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Interactive Metronome: Training to Win
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Transcript of Interactive Metronome: Training to Win
A Rehab Revolution
Introducing Interactive
Metronome evaluation and
training for athletes, students
who wish to improve their timing,
accuracy and academics.
Appointments available with Dr. Doreo
and staff (805)777-7184
History of Interactive Metronome
Originally developed to assist musicians with studio recording
Used later to help developmentally delayed students with music training
Formal clinical research began in 1994
Early Studies: Motor Skills Study
Special Education students
Improved fine and gross motor and visual motor skills
Results presented to the American Educational Research Association
Stanley I. Greenspan, MDChairman, IM Scientific Advisory
Board
Clinical Professor Psychiatry, George Washington Medical School
Contributor to over 100 articles and 27 books, including Building Healthy Minds, and The Child with Special Needs
Child Development Expert Featured in The Washington Post, Newsweek, Time Magazine, ABC’s Nightline, NBC, and CBS
“Motor Planning and Sequencing is a critical component of the deficit in a variety of developmental and learning disorders.”
Science Overview
Motor Planning and Sequencing are core functions of the brain.
- Stanley I. Greenspan, M.D.
Large-Scale Correlation Study
Timing and Child Development Study Published• Conducted in Illinois by High/Scope
Foundation• 585 students, 6-10 years old
The First Link
AJOT Published Clinical Study
3 groups of ADHD boys separated by: Control / Placebo / IM-trained
Statistically significant improvement in:• Attention• Motor Control and
Coordination• Language Processing• Reading• Control of Aggression
and Impulsivity
AJOT Published Clinical Study
Language Processing Test Similarities
Pre and Post Test Differences
2.666
9.316
-1
-2
0
2
4
6
8
10
Control Placebo IM
Sim
ilari
ties
(Sta
ndard
Sco
re)
Interaction Effect = 0.005
Academic Fluency Study
Over 700 middle and high school students
Pre and Post subtest on nationally standardized Woodcock-Johnson III test
Results showed significant increases in grade equivalent (GE) performances in IM Group
2.21 GE Gain in Reading Fluency 1.66 GE Gain in Math Fluency
Academic Fluency Study
12.46
10.25
0
2
4
6
8
10
12
14
Pre IM Post IM
Gra
de E
quiv
ale
ncy
2.21 GE gain, n=718, Woodcock Johnson, 3rd Ed. 1.66 GE gain, n=703, Woodcock Johnson, 3rd Ed.
12.39
10.73
9.5
10
10.5
11
11.5
12
12.5
13
Pre IM Post IM
Gra
de E
quiv
ale
ncy
Results from Early Clinical Trials
MEDIAL BRAINSTEM
Neuro-Motor Pipeline
BASAL GANGLIA
Integrates Thought and Movement
CINGULATE GYRUS
Allows Shifting of Attention
Cognitive Flexibility
Results from a Pilot fMRI (Brain Scan) study show IM Directly Activates
Multiple Parts of the “Neuronetwork”
Key Diagnoses
CVA and Brain Injury
Amputees
Parkinson’s
General Rehabilitation
ADHD
Cognitive / Developmental Disorders
Academic / Sports Performance
Who Can Benefit?
Loss of Motor Control
Loss of Speech/Cognition
Loss of Balance and Gait
ADD/ADHD
Asperger's Syndrome
Sensory Integration
Language Processing
Motor Control and Coordination
Impulsive/Aggressive
Enhanced Coordination
Improved Focus and Attention
Improved Academic Performance
PERFORMANCE NEURO-SCHOLASTIC
REHABILITATION
PLANNINGPLANNINGSEQUENCINGSEQUENCING
What are the Benefits?
ATTENTION / FOCUS1
MOTOR CONTROL / COORDINATION3BALANCE & GAIT4
LANGUAGE PROCESSING5CONTROL OF AGGRESSION / IMPULSIVITY6
MENTAL / COGNITIVE PROCESSING2
Performance on IM directly correlates with performance in:
Attention and Concentration
Mental Processing
Motor Planning and Sequencing
Language Processing
Behavior (Aggression and Impulsivity)
Executive Functioning
Performance on IM directly correlates with performance in:
Balance and Gait
Endurance
Strength
Fine/Gross Motor Skills
Coordination
Jake: TBI
16 year old male - TBI from MVA
Severe impairments:
Sustained attention & concentration
Poor memory
Left-right discrimination
Gross and fine motor coordination
Balance
Jake: TBI
After 6 weeks of IM Training:
Able to attend to paper/pencil tasks for up to 50mins in preparation for school
Only needed minimal cues for L-R discrimination
Reported that he could hold conversations for longer periods of time and now able to “day dream”
Alexandria: Sensory Integration Disorder
9 year old female – Sensory Integration Disorder
Impairments:
Poor fine motor coordination
Balance
Multiple Tantrums Each Day
D Average in Math
Alexandria: Sensory Integration Disorder
After 5 weeks of IM Training:
Able to ride her bicycle without training wheels for the 1st time
Her attention increased dramatically
Earned and A and B on her next two math tests
Drastic decrease in frequency and duration of emotional outbursts
Diane: ADHD & Severe Learning Disabilities
Her therapist reported that she was “bouncing off the walls” and tried to even tried to stand on her head in her chair during her 1st visit
Following 2 weeks of training:
Sat and read her mom a book
Able to sit quietly for up to 20 minutes
Diane: ADHD & Severe Learning Disabilities
Enrolled in the IM program at age 8
Deficits addressed:
Poor Attention & Concentration
Great difficulty processing multiple instructions
Benefits of IM
Non-invasive
Non-pharmaceutical(not exclusive of Rx)
Complements existing therapy
Short-term
Measurable outcomes
Functional cross-over
Clinical differentiator
Demonstration
1 second = 1,000 milliseconds
200 100
40 15
0
15 40
100 200
Assessment
0 - 15 ms Perfect16 - 40 ms Above Average41 - 100 ms Average
Questions and Answers
Other Case Studies
Stroke
TBI
Amputee
Lizette: Stroke
Initial Therapy:
Met all IP and OP functional goals
Discharged to home
Returned with cognitive shifting deficits
IM training initiated
Patient returned to work with improvement in concentration, speech, balance, and motor coordination.
Edward: TBI
Improved Auditory Sequencing
Improved Concentration
Motor improvements particularly in his lower body
After only his third session he demonstrated improvements in his ability to attend for much longer periods of time without stopping or talking
14 years old
Veronica: Stroke
37 year old female - CVA
Deficits addressed:
Poor attention & concentration • Unable to attend to tasks
for more than 10-15 minutes without getting externally distracted
Decreased stamina and endurance• Unable to stand for more
than 15-20 minutes
Case Study 2: Stroke
Following 8 weeks of IM training:
Able to complete simulated work activity for at least 60 minutes without becoming distracted
Able to stand and complete household activities for at least 45 minutes
Brenda: Amputee
6 months of traditional therapy with poor outcome
Thousands of IM reps particularly using her feet
Significant improvements in motor sequencing
Improved gait & balance
Brenda: Amputee
Disney Marathon
FINISH LINE!
January 2004
Interactive Metronome
evaluation and training
available by appointment with
Dr. Doreo and her staff
(805)777-7184
Thousand Oaks, CA
www.drdoreo.com