Our Products

Supporting Research

Here is a review of the literature that supports the efficacy of the Core:Tx ® treatment method.

 

Overall Efficacy

Core Belief: Core:Tx’s effectiveness is it’s ability to engage and facilitate therapeutic benefit in a game-like environment. This game-like environment engages and motivates the patient. At the same time, a patient’s skills are developed and reinforced on an automatic level.

Supporting Research: “The patients exhibited increases in practice volume and attention span during training with the game-based tool. In addition, they demonstrated substantial improvements in dynamic balance control. These observations indicate that a video game-based exercise approach can have a substantial positive effect by improving dynamic short-sitting balance” (Betker AL, Desai A, Nett C, Kapadia N, Szturn T, 20071)

Core Belief: The patient’s active participation will improve his or her scores and thus performance.

Supporting Research: “Equally important to the dose of practice is the need for ‘active participation’ regardless of how the practice and use is promoted.” “Active participation is fundamental to skill acquisition” (Winstein C, Wing AM, Whitall J2)

Back To Top

 

Neuroplasticity

Neuroplasticity refers to the changes that occur in the organization of the brain as a result of experience and activity. Researchers have found that neuroplasticity can be facilitated through various techniques.

Core Belief: It has been found that skilled or problem-solving activities, like those involved in the Core:Tx therapy system, are more effective that simply performing exercises.

Supporting Research: “These results indicate that representational map plasticity is driven by skill acquisition, learning, or practice of a newly acquired action, but not by simple repetitive motor activity” (Butler and Wolf, 200714; Plautz, et al, 20006; Classen, et al, 19987)

Core Belief: The Core:Tx uses visual information to provide the patient with information about his or her performance. The use of visual feedback for skill acquisition in stroke patients has also been shown to be effective.

Supporting Research: “These findings indicate that the visual feedback approach alone can effect improvement but visual feedback together with mental practice produces further positive effect on improving and maintaining a symmetrical stance posture in people with hemiparetic stroke” (Yoo and Chung; 20068)

Core Belief: The Core:Tx allows the patient to perform simple functional or synergic motor patterns, either by selecting the appropriate joint and movement or combination of movements that allow the patient to get performance based feedback throughout a synergic pattern or component of a functional task.

Supporting Research: “The idea is to simplify control by combining a small number of primitives, for example, patterns of muscle activations (synergies), in certain pre-specified proportions rather than individually controlling each muscle” (Wolpert D, Ghahramani Z and Flanagan J9).

Core Belief: The Core:Tx ® uses visual and auditory input to facilitate proprioceptive learning - a clear challenge for stroke patients.

Supporting Research: “Results indicate that the deficits that individuals with stroke experience when adapting their movements to changed load conditions may be due to difficulty in rapidly integrating visual and proprioceptive information.” (Dancause N, Ptito A, Levin MF, 200210)

Back To Top

 

Motor Learning

Core Belief: By providing feedback, the Core:Tx ® has the potential to facilitate proprioceptive ability and thus motor learning.

Supporting Research: “Registration improves movement accuracy when veridical visual feedback is provided but is not invoked when hand-path errors are eliminated1” (Scheidt RA, Conditt MD, Secco EL and Mussa-Ivaldi11)

Core Belief: It’s not enough to perform performance-based feedback. The Core:Tx ® game-like format provides an environment where visual, auditory and proprioceptive feedback can be practiced.

Supporting Research: “Feedback, along with practice, is considered to be a potent variable affecting motor skill learning.” (VanDijk, et al, 200512)

Core Belief: In addition, it has been shown that sensory-motor modalities have an effect on motor working memory. Motor working memory is an important component of motor planning and the development of new skills.

Supporting Research: “Experiments have shown that subjects are able to learn visuomotor motor and dynamic transformations independently when presented in parallel. Thus, sensory-motor modality might be an important factor influencing the organization of motor working memory” (Wolpert D, Ghahramani Z and Flanagan J9).

Core Belief: By addressing the neuro-muscular component of motor learning, the Core:Tx ® has a direct impact on nerve-muscle training and communication facilitation. As a result, of improved coordination through performance based feedback motor control training through practice and skill simulation can be achieved.

By improving proprioception and motor control, the Core:Tx ® has the potential to improve muscular balance and joint stability.

Supporting Research: “The sensorimotor system encompasses all of the sensory, motor, and central integration and processing components involved with maintaining joint homeostasis during bodily movements (functional joint stability)” (Riemann BL and Lephart SM, 200213)

Back To Top

 

References

  1. Betker AL, Desai A, Nett C, Kapadia N, Szturn T (2007) Game-based exercises for dynamic short-sitting balance rehabilitation of people with chronic spinal chord and traumatic brain injuries. Physical Therapy, 87(10): 1389-1398
  2. Winstein C, Wing AM, Whitall J. Motor control and learning principles for rehabilitation of upper limb movements after brain injury. Handbook of Neuropsychology, 2nd Edition, 9: 77 - 137
  3. Robertson EM, Theoret H, Pascual-Leone A (2003) Skill Learning. In: Boniface S, Ziemann U (eds) Motor Plasticity and TMS: basic science and clinical applications. Cambridge University Press, Cambridge: pp 107-134
  4. Nudo RJ, Friel KM, Delia SW (2000) Role of sensory deficits in motor impairments after injury to primary motor cortex. Neuropharmacology, 39: 733-742
  5. Nudo RJ, Milliken GW, Jenkins WM, Merzenich MM (1996) Use-dependent alterations of movement representations in primary motor cortex of adult squirrel monkeys. Journal of Neuroscience, 16: 785-807
  6. Plautz EJ, Milliken GW, Nudo RJ (2000) Effects of repetitive motor training on movement representations in adult squirrel monkeys: role of use versus learning. Neurobiology of Learn and Memory, 74: 27-55
  7. Classen J, Liepert J, Wise SP, Hallett M, Cohen LG (1998) Rapid plasticity of human cortical movement representation induced by practice. Journal of Neurophysiology, 79: 1117-1123
  8. Yoo E, Chung B (2006) The Effect of visual feedback plus mental practice on symmetrical weight-bearing training in people with hemiparesis. Clinical Rehabilitation, 20(5): 388-397
  9. Wolpert DM, Ghahramani Z, Flanagan JR (2001). Perspectives and problems in motor learning. TRENDS in Cognitive Sciences, 5(11): pp 492
  10. Dancause N, Ptito A, Levin MF (2002). Error correction strategies for motor behavior after unilateral brain damage: short-term motor learning processes. Neuropsychologia, 40(8): 1313 – 1323
  11. Scheidt RA, Conditt MD, Secco EL and Mussa-Ivaldi FA (2005). Interaction of visual and proprioceptive feedback during adaptation of human reaching movements. Journal of Neurophysiology, 93: 3200-3213
  12. VanDijk G, Jannink MJA, Hermans HJ (2005). Effect of augmented feedback in motor function of the affected upper extremity in rehabilitation patients: A systematic review of randomized controlled trials. Journal of Rehab Medicine; 37: 202 – 211
  13. Bryan L. Riemann and Scott M. Lephart (2002). The Sensorimotor System, Part I: The Physiologic Basis of Functional Joint Stability. Journal of Athletic Training, 37(1): 71–79.
  14. Andrew J. Butler and Stephen L. Wolf (2007). Putting the Brain on the Map: Use of Transcranial Magnetic Stimulation to Assess and Induce Cortical Plasticity of Upper-Extremity Movement. Physical Therapy, 87(6): 719-736

Back To Top