TYROSOLUTION DAS VIELSEITIGE KONZEPT FÜR DIE OBERE EXTREMITÄT - in allen Phasen der Rehabilitation!
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
TYROSOLUTION DAS VIELSEITIGE KONZEPT FÜR DIE OBERE EXTREMITÄT … in allen Phasen der Rehabilitation! Süssmed Veranstaltungsreihe 06.06.2018
ÜBERBLICK
Vorstellung
Was ist die Herausforderung?
Welche Lösung bietet Tyromotion
Wie werden die Geräte eingesetzt?
www.tyromotion.com 2
TYROMOTION
www.tyromotion.com 3
TYROMOTION GMBH
2007 gegründet
Einer der weltweit führenden Hersteller von robotik- und
computergestützten Therapiegeräten
Hauptsitz in Graz (>50 Mitarbeiter)
Forschung+Entwicklung+Produktion in Österreich
Weltweites Vertriebsnetz
Endeffektor-Ansatz
www.tyromotion.com 4
NICOLINE KLUPPENEGGER
Bachelor in Ergotherapie (FH Joanneum)
Master in Health Assisting Engineering (FH Campus Wien)
> 7 Jahre Berufserfahrung als Ergotherapeutin
Tyromotion Mai 2017
Clinical Application and Education Specialist
IDPM 2018 – GET BETTER. EVERY DAY. 5
HERAUSFORDERUNGEN IN DER THERAPIE
Stroke
major cause of chronic impaired arm function and may affecting many
activities of daily living
2/3 arm paresis reduced upper extremity function
despite multidisciplinary rehab approach, four out of five patients
leave rehabilitation with restricted arm function
There is still an urgent need for rehabilitation strategies
that match the specific patient needs
Mehrholz et al. 2012
HERAUSFORDERUNGEN IM REHABILITATIONSPROZESS
Nicht genug Personal (1:1)
Unterschiede in der Ausbildung der TherapeutInnen
Kurze effektive Therapiezeit
Aufenthaltsdauer immer kürzer
Rehabilitationsprozess lange und ermüdend
Große Ziele aber nur kleine Verbesserungen
Körperliche und mentale Belastung für TherapeutInnen
www.tyromotion.com 7
TYROTHERAPY – VIELSEITIGE THERAPIE
www.tyromotion.com 8
INDIKATIONEN Sehnenverletzungen
Zerebralparese
Rückenmarksverletzungen
Muskeldystrophien
Multiple Sklerose
Traumatische
Morbus Parkinson
Schulterverletzung
Insult
Amputation Schädel-Hirn-Trauma
Tumor
Künstlicher Gelenksersatz Frakturen
www.tyromotion.com 10
ZIELORIENTIERTE THERAPIE
HAND ARM
Eingeschränkte Greiffunktion Defizite in der Kontrolle der Bewegung
Individuelle Fingerbewegungen Arm heben gegen die Schwerkraft
Greifen und Loslassen Gezielte Bewegungen präsziese ausführen
Spastizität Koordination
Sensibilität Schulterstabilität
Bewegungskontrolle Rumpfstabilität
Präzision
Kraftkontrolle
Bewegungskoordination BALANCE
Reaktion POSTURALE KONTROLLE
RUMPFSTABILITÄT
AUFGABENORIENTIERTE INTERAKTION Gewichtsverlagerung
Motorik und Kognition Gewichtsbelastung
Graphomotorik Symmetrie
Räumlich-visuelle Exploration Stabilität
www.tyromotion.com 11MAX MUSTERMANN
HAND ARM
Eingeschränkte Greiffunktion Defizite in der Kontrolle der Bewegung
Individuelle Fingerbewegungen Arm heben gegen die Schwerkraft
Greifen und Loslassen Gezielte Bewegungen präsziese ausführen
Spastizität Koordination
Sensibilität Schulterstabilität
Bewegungskontrolle Rumpfstabilität
Präzision
Kraftkontrolle
Bewegungskoordination BALANCE
Reaktion POSTURALE KONTROLLE
RUMPFSTABILITÄT
AUFGABENORIENTIERTE INTERAKTION Gewichtsverlagerung
Motorik und Kognition Gewichtsbelastung
Graphomotorik Symmetrie
Räumlich-visuelle Exploration Stabilität
www.tyromotion.com 12www.tyromotion.com 13
AMADEO® ROBOT-ASSISTED HAND THERAPY
Grasping CONVENTIONAL THERAPY
AMADEO® THERAPY - FUNCTIONALITY
Single Fingers
Force • paretic hand after stroke
• no active hand opening
• spasticity
feasible, safe, and effective for patients in all
• easily adjustable for all hand sizes (children & adults) ROM
phases of stroke rehabilitation:
• allows therapy with focus on finger extension acute (Sale et al. 2012, 2014)
sub acute (Orihuela-Espina et al. 2016)
• active, assistive, passive & sensory therapy
chronic (Stein et al. 2011)
Vibration
www.tyromotion.com 14DIEGO® ROBOT-ASSISTED ARM THERAPY
DIEGO® THERAPY - FUNCTIONALITY Arm Weight CONVENTIONAL THERAPY
Support
Assist-as-needed
Compensation or non-use
3D Workspace
• assists physiologic movements in 3D space
• allows focus on impairment & task-oriented therapy
• helps stabilizing the shoulder (& trunk) and allows a
bigger distal challenge Uni- & Bilateral
www.tyromotion.com 16MYRO® MULTISENSORY THERAPY SURFACE
MYRO® THERAPY - FUNCTIONALITY INTERACTION ADJUST THE FOCUS & DIFFICULTY
OF ARM MOVEMENTS
BOARD Lifting
FORCE
push & pull
Transfer
OBJECT TABLE
manipulation
pick & place
Scalable Workspace & Surface angle
• practice conditions that match activities of daily living
• sitting, supported, or standing position
• easy wheelchair access or bedside use
TOUCH
www.tyromotion.com 19TYROS – CROSS SYSTEM SOFTWARE
www.tyromotion.com 21PABLO® - HAND, ARM & TRUNK
Assistance and movement
guidance for weaker patients
with Pablo Sensor Handle Multiball Multiboard Motionsensors
fine motor dexterity gross motor function force control hand positioning reaching trunk
and in everyday life Sensor-based therapy device for the whole body …
www.tyromotion.com 22TYMO® - SUPPORTING & TRUNK CONTROL
Postural control is a prerequisite for any activity Force biofeedback repetitive task training
SUPPORTING
Shoulder stability
SITTING Weight bearing ability
Weight distribution
SIT-TO-STAND Weight-shift training
Weight transfer
STANDING Symmetry
static unstable surface dynamic
www.tyromotion.com 23IMPLEMENTATION TRENDS
Intensive therapy Group therapy
in addition to conventional therapy
increase the intensity, number of movement repetitions, and overall therapy time
technology can support the therapist who is the brain of the operation
www.tyromotion.com 24VIELEN DANK FÜR DIE AUFMERKSAMKEIT
Nicoline.kluppenegger@tyromotion.com
www.tyromotion.com 25REFERENCES
Bishop L, Gordon AM, Kim H. Hand robotic therapy in children with hemiparesis: A pilot study. Am J Phys Med Rehabil. 2017 Jan;96(1):1-7.
Borghese NA, Pirovano M, Lanzi PL, Wüst S, de Bruin ED. Computational intelligence and game design for effective at-home stroke rehabilitation. Games for Health
Journal. 2013 apr; 2(2): 81-88.
Brailescu CM, Scarlet RG, Nica AS, Lascar I. A study regarding results of a rehabilitation program in patients with traumatic lesions of the hand after surgery. Palestrica of
third millennium – Civilization and Sport. 2013; 14(4), 263-270.
Celadon N, Dosen S, Binder I, Ariano P, Farina D. Proportional estimation of finger movements from high-density surface electromyography. J Neuroeng Rehabil. 2016 Aug
4;13(1):73.
Colomer, C., LlorensEmail, R., Noé, E., Alcañiz, M., Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke. Journal of
NeuroEngineering and Rehabilitation ,2016 May 11;13(1):45.
Gharabaghi A, Kaus D, Leão MT, Spüler M, Walter A, Bogdan M, Rosenstiel W, Naros G and Ziemann U. Coupling brain-machine interfaces with cortical stimulation for
brain-state dependent stimulation: enhancing motor cortex excitability for neuro rehabilitation. Frontiers in Human Neuroscience, March2014, Vol.8: Article122.
Hesse S, Heß A, Werner CC, Kabbert N, Buschfort R. Effect on arm function and cost of robot-assisted group therapy in subacute patients with stroke and a moderately to
severely affected arm: a randomized controlled trial. Clin Rehabil 2014; 28(7):637-47.
Hwang CH, Seong JW, Son DS. Individual finger synchronized robot-assisted hand rehabilitation in subacute to chronic stroke: a prospective randomized clinical trial of
efficacy. Clinical Rehabilitation 2012; 26(8), 696-704.
Kwakkel G, Meskers CGM. Effects of robotic therapy of the arm after stroke. Lancet Neurology; Vol 13: Feb 2014.
Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. The Lancet Neurology 2009(8): 741-754.
Lo AC, Guarino PD, Richards LG, et al. Robot-assisted therapy for long-term upper-limb impairment after stroke. N Engl J Med 2011; 365(18):1749.
www.tyromotion.com 26REFERENCES
Mehrholz J, Pohl M, Platz T, Kugler J, Elsner B. Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle
strength after stroke. Cochrane Database of Systematic Reviews 2015, Issue 11.
Nica AS, Brailescu CM, Scarlet RG. Virtual reality as a method for evaluation and therapy after traumatic hand surgery. Stud Health Technol Inform. 2013; 191: 48-52.
Orihuela-Espina F, Femat Roldán G, Sánchez-Villavicencio I, Palafox L, Leder R, Enrique Sucar L, Hernández-Franco J. Robot training for hand motor recovery in subacute
stroke patients: A randomized controlled trial. J Hand Ther. 2016 Jan-Mar; 29(1):51-7.
Pinter, D., Pegritz, S., Pargfrieder, C., Reiter, G., Wurm, W., Gattringer, T., Linderl-Madrutter, R., Neuper, C., Fazekas, F., Grieshofer, P., Enzinger, C. (2013). Exploratory Study
on the Effects of a Robotic Hand Rehabilitation Device on Changes in Grip Strength and Brain Activity after Stroke. Topics in Stroke Rehabilitation, 2013 20, (4). 308-
316.
Platz, T., Roschka, S. (2011). Rehabilitative Therapie bei Armlähmung nach einem Schlaganfall. Patientenversion der Leitlinie der Deutschen Gesellschaft für
Neurorehabilitation. Bad Honnef: Hippocampus.
Royal College of Physicians, Intercollegiate Working Party for Stroke. National clinical guidelines for stroke, 4rd edition. London: Royal College of Physicians, 2012.
Sale, P., Lombardi, V., Franceschini, M. Hand robotics rehabilitation: feasibility and preliminary results of a robotic treatment in patients with hemiparesis. Stroke research
and treatment, 2012, 820931.
Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, Damiani C, Franceschini M. Recovery of hand function with robot-assisted therapy in acute stroke
patients: a randomized-controlled trial. Int J Rehabil Res. 2014 Sep; 37(3):236-42.(2014)
Seitz, RJ., Kammerzell, A., Samartzi, M., Jander, S., Wojtecki, L., Verschure, P., Ram, D. (2014). Monitoring of visuomotor coordination in healthy subjects and patients with
stroke and Parkinson's disease: An application study using the PABLO®-device. International Journal Neurorehabilitation 2014. 1:113.
Speth F. The role of sound in robot-assisted hand function training post-stroke. PhD thesis. July 2016.
www.tyromotion.com 27REFERENCES
Stein J, Bishop L, Helbok R. Robot-assisted exercise for hand weakness after stroke: a pilot study. American Journal of Physical Medicine & Rehabilitation. 2011 Nov;
90(11): 887-894.
VA/DoD Clinical practice guideline for the management of stroke rehabilitation, Department of Veterans Affairs, Department of Defense, The American Heart Association,
American Stroke Association, Version 2.0, 2012
Wagner TH, Lo AC, Peduzzi P, Bravata DM, Huang GD, Krebs HI, et al. An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke.
Stroke 2011; 42:2630–2.
Waller S and Whitall J. Bilateral arm training: Why and who benefits? NeuroRehabilitation. 2008;23(1):29-41.
Wright DL, Shea CH. Cognition and motor skill acquisition: Contextual dependencies. In: Reynolds CR. Cognitive Assessment: A Multidisciplinary Perspective. Boston, MA:
Springer Verlag US; 1994, 89-106.
www.tyromotion.com 28You can also read
