From robotic surgical instruments that have forever changed the OR to nanomotors that chug, unseen, through the human body to attack diseased tissue, many medical devices today are beyond the technologies dreamt about even a decade ago.
But sometimes a low-tech device is still the best option to treat and heal. Stroke survivors, for instance, live for the day they can again use a limb that no longer works. Now a new rehabilitation device that's designed to help improve arm movement, even if the stroke occurred many years ago, is available over the counter.
The Tailwind was developed by University of Maryland (College Park) doctors specializing in physical therapy rehabilitation after a decade of scientific research.
"Based on our studies, the device can promote meaningful change in patients, particularly in bilateral arm functions," said Tailwind inventors Sandy McCombe and Jill Whitall, professors and researchers at the University of Maryland Medical School. It's available through start-up Encore Path (Baltimore) and is already in use in 20 states and on five continents since its launch last year.
"We know that doing a task repetitively is a good way to recover a movement," Kris Appel, president of Encore Path told Medical Device Daily. "Even in patients who have paralysis on one side, we know it's better to retrain both extremities because the arms were meant to work together. If you just exercise one side, you don't help the brain to recover bilateral movement. The Tailwind combines that with an auditory cue because it's better to do the activity to the rhythm of a steady beat. All of that combined has been shown to help stroke survivors improve arm function."
Tailwind looks like a part of an elliptical trainer found at most gyms, but it sits tabletop and doesn't include weights. The user grabs each side and simply pushes and pulls grips along a resistance-free track. The movement must be initiated by the user, thus requiring neuromuscular control. Affected hands may be attached to the device with simple straps in order to facilitate movement for the more moderate to severely impaired individuals.
"There's a greater understanding now about how the brain recovers after injury," Appel said. "You can enhance something like Tailwind with software and video and make it high tech. But it doesn't have to be high tech to work. Our goal was to build a device that was simple and easy enough to use at home by people who had a stroke, even a long time ago. We had people in our studies that were 20 years post-stroke who gained mobility after exercising with Tailwind. We specifically and purposely made it low tech because we didn't believe we need to add a lot of bells and whistles."
Co-inventors Whitall and McCombe created Tailwind through research conducted in the late 1990s at the University of Maryland School of Medicine.
The inventors published studies in both Stroke (2000) and JAMA (2004) detailing how six weeks of bilateral arm training with rhythmic auditory cueing (BATRAC) with Tailwind improved several key measures of sensorimotor impairments, functional ability (performance time), and functional use in patients with chronic upper extremity hemiparesis. Those improvements were maintained at two months after patients stopped training, suggesting that the motor improvements were potentially durable, according to the Stroke article. The JAMA article focused on how BATRAC induces reorganization in contralesional motor networks and provides biological plausibility for repetitive bilateral training as a potential therapy for upper extremity rehabilitation in hemiparetic stroke.
Will this simple, portable device replace physical therapy and other modalities? Not at all, Appel said.
"It's a really good compliment to anything else out there," she said. "Not every treatment works for every patient. Stroke rehab is really challenging. If you're doing electrical stimulation or stretching exercises or any other out therapy for arm rehabilitation, this is a good compliment. It's not going to cause any damage. One thing we know is that you recover when you're actually moving the part o the body that's affected, in that sense, any exercise is beneficial."
Encore hasn't rolled out a massive commercialization campaign. In fact, sales so far have relied on the company's web site and word-of-mouth marketing.
"The thing about stroke survivors is that they are out there looking for you, reading about new technologies," she said. "So we're getting a fair amount of people contacting us. We're also doing outreach to hospitals and rehab facilities."
At a price just under $3,000, there is no reimbursement for Tailwind.
Encore is now using the same approach to develop a leg device, which is likely to be available within two years.
Lynn Yoffee, 770-361-4789;