clinical Education Director, for
resources regarding fitting IM into core curriculum.
Score (ms) For Discharge
Q:
How do you know when to discharge from IM? Should a
patient reach a certain score on all tasks?
A:
When working with a patient attempt to get ms scores as
low as possible by adjusting IM settings and cues
provided, but keep your focus always on function. Some
patients make significant gains in daily function
despite the fact that their ms scores are still poor.
Do
not discharge based upon a score, rather look to see if
you can make the IM settings more challenging to improve
motor, processing, and/or cognitive skills further.
Seizure
Q:
Are there any
seizure precautions that I should be aware of?
A:
Seizures can be triggered by auditory, vestibular,
and/or visual stimulation, as well as stress and
fatigue. If seizures are well-controlled with
medication, there should not be a problem. If the
patient is at risk for seizures, monitor for signs of
seizure activity throughout session and once home. If
any concerns, consult with patient’s physician.
Sensory Processing Disorder
Q:
Has there been any research about the effect of IM on
sensory processing/integration?
A: No,
there has not been any research on sensory
processing/integration
at this time. There are a couple of published temporal
processing (AKA mental timing) research articles that
help explain the relationship between our internal
mental clock and symptoms associated with sensory
processing, including: The Neural Basis for Temporal
Processing (Mauk & Buonomano, 2004) &
Decision-Making, Impulsivity, & Time Perception (Wittman
& Paulus, 2007). IM is widely used for this clinical
application with significant treatment outcomes. In this
and many other clinical arenas, the clinical application
of IM has outpaced research.
Session
Wizard - Auto Train
Q:
What is the Session Wizard?
A:
The Session Wizard allows
you to design and pre-determined IM treatment plans.
This allows you to use Auto Train, in which the patient
does a preset training program and receives visual
fireworks if performance criteria are met. While the
fireworks are nice, IM treatment is most successful if
implemented in a flexible and dynamic way so that each
time the patient performs a task you assess how he is
doing and make adjustments along the way to make the
program easier or more challenging.
Sleep
Q:
What is IM's effect
on sleep?
A: Currently there is no published research on
the effect on IM on sleep. However, sleep outcomes are
being researched in the study currently underway at
Walter Reed Army Medical Center.
T
Tempo
Q:
Why is 54 tempo the default?
A:
The
inventor was an acoustical engineer who worked with
professional musicians. He purposely selected a tempo
slower than the quarter beat (which is around 60) so
that the task would not be automatic and the musicians
would have to focus more on what they were doing.
Tourette's
Q:
Is IM used with patients suffering from Tourettes?
A:
Yes,
IM has been used on patients suffering from Tourette's.
An IM provider who also suffers from Tourette's was the
first to undergo IM treatment for cognitive and motor
issues associated with this diagnosis. He reported
significant improvement including 85% reduction in tics,
improved haptic closure, etc. He now uses IM with other
Tourette's sufferers and reports similar outcomes. To
learn more about the application of IM to the Tourette's
population and his own personal story, visit
www.mcnattlearningcenter.com.
Triggers
Q:
How many triggers can be used at once?
A:
You
can use as many hand and foot triggers as you desire
with IM by using splitters. Please note IM does not come
with splitters, but they can be purchased at stores like
Radio Shack for as little as $5.00. See
best practice photos for ideas on how to use
multiple triggers.
However, as far as
wireless triggers are concerned, they work best if you
only use one hand and one foot trigger during same task
due to this type of technology. Certain patients may
have difficulty holding one extremity still while the
other one moves, moving the extremity will cause a hit
to be registered.
Q:
What is the advantage
of using a wireless trigger?
A:
The advantage
of wireless is that you don’t have wires to get tangled,
kids playing with the wires, or individuals who are
hypersensitive to light touch having the wires brushing
against their skin.
Q:
Can
you use other types of triggers with IM?
A:
Yes. Any switch can be used with IM. Some providers have
used IM to train patients to activate wheelchair,
augmentative/alternative communication, and
environmental control devices.
V
Visual Attention & Processing
Q:
Can IM improve visual attention/processing? Is there any
IM research in this area?
A:
Yes,
IM can improve visual attention/processing. However,
some patients may require a forced-use approach whereby
you turn off the IM sounds altogether (by unplugging the
headphones), turn on the visual mode with the center
flash, then use the visual metronome stimulus and visual
feedback to stay on the beat. This approach was
developed by Amy Vega, a speech pathologist who
specialized in working with adolescents and adults with
TBI, stroke, and other neurological impairments. She has
presented nationally on this subject and has shared her
approach with other IM providers around the globe. She
is now the Clinical Education Director for IM and can be
contacted for more information, including a treatment
hierarchy and supplemental visual stimuli to use with IM
to improve visual memory, visual scanning, executive
functions, etc. Her email address is
avega@interactivemetronome.com
Volume (dB)
Q:
How
loud are the sounds coming from the headphones (in
decibels [dB])?
A:
If
the Master Volume is raised to full (27),
volume from headphones is 98 decibels. There should be
no need to raise it that loud for anyone.
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