Accelerate Outcomes.
Exceed Expectations.
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Right Ear
LATE
Left Ear
EARLY
Buzzer
Rubber
band
twang
High Pitch
Rewarding
Sound
Rubber
band
twang
Buzzer
1 second = 1,000 milliseconds
40
200
Slide 2
100
15
15
40
0
0 - 15 ms Perfect
16 - 40 ms Above Average
41 - 100 ms Average
100
200
Interactive Metronome
 Assessment &
Treatment
 Evidence-based
 Objective
 Flexible
 Engaging
Slide 3
IM Equipment
 Software
 Hardware
•
•
•
•
Master Control Unit
Hand Trigger
Foot Trigger
Headphones
 Optional wireless
equipment
• Hand Trigger
• Foot Trigger
• Gait Switch
Slide 4
IM’s Goals
1) To drive functional
neuroplasticity
2) To improve
mental/interval
timing
3) To improve the
brain’s efficiency
and performance
Slide 5
Randolph J. Nudo, Ph.D.
Director, Landon Center on Aging
Professor, Department of Molecular and Integrative Physiology
University of Kansas Medical Center
Kansas City, KS
"Synchronous activity drives dendritic growth."
Slide 6
To improve mental/interval timing
IM…
IM…
Slide 7
Based upon Scalar Timing Theory
IM Impacts Mental/Interval
Timing Structures of the Brain
The Brain
Dorso Lateral
Pre-Frontal Cortex
•Timing
•Motor Planning
•Speech
Basal Ganglia
•Timing
•Voluntary Motor
•Coordination
Cingulate Gyrus
•Timing
•Executive
Functioning
•Modulate Emotions
Cerebellum
•Timing
•Sense of
Body Position
•Production of
Speech
Hemiplegia Study
Thaut et al. (2002): Published in Neuropsychologia
 Investigated effect of rhythm on
control of paretic arm movements
21 hemispheric
stroke patients
Slide 9
 "the observed changes in timing and
trajectory control strongly suggest
that the structured time information
in auditory rhythm added significant
kinematic stability to the patient’s
paretic arm reaching motions. These
changes were not present during the
non-rhythmic condition...Our data
suggest, therefore, that auditory
rhythm may offer an essential
component of enhanced sensorimotor
control to make hemiparetic arm
training more effective."
To improve the brain’s
efficiency and performance
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Slide 10
By improving:
Auditory Processing
Short Term Memory
Working Memory
Processing Speed
Cognitive Resources
Executive Functions
Motor Coordination
Sensory Processing
IM Research
 First private research (1994)
 Autistic children
 Showed fine/gross/visual-motor improvements in
coordination
 Published in academic circles
 IM came to attention of Stanley Greenspan, MD
Slide 11
Stanley I. Greenspan, MD
Chairman, IM Scientific Advisory Board
 Clinical Professor of Psychiatry,
Behavioral Sciences, and Pediatrics at
George Washington University Medical
School.
Slide 12
Academic Correlation Study
Timing in Child Development.
High/Scope Educational Research Foundation
Kuhlman, K. & Schweinhart, L.J. (1999)
 585 students
 Significant correlation between IM timing and
academic performance
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Slide 13
Reading, Mathematics
Oral/written language
Writing
Attention
Motor coordination and performance
ADHD Study
Effect of Interactive Metronome Training on Children with ADHD.
The American Journal Of Occupational Therapy
Schaffer et al., (2001)
 56 boys, age 9-12
 15 sessions
 3 Groups
 Treatment,
 Video Game (Placebo)
 Control
Slide 14
ADHD Study
Effect of Interactive Metronome Training on Children with ADHD.
The American Journal Of Occupational Therapy
 Statistically significant
improvement:
 Attention
 Motor control and
coordination
 Processing speed
 Language processing
 Reading
 Consistency of responses
 Decrease in aggressive
behavior
Slide 15
ADHD Study
Effect of Interactive Metronome Training on Children with ADHD.
The American Journal Of Occupational Therapy
Language Processing Test
Standard Score
Pre and Post Test Differences
Slide 16
10
9
8
7
6
5
4
3
2
1
0
-1
-2
9.316
2.666
-1
Control
Placebo
IM
Interaction Effect = 0.005
Academic Fluency Study
Jacokes (2004)
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1500 middle and high school students
20 different schools
Completed 12 sessions of IM
Participated in pre & post-testing via WJ-III
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
Reading fluency
Math fluency
 significant increase in grade equivalent
performance
Slide 17
Academic Fluency Study
2.21 GE Gain in Reading Fluency
13.5
10.5
10.25
12
10.5
9
7.5
6
4.5
3
6
4.5
3
0
0
2.21 GE gain, n=718, Woodcock Johnson, 3rd Ed.
10.73
7.5
1.5
Post IM
12.39
9
1.5
Pre IM
Slide 18
13.5
Grade Equivalency
Grade Equivalency
12
12.46
1.66 GE Gain in Math Fluency
Pre IM
Post IM
1.66 GE gain, n=703, Woodcock Johnson, 3rd Ed.
Harvard Learning & The Brain
Presented by Taub, McGrew & Keith (2005)
Study 1
Study 2
 Flanagan High School
 283 9th grade students
 Nap Ford Elementary
School
 Title 1 school
 86 students
 Control grp 151
 Experimental grp 132
 Pre/post testing: WJIII
reading & math
achievement tests
 Control grp 37
 Experimental grp 49
 Pre/post testing: WJ III
& more detailed battery
to examine pre-literacy
skills
Harvard Learning & The Brain
Presented by Taub, McGrew & Keith (2005)
Primarily
elementary
All
secondary
Dependent variable
%
IM Performance
48 %
•CTOPP Letter Naming (RAN)
•TOWRE (sight word efficiency)
•National Reading Panel
20 %
18 %
15%
•WJ III Math Calculation
•WJ III Math Fluency
•WJ III Pair Cancellation (attn/conc)
12 %
10 %
10 %
•WJ III Reading Fluency
•WJ III Math Calculation
•WJ III Math Fluency
•WJ III Broad Reading
•WJ III Math Calculation
07 %
07 %
07 %
07 %
07 %
Blue = high school Black = elementary school
Neuro-imaging Study
Presented at 65th Annual American PM&R Conference
Alpiner (2004). Results from this pilot fMRI study show
IM directly activates multiple parts of the “neuro-network.”
CINGULATE GYRUS
BASAL GANGLIA
MEDIAL BRAINSTEM
Allows Shifting of Attention
Integrates Thought and
Movement
Neuro-Motor Pipeline
Cognitive Flexibility
Slide 21
Parkinson’s Study
Pending Publication in Neurology
“In this controlled study computer directed
rhythmic movement training was found to
improve the motor signs of parkinsonism.”
- Daniel Togasaki, MD, Parkinson’s Institute
Slide 22
Motor Study
The Journal of General Psychology
 Comparison of IM- trained
golfers to a control group
 Pre/post tested on
computerized driving range
 Significant improvements in
golf shot accuracy
Slide 23
Motor Study
The Journal of General Psychology
28.23%
30%
24.22%
% Improvement
25%
19.85%
20%
15%
14.98%
14.05%
10%
5%
0%
-5%
-10%
9 Iron
7 Iron
IM Group
5 Iron
Driver
Overall
Control Group
 20% Overall Gain in Shot Accuracy
 35% Increase for advanced golfers who had
consistent swing mechanics
Slide 24
Auditory Processing Pilot Study
Etra (2006)
Applied Dissertation, Nova Southeastern University

8 children, 15 hours of IM training

SCAN-C
1.
2.
3.
4.

Statistically significant gains
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
Filtered Words
Auditory Figure-Ground
Competing Words (dichotic listening)
Competing Sentences (dichotic listening)
All subtests
Greatest Gains subtests 3 & 4
Strongly suggests IM affects auditory processing
disorders by influencing neurological organization.
Ongoing Research
Drexel University: Durability & Generalization
University of Rochester: Visual Attention
University of Cincinnati: Hemiplegic Arm
East Carolina University: CVA
Veterans Administration: Cognitive, Behavioral & Motor Skills
(normals & veterans with blast injuries)
Walter Reed Army Medical Center: PTSD, Sleep, Cognition
Slide 26
Right Ear
LATE
Left Ear
EARLY
Buzzer
Rubber
band
twang
High Pitch
Rewarding
Sound
Rubber
band
twang
Buzzer
1 second = 1,000 milliseconds
40
200
Slide 27
100
15
15
40
0
0 - 15 ms Perfect
16 - 40 ms Above Average
41 - 100 ms Average
100
200
Analysis
What we see
Patient exercises four neurological functions
at once:
 Attention & Concentration
 Sensory Integration
 Functional Motor Control
 Synchronization
“What is fired together is wired
together”…Neuroplasticity
IM GAIT MATE
http://www.interactivemetronome.com/IMPublic/GaitMate.aspx
IM GAIT MATE
“Pre-gait” skills are important
 Weight shifting
 Unilateral stance
 Limb Advancement
BUT
 The only true way to practice walking is to
WALK.
IM GAIT MATE
IM Gait Mate is an extension of IM
 Expands IM's capabilities:
• Allows the patient to move freely AND receive
continuous feedback during gait exercises.
Feedback will help the patient develop a
symmetrical gait pattern.
IM-HOME
Therapy Extension
32
Continuing Education
Live Certification Courses
 $15 off cost of course if you register within a
week of this webinar. Contact Sales
Representative.
Self-Study Certification
Courses
Advanced Live Courses
Advanced Self-Study
Courses
Webinars- Introductory &
Advanced Levels
Slide 33
Interactive Metronome Today
Currently provided by over 7,500
therapists
In 3,000 hospitals, clinics and
universities
Questions
Kelli Crovo
(954) 385-4660 x240
kcrovo@interactivemetronome.com
Slide 35