1. NeuromoveNeuromove

2. What is theWhat is the NeuroMoveNeuroMove??
It is an EMG TriggeredIt is an EMG Triggered
Neurological Relearning tool forNeurological Relearning tool for
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Neurological Relearning tool forNeurological Relearning tool for
Stroke and Brain Injury ParalysisStroke and Brain Injury Paralysis

3. Stroke and TBI Rehabilitation Centers
Spinal Cord Rehabilitation Centers
Where are you going to
sell the NeuroMove?
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Spinal Cord Rehabilitation Centers
Why do Rehab Clinics need such a product?
Shortens patients time spent in Rehab
Motivates patients to work at their own therapy
Works when there is total paralysis or no
voluntary movement.

4. What Neuro-rehabilitation devices do you use for
Opening Lines
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What Neuro-rehabilitation devices do you use for
stroke patients?
Do you have a Neuro Re-learning Tool?
The NeuroMove retrains the brain to
regain voluntary movement.

5. Who Benefits from theWho Benefits from the NeuroMoveNeuroMove??
StrokeStroke PatientsPatients
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StrokeStroke PatientsPatients
The number One cause of treatableThe number One cause of treatable
paralysisparalysis
••Traumatic Brain InjuryTraumatic Brain Injury
••Palsy and other congenital paralysisPalsy and other congenital paralysis
••Spinal Cord InjurySpinal Cord Injury

6. Sales Tools:Sales Tools:
Establish an invite toEstablish an invite to on our websiteon our website
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Establish an invite toEstablish an invite to on our websiteon our website
I will send it to your email addressI will send it to your email address
All documents can be modified and saved.All documents can be modified and saved.
Power pointsPower points
Marketing itemsMarketing items
Clinical StudiesClinical Studies
PicturesPictures

7. U.S. FDAU.S. FDA
--For Stroke, TBI and SCI RehabilitationFor Stroke, TBI and SCI Rehabilitation
--Relaxation of Muscle Spasms & Muscle ReRelaxation of Muscle Spasms & Muscle Re--educationeducation
--Prevention of Retardation of disuse atrophyPrevention of Retardation of disuse atrophy
--Increase Local Blood CirculationIncrease Local Blood Circulation
--Maintaining or Increasing Range of MotionMaintaining or Increasing Range of Motion
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--Maintaining or Increasing Range of MotionMaintaining or Increasing Range of Motion
European Heath StandardsEuropean Heath Standards
CConformitéonformité EEuropéeneuropéene -- CECE
--Approved forApproved for –– Stroke RecoveryStroke Recovery
--class II deviceclass II device
ZynexZynex is an ISOis an ISO--13485 Company13485 Company
The NeuroMove is manufactured in the U.S.The NeuroMove is manufactured in the U.S.
SFDA PendingSFDA Pending

8. Evidenced Based Success
--Peer Reviewed Clinical TrialsPeer Reviewed Clinical Trials
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--Peer Reviewed Clinical TrialsPeer Reviewed Clinical Trials
Direct clinicians toDirect clinicians to
www.neuromove.comwww.neuromove.com
--Patient TestimonialsPatient Testimonials
--Rehab Hospitals usage protocolRehab Hospitals usage protocol
Show hospital listShow hospital list

9. Clinical StudiesClinical Studies
Chronic Motor Dysfunction AfterChronic Motor Dysfunction After
StrokeStroke
ConclusionConclusion: “Two lines of evidence clearly: “Two lines of evidence clearly
support the use of EMG triggered NMESsupport the use of EMG triggered NMES
treatment to rehabilitate wrist and fingerstreatment to rehabilitate wrist and fingers
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support the use of EMG triggered NMESsupport the use of EMG triggered NMES
treatment to rehabilitate wrist and fingerstreatment to rehabilitate wrist and fingers
extension movements ofextension movements of hemiparetichemiparetic
individuals > 1 year after stroke…individuals > 1 year after stroke…
Recovering Wrist and Finger Extension by EMGRecovering Wrist and Finger Extension by EMG TriggereTriggere
Neuromuscular stimulation.Neuromuscular stimulation.
By JamesBy James CaraughCaraugh,, Ph.DPh.D
See all clinical studies atSee all clinical studies at www.neuromove.comwww.neuromove.com

10. Clinical StudiesClinical Studies
““Progress often far exceeded that ofProgress often far exceeded that of
previous conventional therapy. Regardingprevious conventional therapy. Regarding
mechanisms, impaired proprioceptivemechanisms, impaired proprioceptive
feedback is considered central to strokefeedback is considered central to stroke--
disrupted sensorimotor control. EMGdisrupted sensorimotor control. EMG--
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disrupted sensorimotor control. EMGdisrupted sensorimotor control. EMG--
triggered EMS is intended to improve braintriggered EMS is intended to improve brain
relearning by reinstating proprioceptiverelearning by reinstating proprioceptive
feedback timefeedback time--locked to each attemptedlocked to each attempted
movement. Clinical results were consistentmovement. Clinical results were consistent
with this theorywith this theory.””
See all clinical studies at www.neuromove.com

11. NeuroMoveNeuroMove
Prescribed by Leading Rehab HospitalsPrescribed by Leading Rehab Hospitals
Johns Hopkins, MDJohns Hopkins, MD
TawamTawam Hospital, UAEHospital, UAE
Cleveland ClinicCleveland Clinic
Kennedy Krieger Intl.Kennedy Krieger Intl.
St. John’s Mercy, St. LouisSt. John’s Mercy, St. Louis
Mt. Sinai, NYMt. Sinai, NY
Marlton Rehab, NJMarlton Rehab, NJ
Montefiore, Bronx, NYMontefiore, Bronx, NY
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Kennedy Krieger Intl.Kennedy Krieger Intl.
Spine InstituteSpine Institute
Rehab Institute ofRehab Institute of
ChicagoChicago
Mayo Clinic, MNMayo Clinic, MN
Kessler, NJKessler, NJ
Moss Magee Rehab, PAMoss Magee Rehab, PA
Queen Elizabeth, H.K.Queen Elizabeth, H.K.
Montefiore, Bronx, NYMontefiore, Bronx, NY
Lutheran Hospital,Lutheran Hospital,
Brooklyn, NYBrooklyn, NY
TIRR of HoustonTIRR of Houston
Mission Hospital, CAMission Hospital, CA
LethbridgeLethbridge Hosp. CanadaHosp. Canada
TanTan TokTok SengSeng, Singapore, Singapore

12. What Hospitals SayWhat Hospitals Say
about theabout the NeuroMoveNeuroMove
““……treatmentstreatments areare focusedfocused onon patientspatients whowho havehave
hadhad aa recentrecent strokestroke asas wellwell asas thosethose whowho havehave
sufferedsuffered fromfrom strokestroke--relatedrelated disabilitiesdisabilities forfor yearsyears..
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sufferedsuffered fromfrom strokestroke--relatedrelated disabilitiesdisabilities forfor yearsyears..
Lutheran'sLutheran's "Re"Re--traintrain thethe Brain"Brain" strokestroke recoveryrecovery
programprogram manymany longlong--sufferingsuffering patientspatients cancan
regainregain longlong lostlost mobilitymobility andand functionfunction..””
RR.. Ahmad,Ahmad, OTR,OTR, DirectorDirector
LutheranLutheran RehabRehab Network,Network, Brooklyn,Brooklyn, NYNY
TalkTalk toto thethe leadlead therapisttherapist aboutabout adoptingadopting aa NeuroNeuro
RehabilitationRehabilitation programprogram..

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85% of strokes are Ischemic85% of strokes are Ischemic
Restriction of Blood to the BrainRestriction of Blood to the Brain
Hemorrhagic StrokeHemorrhagic Stroke
Bleeding into the brainBleeding into the brain

14. What HappenedWhat Happened
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What HappenedWhat Happened
Loss of Brain Cells and theLoss of Brain Cells and the
functions they controlfunctions they control
Causing HemiplegiaCausing Hemiplegia

15. Be aware of what is done in the
stroke rehab clinics
-Find lead Occupational Therapist
-Private and Gov’t programs
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Treatment of Stroke ParalysisTreatment of Stroke Paralysis
Physical training including:Physical training including:
Therapeutic exercisesTherapeutic exercises
Movement modificationMovement modification
Special equipmentSpecial equipment -- FESFES
Assistive devicesAssistive devices
OrthoticsOrthotics

16. Treatment ApplicationTreatment Application
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Treatment ApplicationTreatment Application
Acute RehabAcute Rehab
OnceOnce stabilizedstabilized
Out patient RehabOut patient Rehab
Home Care TherapyHome Care Therapy
This is the goalThis is the goal

17. Re Train the Brain ToolRe Train the Brain Tool
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18. NeuroplasticityNeuroplasticity
ReRe--Mapping the brain pathways byMapping the brain pathways by driving thedriving the
healthy neurons to take over for damagedhealthy neurons to take over for damaged
neurons thus regaining voluntary contractionsneurons thus regaining voluntary contractions
TheThe NeuroMoveNeuroMove: Not just FES!: Not just FES!
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TheThe NeuroMoveNeuroMove: Not just FES!: Not just FES!
PPatient imagines movement and is rewardedatient imagines movement and is rewarded
through stimulated muscle contraction…through stimulated muscle contraction…
MOVEMENT!MOVEMENT!

19. What makes a SuccessfulWhat makes a Successful
Brain Relearning Tool?Brain Relearning Tool?
Patient must be CognitivePatient must be Cognitive
Engages the BrainEngages the Brain
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IntensiveIntensive
Concentrated EffortConcentrated Effort
FrequencyFrequency
Focused RepetitionFocused Repetition

20. The Re-learning Tool - NeuroMove
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EMG detects targeted neurological
attempts to move the muscle
Utilizing Repetitive attempts and
reward to stimulate Neural re-
mapping

21. Patients can experiencePatients can experience
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Patients can experiencePatients can experience
immediate results.immediate results.
Gives Stroke patientsGives Stroke patients realreal
hopehope and motivationand motivation

22. Contraindications/PrecautionsContraindications/Precautions
Implanted electrical devicesImplanted electrical devices
Cardiologist approval for use withCardiologist approval for use with
pacemakers.pacemakers.
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pacemakers.pacemakers.
EpilepsyEpilepsy
Cancer LesionsCancer Lesions
Use on Muscles onlyUse on Muscles only

23. In the KitIn the Kit
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Electrode Placement Guide Book
Instructional CD
AC Cord for recharging
3-Packs of 3-Electrodes
Connecting lead wire
Program Manual

24. TherapyTherapy
SessionSession
SetSet--upup
Attach electrodesAttach electrodes musclemuscle
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Attach electrodesAttach electrodes musclemuscle
groupgroup
Turn on Unit.Turn on Unit.
Set eSet e--stimstim to visible yetto visible yet
comfortable contractioncomfortable contraction

25. Start onStart on
Any Group of MusclesAny Group of Muscles
Wrist & Finger ExtensionWrist & Finger Extension -- FlexionFlexion
Front & Back Elbow FlexionFront & Back Elbow Flexion
Shoulder Subluxation/AbductionShoulder Subluxation/Abduction
Ankle DorsiflexionAnkle Dorsiflexion
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Ankle DorsiflexionAnkle Dorsiflexion
Knee ExtensionKnee Extension
Starting pointsStarting points
upper or lower extremitiesupper or lower extremities
distally or proximallydistally or proximally

26. Ankle Dorsiflexion (Drop Foot)/Flexion
Red
Black
Red
Knee Extension - Front
Red
Red
Black
Shoulder Subluxation/Abduction
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Knee Extension - Front
Red
Red
Black
Flexible: Use on any
Muscle Group
Refer to the Guide

27. Therapy Session OverviewTherapy Session Overview
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Cycle of Therapy
RELAX: NM is Setting Threshold
READY: Patient makes ATTEMPT
GOOD: Stimulation or Reward
RELAX: Deliberate rest

28. RELAXRELAX
The processor begins to detect EMG and set the
threshold
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Threshold is adjusted up or down every 15
seconds Automatically

29. READYREADY
Patient makes concentrated attemptsPatient makes concentrated attempts
to make muscle exertion sensorsto make muscle exertion sensors
detect real attempts.detect real attempts.
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Encourage the patient to imagine or
visualize movement, have them close their
eyes. Engage the brain!

30. RewardReward
Imagination or attempt “strikes”
the threshold and triggers
physical movement…the reward.
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31. Cycle is RepeatedCycle is Repeated
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The threshold is re-set every cycle and
moves up or down to continually
challenge or encourage the patient.

32. NeuroMoveNeuroMove Hands On!Hands On!
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33. Other ApplicationsOther Applications
Spinal Cord InjurySpinal Cord Injury
*Set SCI Mode*Set SCI Mode
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Other ReliefOther Relief
Erb’sErb’s PalsyPalsy
Bell’sBell’s PalseyPalsey
Cerebral PalsyCerebral Palsy
Multiple SclerosisMultiple Sclerosis

34. Trouble ShootingTrouble Shooting
SignalsSignals
“check electrodes“check electrodes””
clean skin and wet electrodesclean skin and wet electrodes
“Poor or sporadic Signal on Screen”“Poor or sporadic Signal on Screen”
Restart NM between muscle groups changesRestart NM between muscle groups changes
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Make sure Full Battery ChargeMake sure Full Battery Charge
Set DefaultSet Default –– See Program GuideSee Program Guide
Check for Broken lead wiresCheck for Broken lead wires
EMG signal too low or too highEMG signal too low or too high
Set Defaults and restartSet Defaults and restart
See Trouble Shooting Guide onSee Trouble Shooting Guide on dropboxdropbox

35. NeuroMove PatientsNeuroMove Patients
Post stroke and SCI treatment may begin:Post stroke and SCI treatment may begin:
Once stabilizedOnce stabilized
Out patient or home useOut patient or home use
Must be cognitiveMust be cognitive
Up to 30 years post strokeUp to 30 years post stroke
Treatment TimeTreatment Time
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Treatment TimeTreatment Time
1515--60 Minutes each session60 Minutes each session
Once a day building to 2 or 3 times a dayOnce a day building to 2 or 3 times a day
Expect 4 months to a year treatment planExpect 4 months to a year treatment plan
Can be used with:Can be used with:
BotoxBotox –– High Tone patientsHigh Tone patients
Baclofen PumpBaclofen Pump –– Spinal Cord patientsSpinal Cord patients

36. Ancillary Benefits of NMAncillary Benefits of NM
High Quality NMESHigh Quality NMES
Programmable ParametersProgrammable Parameters
Treatment of Muscle AtrophyTreatment of Muscle Atrophy
& Re& Re--educationeducation
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& Re& Re--educationeducation
Muscle SpasmsMuscle Spasms
Pain ReliefPain Relief

37. Is this like regular biofeedback?Is this like regular biofeedback?
No - Regular EMG (electromyography) may also have a very sensitive
input, but for most other applications the input signals are filtered and
averaged.
Some stroke survivors have no EMG activity or a strong muscle tone
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Some stroke survivors have no EMG activity or a strong muscle tone
with high background “noise” - regular EMG/biofeedback will not stand a
chance of detecting the changes that indicate a real attempt from the
brain. The NeuroMove measures peak values in the EMG and has very
fast input circuitry. Instead of averaging the input it does the opposite – it
looks for a pattern in the small changes that indicate a real attempt. A
very effective demonstration of this is when a non-patient actually
triggers the NeuroMove just by thinking about it and imagining a
movement

38. Why only one channel?Why only one channel?
FESFES vsvs NeuroMoveNeuroMove
It has one channel, patient must concentrate on one
movement at a time
Is it like FES – No, FES or an elaborate functional
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Is it like FES – No, FES or an elaborate functional
stimulation product does not engage the brain. The
patient can be watching TV and doing FES, but the brain
will not relearn new pathways

39. Is it complicated to set up?Is it complicated to set up?
No – Encourage Home-use.
Turn on the device and turn stimulation level up slowly for
a comfortable contraction of the muscle
Think very hard about moving the fingers, wrist, shoulder,
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Think very hard about moving the fingers, wrist, shoulder,
foot and other muscles
After relaxing, it returns to “Ready” and is ready for the
next attempt, relaxing is as important as concentrating

40. Program SettingsProgram Settings
Set thresholdSet threshold to increaseto increase
or decrease challenge (can be setor decrease challenge (can be set
during session)during session)
Rest PeriodRest Period
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Rest PeriodRest Period (default(default –– 15 sec. Set:6015 sec. Set:60
seconds)seconds)
Mode: Stroke & SCIMode: Stroke & SCI SesitivitySesitivity
Set Audio On or OffSet Audio On or Off
Compliance DataCompliance Data (number of sessions(number of sessions
and total time used)and total time used)

41. Program SettingsProgram Settings
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Change ParametersChange Parameters
oo Frequency and pulse width, ramp up/off timeFrequency and pulse width, ramp up/off time
oo stimstim periodperiod (default at 5 sec.)(default at 5 sec.)
oo RangeRange:: Can only be set when SCI Mode is selectedCan only be set when SCI Mode is selected
SCI two sensitivity ranges:SCI two sensitivity ranges:
oo 0.250.25--2525 uVuV
oo 0.500.50--5050 uVuV ((use if signal is off screenuse if signal is off screen w stroke patients)w stroke patients)

42. Hands on Therapy SessionHands on Therapy Session
Email: info@painezee.com
Tel: +91 9030022402
Web: www.junopharm.com
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