Reflex Therapeutics Website

Press release from 1 March 2006

IMF Therapy® at the Millesi Center for Neurosurgery
at the Wiener Privatklinik

IMF Therapy®, an innovative approach in the treatment of peripheral nerve lesions, achieves spectacular results at the Millesi Center for Neurosurgery at the Wiener Privatklinik

The "Millesi Center for surgery of peripheral nerves" at the Wiener Privatklinik has begun treating patients who have suffered injuries to the peripheral nervous system (for example in a traffic accident) using an innovative therapeutic approach. IMF®-Therapy (intention-triggered MyoFeedback) is applied in addition to conventional physiotherapy and has already lead to spectacular results. It is a new combination of mental and sensory intensive training, referring to movement patterns acquired prior to the injury.

How can I learn to use my hands again? Being able to use your hands again in everyday activities, such as picking up and grasping things, is the most important aim for many patients who have suffered an injury to the nerves in their hands or arms. At the Millesi Center defects in the neural structure, caused by accidents or injuries to the nerve tissue, are being reconstructed through nerve transplantation. Despite successful surgery some patients do not regain movement in the affected limbs. They are unable to carry out arbitrary movements with the affected muscle. This leads to flaccid paralysis in the hand or arm, causing certain functional deficits. These peripheral changes trigger structural changes in the brain; the related brain areas gradually change their function and structure.

The limits of conventional physiotherapy

Until recently therapeutic aftercare used to focus only on physiotherapy and electrotherapy, with the aim of channelling movements and rebuilding muscles. This approach was based on the assumption that movement is simply a motoric process in the peripheral nervous system and was therefore not extensive enough.
New visual research methods have shown that there is a strong connection between motor abilities and the movement patterns stored in the motor memory. Despite these new insights cognitive concepts have rarely been applied to regain movement in physiotherapy after peripheral paralysis (Miltner et al. 2000).

This is precisely where IMF Therapy® comes in. The patient is encouraged to reactivate movements he was able to carry out before the accident, in order to trigger a rehabilitation process in the brain and in the peripheral nervous system. This will result in arbitrary motor functions.

Basic assumptions

Imagining a movement is a tried and tested way of reactivating movement patterns acquired prior to an injury.

The motor memory part of the brain not only stores previously learnt movement patterns but also those acquired after an injury. Thus the patient resorts to pathological structures caused by the disability every time he attempts a movement.

However, if the patient, after a period of training, succeeds in imagining a previously learnt arbitrary movement, he thereby activates all motor channels in the central and peripheral nervous system that supply the paralysed muscle. In regular mental training sessions the same patterns are visualised again and again. The brain then gradually corrects (reorganises) the changes caused by the injury and a process of regeneration begins in the peripheral nerve system.

Imagined movement amplifies muscle activity

The mere imagining of a movement causes the same degree of measurable electrical potentials in the muscle as the actual physical execution. (Heuer 1985).

Mental training results in an improved neural supply of the paralysed muscle, which in turn adds to muscular strength. Daily exercise helps to improve the channelling of the paralysed muscle.

University Professor Dr. Hanno Millesi, a specialist in neurosurgery and patron saint of the "Millesi Center for surgery to peripheral nerves" at the Wiener Privatklinik, confirms the advantages of IMF Therapy®:

"The therapeutic range of the Millesi Center includes surgical treatment of neural traumas, neural tumours and nerve entrapment syndromes, where nerves are compressed for various reasons. Neural defects, caused by an accident or through the removal of a 'neural scar' in the nerve tissue following an accident, are treated via nerve transplantation. Without diminishing the undoubtedly impressive surgical skills in this area, the importance of therapeutic care following the surgery should not be underestimated. The additional use of IMF Therapy® can lead to significantly quicker and better therapy results."

The IMF Therapy® method

IMF Therapy® combines mental, sensory and repetitive training, supported by the medical device MfT Z²:

Mental training

The patient imagines an arbitrary movement, which he learnt prior to the injury. MfT Z² picks up these weak potentials in the paralysed muscle via sensors (surface-EMG-electrodes), amplifies them and channels them back to the paralysed area in form of a muscle stimulation.

With every imagined movement the patient activates the part of the paralysed muscle fibres (Type I), which have been worst affected by atrophy.

Sensory training

In order to practice a grasping movement the stimulation electrodes are placed on muscle areas relevant to this movement. The patient creates some nerve activity which stimulates the remaining muscle fibres (Type II). Every time the patient imagines a movement using his paralysed limb he is being rewarded with a motoric reaction, thus educating his physical awareness and sensation, which had been impaired by the injury

Mode of action

This method influences the following parameter: Motivation, concentration, tonicity, sensitivity, passive flexibility, function, pain, trophicity, by specifically training the ability to concentrate (focusing on the affected limb), motor activity (mentally focusing on the movement), and perception of movement (linking-up anticipation and feedback). Only in the last century could proof for the plasticity of the brain be found, which forms the basis for the rehabilitation of brain structures. Rehabilitation can be supported by specific learning methods aimed at improving arbitrary motor activity.

The patient learns to stop pathological patterns and to establish physiological movements.

Proven effects of mentally practicing motor activity (MT)

a)         MT was more effective for stroke patients than KG (PNF) (n=217). (GÜNTHER, W., 1980)
b1)       In some cases MT is more effective than active training.
b2)       MT greatly activates the central nervous system; it increases the blood circulation in the brain. (WEISS, T., 1995)

Proven effects of reafference

(Feedback based on own individual activity)
Reafference is the prerequisite for the development of sensor-motor coordination.
(HELD, Richard)

Repetitive training

During their stay at the Wiener Privatklinik patients receive individual training that prepares them to use the method at home on their own. Despite their physical disability most patients will be able to exercise intensively in their own home. The best effects are achieved through repeatedly imagining a movement at an ideal personal level. (Immenroth 2002). This repetitive training highlights the close link between imagined movement and the physical aim of the excercise, which means that the patient only has to imagine an arbitrary movement when using IMF®-Therapy in order to experience a physical and motoric sensation, albeit with the initial help of the technical device MfT Z².

Results

10 patients who suffered from the effects of a plexus brachialis lesion caused by an accident, started IMF®-Therapy an average of 7.3 years after the accident. All of them suffered from complete arm-plexus-paralysis when the therapy commenced, including sensitivity disorder and pain. Check-ups were carried out after 2, 6 or 9 weeks. 8 out of 10 patients achieved clear improvement in muscle strength and physical sensation within 9 weeks, as well as positive effects on pain.