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HandTutor for hand rehabilitation

Source agency:

NHSC

Date of Submission:

05/11/2009

Date of Printing:

05/02/2012

Disclaimer:

This report is work in progress and should not be used for external distribution without permission from the originating agency. Users should be aware that reports are based on information available at the time of research and often on a limited literature search.

Technology, Company & Licensing

Technology name:

HandTutor

Technology - description:

The HandTutor is a novel system designed to evaluate and support the rehabilitation of sensory, motor and cognitive hand impairments. The system is composed of a glove worn by the patient that acts like a computer mouse, and the MediTutor support software. A disposable glove is used inside the HandTutor system to reduce the risk of cross-infection.

HandTutor is designed to be used by therapists including occupational therapists (OT) and physical therapists (PT) to provide intensive active hand exercises with visual and auditory patient and therapist feedback. HandTutor can also evaluate passive and active range of motion, velocity of finger movements, as well as characterisation of the quality of movements and fine motor skills. The information gained can be used to quantify patient performance, determine therapy goals and monitor patient progress. HandTutor can be used by patients in their own home.

Company or developer:

 

Reason for database entry:

The HandTutor system would supplement current therapy options and may enable the physiotherapist to tailor a patient’s treatment more closely to their specific needs. The system also enables monitoring of patient progress.

Technology - stage in early warning process:

Assessment complete

Technology - stage of development:

Investigational - phase III

Licensing, reimbursement and other approval:

 

Technology - type(s):

Drug

Technology - use(s):

Therapeutic

Patient Indication & Setting

Patient indications:

Hand dysfunction due to underlying neurological conditions e.g. cerebral palsy, stroke, multiple sclerosis (MS), traumatic brain injury, movement disorders, nerve injury and post hand surgery.

Disease description and associated mortality and morbidity:

It is difficult to estimate the exact number of patients who could be suitable for, or benefit from HandTutor. In the UK stroke affects between 174 and 216 people per 100,000 of the population each year (1). This equates to between 94,000 and 117,000 people in England and Wales (2). The annual incidence of MS is 3.5 to 6.6 people per 100,000 population, equivalent to around 1,800 to 3,400 people each year in England and Wales (3). Prevalence is between 100 to 120 per 100,000 population, equivalent to about 52,000 to 62,000 people with MS in total in England and Wales3. It is difficult to estimate how many of these patients would benefit from the use of HandTutor to help with their rehabilitation.

Number of Patients:

 

Technology - specialities(s):

None

Technology - setting(s):

None

Setting - further information:

 

Impact

Alternative and/or complementary technology:

 

Current Technology:

Physiotherapy and occupational therapy aim to restore movement and function to as near normal as possible, and to support people to become as independent as possible in their activities of daily living. Activities include designing and supporting exercise training and conditioning programmes, using treatments such as electrotherapy, advising on equipment, and sensory re-education.

Health Impact:

 

Diffusion:

 

Cost, infrastructure and economic consequences:

 

Ethical, social, legal, political and cultural impact:

 

Evidence & Policy

Clinical evidence and safety:

Trial: Stroke rehabilitation, HandTutor vs standard treatment.
Sponsor: MediTouch.
Status: Published (4).
Source of information: Abstract .
Location: Israel.
Design: Controlled study, age matched controls.
Participants and schedule: n=31; adults; age 65 +/-7 years; 10-70 days post cerebral vascular accident (stroke).
Allocated to HandTutor plus standard treatment or standard therapy for 15 sessions of about 30 minutes each; 5 sessions a week.
Follow-up: After 15 sessions.
Primary outcomes: Box and Block dexterity test (B&B)(a) and Fugal-Meyer (FM)(b).
Secondary outcome: Performance accuracy.
Key results: Significant improvement in B&B (p=0.015), FM (p=0.041) and performance accuracy on both x and y axes (p<0.001) between the treatment group and the control group.
Expected reporting date : Not known.
Adverse effects (AEs): None reported.

A: A performance based test to investigate unilateral gross manual dexterity.
b: An assessment of motor recovery after a stroke.

Economic evaluation:

 

Ongoing research:

 

Ongoing or planned HTA:

 

Web link:

http://www.nhsc-healthhorizons.org.uk/outputs/specialties/

References and sources:

1: National Institute for Health and Clinical Excellence. The management of atrial fibrillation. Clinical guideline CG36. London: NICE; June 2006.

2: National Collaborating Centre for Chronic Conditions (NCC-CC) at the Royal College of Physicians. Multiple Sclerosis: National clinical guideline for diagnosis and management in primary and secondary care. August 2004.

3: National Institute for Health and Clinical Excellence. The management of multiple sclerosis in primary and secondary care. Clinical guideline CG08. London: NICE; November 2003.

4: Eli E, Sara P, Gadi B et al. HandTutor-Enhanced stroke rehabilition. 59th Annual conference of the Israeli.
Association of Physical Medicine and Rehabilitation. Oral presentation. http://translate.google.co.uk/translate?hl=en&sl=iw&u=http://www.medrehab.org.il/&ei=-LzNSsOXF4eTjAfigaXwBw&sa=X&oi=translate&resnum=5&ct=result&prev=/search%3Fq%3DIsraeli%2Bassociation%2Bof%2Bphysical%2Bmedicine%2Band%2Brehabilitation%26hl%3Den Accessed on 23rd September 2009.

Notes: