Testimonials

Jenny Quaill
Senior Rehabilitation Physiotherapist
Gold Coast Hospital
Australia

The value of the Muz-mo in Rehabilitation of neurological patients

I have had the privilege of using the Muz-mo with my rehabilitation patients since its conception. I currently have two Muz-mo units available for our use in the Neuroscience Rehabilitation Unit at the Gold Coast Hospital. The Muz-mo is a simple yet brilliant auditory feedback device that can be used in a number of ways to assist in the retraining of lower limb muscle activity following neurological events such as stroke, brain injury and spinal cord injury.

We use the Muz-mo in the following ways:

• Retrain ankle dorsiflexion and eversion – strength training (open-chain exercise)
• Part practice of stance phase to prevent knee hyperextension or to prevent
excessive ankle
• dorsiflexion e.g. during weight shift training, sit to stand training, stepping practice
• Part practice of swing phase to facilitate ankle dorsiflexion & eversion e.g. step forward and land with heelstrike, heelstrike onto box
• Gait retraining – both stance phase (prevent knee hyperextension or excessive ankle dorsiflexion) and swing phase components (ankle dorsiflexion + eversion) £The Muz-mo has become an integral part of our daily clinical practice and is an invaluable tool for increasing the intensity of training of our rehabilitation patients. We know from the literature that to retrain the brain after stroke and brain injury we must provide intensive task-specific training. The Muz-mo helps us to do just that. Its auditory cue provides instant feedback to the patient about their performance of a task allowing the patient to quickly correct any errors made to ensure quality practice. Whether it is being used to help a patient learn to dorsiflex/evert their ankle or keep their knee from hyperextending in stance phase, the Muz-mo promotes motor learning and taps into the neuroplasticity of the brain to retrain impaired movement/function.

The most outstanding thing about the Muz-mo is that it allows us to set up our patients to practice tasks independently and with minimal errors. As a result, our patients receive a great deal more training in addition to that provided in one-on- one sessions with their physiotherapist or physiotherapy assistant. The value of this cannot be overstated.

I commend Joel Arnstein* for his development of the Muz-mo. It makes my job as a Rehabilitation Physiotherapist easier and it has improved our ability to retrain walking in neurological patients. I am excited by the prospect of this device becoming commercially available to Rehabilitation Units as is a very valuable rehabilitation tool with the potential to help thousands of people worldwide. I am confident it will be a very successful product when made available to the worldwide rehabilitation community.

Yours sincerely,

Jenny Quaill
Senior Rehabilitation Physiotherapist
Gold Coast Hospital
+61 (07) 55198501

Muz-mo Use with Stroke Patients

 "I have used the Muz-mo to good effect on some of my stroke patients, in particular issues with foot & ankle biomechanics during gait .I can conclude that it is a good adjunct to physiotherapy whilst relearning aspects of motor control"

Andrew Foxall BSc Hons MCSP

Physiotherapist, Leicestershire, UK

Muz-mo Use in Paediatric Treatment

 “I work with a bright, motivated, ambulant 7 year old boy affected by mild diplegic Cerebral palsy. He could only produce active dorsiflexion of either ankle as a combined movement with knee and hip pulling into flexion. Ie, as a full limb pattern of movement. He could not isolate his ankle movement alone as is very common with his diagnosis. This was obviously a contributory problem during gait. We had tried activation of his tibialis anterior with EMS which he tolerated well. We had some success but still it was impossible for him to control a good, active, isolated dorsiflexion action with his knee extended, hip in neutral and toes relaxed. I was running out of ideas. Then I tried "Muz-mo" a new invention using auditory biofeedback. It was successful on the first attempt. I have yet to see follow through into his movement without the Muz-mo, or try it during walking, but it is the first step. He loves using it too and enjoys the "gadget" side of it!

I have also tried this with three other children and found it a useful adjunct to treatment as well as fun to use.

I have adapted it slightly and tried it with a 12 year old girl who is affected by hemiplegia with a mild elbow flexion contracture. We used it after botox to her biceps to see if auditory biofeedback could help with her awareness of triceps action. She loved hearing the buzzer when she did the correct contraction. I saw some good carry over into her movement without Muz-mo after we took it off, and although this is only anecdotal I would recommend that you give it a try and use your own clinical judgement about its affect. It certainly adds excitement to a paediatric treatment!

It can be fitted so that the slightest active movement triggers the buzzer, in any range of ankle position, even in outer range, and the settings are quick to change so that the antagonist muscle can trigger the buzzer too. Good for learning eccentric control. “ 

 Jenny McLaughlin MCSP HCPC MAACP

Physiotherapist, Gloucestershire, UK

Sally Horsley
Physiotherapy Clinical Leader-Rehabilitation
The Townsville Hospital Rehabilitation service
The Townsville Hospital
PO Box 670,
Townsville, QLD. 4810

MUZMO REPORT

The muzmo has capability of providing accurate feedback to patients regarding joint position for any joint the attachments allow. This is extremely valuable as there are currently no other low-cost biofeedback devices which have the same capability. Muzmo was originally designed to provide feedback/guidance or ankle dorsiflexion during swing phase walking, and subsequently for dorsiflexion during stance phase walking. The Muzmo is the only device which successfully provides accurate feedback to the patient regarding ankle dorsiflexion and eversion position

• Currently constitutes about 150 patients per year, that is, patients with weakness and/or inadequate control of dorsiflexion and eversion for swing phase walking and/or weakness and/or inadequate control of ankle dorsiflexion for stance phase of walking. Most often, these are patients with acquired brain injury, or other neurological conditions such as Guillian Barre or Incomplete spinal cord injury.
• All acquired brain injury patients admitted to rehab are considered for Muzmo.
• Used for part practice tasks and for whole practice walking (stance and/or swing phase dorsiflexion)
• Potential use for joint position feedback for any joint(upper limb and lower limb)

At The Townsville Hospital Patients with Neurological problems, particularly ABI use the MUZMO to facilitate their independent task specific practice of Dorsiflexion in both swing phase and stance phase. This enables them to:

• greatly increase the amount of practice they can do(high number of repetitions) , because they are much less dependent on the therapists to provide guidance and feedback. Current evidence suggests that increased intensity of practice leads to better functional outcomes following Acquired brain injury.

WITH MUZ-MO MY LIFE IS LOOKING UP

USER TYPE: HEMIPLEGIA, FOOT DROP AND HYPEREXTENSION OF KNEE WITH TYPICAL ATROPHY OF EXTREMITIES

USER INFO:  61YEAR OLD, CVA IN 1985. LIVING IN QUEENSLAND AUSTRALIA LYNNE WANTED TO REDUCE DAMAGE TO HER KNEE, REDUCE FALLS RISK AND IMPROVE HER GAIT

HISTORY: POST-STROKE-NUMEROUS FALLS AND HYPEREXTENSION OF AFFECTED KNEE JEOPARDIZING KNEE INTEGRITY.  ADAPTIVE GAIT WAS HARMFUL IN THE LONG RUN

“I was so excited to hear about the invention of Muz-mo as I often thought - - -if I could just retrain some of the muscles to assist me in walking better, I could save a lot of dramas. I have been using Muz-mo for a year now and the results are very good. I was amazed after the first couple sessions wearing the device the effects of the (audio) biofeedback persisted when I no longer was wearing it and I was not “popping” my knee backwards as often or as far.

Progress has continued with better toe lift and almost not hitching my hip/leg also being able to walk with my head up is a new experience.  All of these positive changes continue improving.  Awareness of one’s body is a crucial when recovering from hemiplegia.  I am sure if I had access to a device such as Muz-mo as soon as possible after a CVA, the bad habit's I have learnt with my gait would not exist and some of the 5 falls and fractures I have had could have been avoided   It is so interesting to know that even after 30 years some of the bad habits I developed can be erased.”

Lynne
Hope Island, Queensland 4212
AUSTRALIA