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