Slide 1 Accelerate Outcomes. Exceed Expectations..

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Slide Slide 1 Accelerate Outcomes. Exceed Expectations.

Transcript of Slide 1 Accelerate Outcomes. Exceed Expectations..

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Accelerate Outcomes.Exceed Expectations.

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Buzzer

Rubber band twang

Rubber

band

twangBuzzer

High Pitch Rewarding

Sound

1 second = 1,000 milliseconds

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40 15

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Left Ear Left Ear EARLYEARLY

Right EarRight EarLATELATE

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Interactive Metronome

Assessment & Treatment

Evidence-based Objective Flexible Engaging

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IM Equipment

Software Hardware

• Master Control Unit• Hand Trigger• Foot Trigger• Headphones

Optional wireless equipment

• Hand Trigger• Foot Trigger• Gait Switch

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IM’s Goals

1) To drive functional neuroplasticity

2) To improve mental/interval timing

3) To improve the brain’s efficiency and performance

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Randolph J. Nudo, Ph.D.Director, Landon Center on Aging

Professor, Department of Molecular and Integrative PhysiologyUniversity of Kansas Medical Center

Kansas City, KS

"Synchronous activity drives dendritic growth." 

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To improve mental/interval timing

IM…

IM…

Based upon Scalar Timing Theory

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IM Impacts Mental/Interval Timing Structures of the Brain

The Brain

Dorso LateralPre-Frontal Cortex

•Timing

•Motor Planning

•Speech

Basal Ganglia

•Timing

•Voluntary Motor

•Coordination

Cingulate Gyrus

•Timing

•Executive

Functioning

•Modulate Emotions

Cerebellum

•Timing•Sense of

Body Position•Production of

Speech

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Hemiplegia Study Thaut et al. (2002): Published in Neuropsychologia

Investigated effect of rhythm on control of paretic arm movements

"the observed changes in timing and trajectory control strongly suggest that the structured time information in auditory rhythm added significant kinematic stability to the patient’s paretic arm reaching motions. These changes were not present during the non-rhythmic condition...Our data suggest, therefore, that auditory rhythm may offer an essential component of enhanced sensorimotor control to make hemiparetic arm training more effective."

21 hemispheric stroke patients

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To improve the brain’s efficiency and performance

By improving: Auditory Processing Short Term Memory Working Memory Processing Speed Cognitive Resources Executive Functions Motor Coordination Sensory Processing

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IM Research

First private research (1994) Autistic children Showed fine/gross/visual-motor improvements in

coordination Published in academic circles IM came to attention of Stanley Greenspan, MD

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Stanley I. Greenspan, MD Chairman, IM Scientific Advisory Board

Clinical Professor of Psychiatry, Behavioral Sciences, and Pediatrics at George Washington University Medical School.

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Academic Correlation StudyTiming in Child Development.

High/Scope Educational Research Foundation

Kuhlman, K. & Schweinhart, L.J. (1999) 585 students Significant correlation between IM timing and

academic performance Reading, Mathematics Oral/written language Writing Attention Motor coordination and performance

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ADHD StudyEffect of Interactive Metronome Training on Children with ADHD.

The American Journal Of Occupational Therapy

Schaffer et al., (2001) 56 boys, age 9-12 15 sessions 3 Groups

Treatment, Video Game (Placebo) Control

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ADHD StudyEffect of Interactive Metronome Training on Children with ADHD.

The American Journal Of Occupational Therapy

Statistically significant improvement: Attention Motor control and

coordination Processing speed Language processing Reading Consistency of responses Decrease in aggressive

behavior

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ADHD StudyEffect of Interactive Metronome Training on Children with ADHD.

The American Journal Of Occupational Therapy

Language Processing Test Pre and Post Test Differences

2.666

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Interaction Effect = 0.005

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Academic Fluency Study

Jacokes (2004) 1500 middle and high school students 20 different schools Completed 12 sessions of IM Participated in pre & post-testing via WJ-III

Reading fluency Math fluency

significant increase in grade equivalent performance

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2.21 GE Gain in Reading Fluency 1.66 GE Gain in Math Fluency

Academic Fluency Study

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2.21 GE gain, n=718, Woodcock Johnson, 3rd Ed. 1.66 GE gain, n=703, Woodcock Johnson, 3rd Ed.

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Harvard Learning & The BrainPresented by Taub, McGrew & Keith (2005)

Study 1 Flanagan High School 283 9th grade students

Control grp 151 Experimental grp 132

Pre/post testing: WJIII reading & math achievement tests

Study 2 Nap Ford Elementary

School Title 1 school 86 students

Control grp 37 Experimental grp 49

Pre/post testing: WJ III & more detailed battery to examine pre-literacy skills

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Blue = high school Black = elementary school

IM Performance 48 %

•CTOPP Letter Naming (RAN) 20 % •TOWRE (sight word efficiency) 18 %•National Reading Panel 15%

•WJ III Math Calculation 12 %•WJ III Math Fluency 10 %•WJ III Pair Cancellation (attn/conc) 10 %

•WJ III Reading Fluency 07 %•WJ III Math Calculation 07 %•WJ III Math Fluency 07 %•WJ III Broad Reading 07 %•WJ III Math Calculation 07 %

Primarily elementary

All secondary

Dependent variable %

Harvard Learning & The BrainPresented by Taub, McGrew & Keith (2005)

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Neuro-imaging StudyPresented at 65th Annual American PM&R Conference

MEDIAL BRAINSTEM

Neuro-Motor Pipeline

BASAL GANGLIA

Integrates Thought and Movement

CINGULATE GYRUS

Allows Shifting of Attention

Cognitive Flexibility

Alpiner (2004). Results from this pilot fMRI study show IM directly activates multiple

parts of the “neuro-network.”

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Parkinson’s StudyPending Publication in Neurology

“In this controlled study computer directed rhythmic movement training was found to improve the motor signs of parkinsonism.”

- Daniel Togasaki, MD, Parkinson’s Institute

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Motor StudyThe Journal of General Psychology

Comparison of IM- trained golfers to a control group

Pre/post tested on computerized driving range

Significant improvements in golf shot accuracy

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Motor StudyThe Journal of General Psychology

20% Overall Gain in Shot Accuracy 35% Increase for advanced golfers who had

consistent swing mechanics

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Auditory Processing Pilot StudyEtra (2006)

Applied Dissertation, Nova Southeastern University

8 children, 15 hours of IM training

SCAN-C 1. Filtered Words2. Auditory Figure-Ground3. Competing Words (dichotic listening)

4. Competing Sentences (dichotic listening)

Statistically significant gains All subtests Greatest Gains subtests 3 & 4

Strongly suggests IM affects auditory processing disorders by influencing neurological organization.

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Ongoing Research

Drexel University: Durability & GeneralizationUniversity of Rochester: Visual AttentionUniversity of Cincinnati: Hemiplegic ArmEast Carolina University: CVA Veterans Administration: Cognitive, Behavioral & Motor Skills

(normals & veterans with blast injuries)Walter Reed Army Medical Center: PTSD, Sleep, Cognition

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Buzzer

Rubber band twang

Rubber

band

twangBuzzer

High Pitch Rewarding

Sound

1 second = 1,000 milliseconds

200 100

40 15

0

15 40

100 200

0 - 15 ms Perfect16 - 40 ms Above Average41 - 100 ms Average

Left Ear Left Ear EARLYEARLY

Right EarRight EarLATELATE

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Analysis

What we seePatient exercises four neurological functions

at once: Attention & Concentration Sensory Integration Functional Motor Control Synchronization

“What is fired together is wired together”…Neuroplasticity

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IM GAIT MATE

http://www.interactivemetronome.com/IMPublic/GaitMate.aspx

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“Pre-gait” skills are important Weight shifting Unilateral stance Limb Advancement

BUT The only true way to practice walking is to

WALK.

IM GAIT MATE

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IM GAIT MATE

IM Gait Mate is an extension of IM Expands IM's capabilities:

• Allows the patient to move freely AND receive continuous feedback during gait exercises.

Feedback will help the patient develop a symmetrical gait pattern.

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IM-HOMETherapy Extension

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Continuing EducationLive Certification Courses

$15 off cost of course if you register within a week of this webinar. Contact Sales Representative.

Self-Study Certification Courses

Advanced Live CoursesAdvanced Self-Study CoursesWebinars- Introductory &

Advanced Levels

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Interactive Metronome Today

Currently provided by over 7,500 therapists

In 3,000 hospitals, clinics and universities

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QuestionsKelli Crovo

(954) 385-4660 x240

[email protected]

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