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Accelerate Outcomes. Exceed Expectations. Buzzer. Buzzer. High Pitch Rewarding Sound. 15. 40. 15. 40. Rubber band twang. Rubber band twang. 0. 200. 100. 200. 100. Left Ear EARLY. Right Ear LATE. 1 second = 1,000 milliseconds. 0 - 15 ms Perfect - PowerPoint PPT Presentation
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Slide Slide 22
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
Slide Slide 33
Interactive Metronome
Assessment & Treatment
Evidence-based Objective Flexible Engaging
Slide Slide 44
IM Equipment
Software Hardware
• Master Control Unit• Hand Trigger• Foot Trigger• Headphones
Optional wireless equipment
• Hand Trigger• Foot Trigger• Gait Switch
Slide Slide 55
IM’s Goals
1) To drive functional neuroplasticity
2) To improve mental/interval timing
3) To improve the brain’s efficiency and performance
Slide Slide 66
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."
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
Slide Slide 99
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
Slide Slide 1010
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
Slide Slide 1111
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
Slide Slide 1212
Stanley I. Greenspan, MD Chairman, IM Scientific Advisory Board
Clinical Professor of Psychiatry, Behavioral Sciences, and Pediatrics at George Washington University Medical School.
Slide Slide 1313
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
Slide Slide 1414
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
Slide Slide 1515
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
Slide Slide 1616
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
9.316
-1
-2-10123456789
10
Control Placebo IM
Stan
dard
Sco
re
Interaction Effect = 0.005
Slide Slide 1717
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
Slide Slide 1818
2.21 GE Gain in Reading Fluency 1.66 GE Gain in Math Fluency
Academic Fluency Study
12.46
10.25
0
1.5
3
4.5
6
7.5
9
10.5
12
13.5
Pre IM Post IM
Gra
de E
quiv
ale
ncy
12.39
10.73
0
1.5
3
4.5
6
7.5
9
10.5
12
13.5
Pre IM Post IMG
rade E
quiv
ale
ncy
2.21 GE gain, n=718, Woodcock Johnson, 3rd Ed. 1.66 GE gain, n=703, Woodcock Johnson, 3rd Ed.
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
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)
Slide Slide 2121
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.”
Slide Slide 2222
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
Slide Slide 2323
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
Slide Slide 2424
Motor StudyThe Journal of General Psychology
20% Overall Gain in Shot Accuracy 35% Increase for advanced golfers who had
consistent swing mechanics
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.
Slide Slide 2626
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
Slide Slide 2727
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
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
“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
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.
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
Slide Slide 3333
Interactive Metronome Today
Currently provided by over 7,500 therapists
In 3,000 hospitals, clinics and universities