Patent Publication Number: US-2006005296-A1

Title: Human motor control device and methods

Description:
This Application claims priority to U.S. Provisional Application Ser. No. 60/585,991, entitled “Human Motor Control Device and Methods,” by John Moore, filed Jul. 7, 2004, and is incorporated herein by reference. 
    
    
     FIELD OF THE INVENTION  
      The present invention relates generally to methods and devices for providing somatosensory stimulation, and in particular, for treating motor control dysfunction by providing increased sensory input to wearers of the devices for altering motor control.  
     BACKGROUND OF THE INVENTION  
      Human motor control dysfunctions include neurological disorder such as autism and autism spectrum disorders, and neuromuscular disorders such as cerebral palsy. Both neurological and neuromuscular disorders can be defined, generally, as deficits in the brain&#39;s ability to process sensory information from, for example, proprioceptive, tactile and vestibular inputs. Various conditions can cause these disorders including pre-mature birth, neo-natal trauma, neuralgic insult (e.g., stroke), and/or genetics. They can affect movement of limbs and extremities, and can cause difficulty or inability to control limb positioning whether at rest or in active motion.  
      Proprioceptive input relates to a correlation of unconscious sensations from the skin and joints that allows conscious appreciation of the position of the body. A proprioceptive input disorder causes a person to improperly perceive or process information through the muscles, connecting tissue, skin, and joints. Clumsiness, difficult in sitting or standing without support, and lack of confidence are common symptoms.  
      The tactile sense interprets applied stimuli such as touch, pressure, pain, and temperature through tactile receptors found throughout skin. Tactile deficit disorders can cause the brain to erroneously decrease tactile sense causing a person to be overly rowdy, physical or clingy. Conversely, if the brain erroneously increases tactile sense, the person may show tendencies of tactile defensiveness. Tactile sense disorders can affect learning, body awareness, and space/time positioning, as well as visual perception, motor planning, and social participation.  
      The vestibular system provides space/time positioning information, e.g., up/down directions, balance and coordination. Vestibular system disorder can affect muscle coordination for balancing, motor planning, vision and/or emotional security.  
      Thus, human motor control dysfunctions can affect daily living in such areas of maintaining body balance, processing tasks involving muscle control, and one&#39;s social ability and overall outlook. In particular, one human motor control disorder, Autism spectrum disorder, is a form of neurological disorder and can range from autism to a form known as Asperger&#39;s syndrome.  
      People afflicted with an autism spectrum disorder are often afflicted with multiple stereotypical behaviors. For example, a person may present with constant hand flapping that does not allow or afford the opportunity to perform everyday functions, e.g., sitting, pointing, eating, catching and throwing a ball. With an autism spectrum disorder, the brain appears to be unable to process and organize the senses appropriately.  
      Children afflicted with an autism spectrum disorder may be oblivious to extreme cold or pain. A child with an autism spectrum disorder may fall and break an arm, yet never cry. Another may strike his head against a wall and not wince, but conversely, a light touch may make the child scream with alarm.  
      Sensory integration theory postulates that intervention through therapy can commonly provide enhanced sensory experience within the context of a meaningful, self-directed activity in order to elicit an adaptive behavior. The result is enhanced sensory integration and, in turn, enhanced learning and awareness of body position.  
      In response, a variety of therapeutic intervention techniques have been employed for people with autism spectrum disorders. Physical and occupational therapists provide patients with various types of stimulation including tactile (touch/deep pressure), proprioceptive (spatial/body awareness at rest), kinesthetic (spatial/body awareness in motion), and vestibular (spatial/body awareness in space).  
      One method of proprioceptive and tactile stimulation is repetitive deep pressure or deep touch pressure using weighted garments. For example, weighted gloves, vests, collars, and weighted quilts are available for creating deep pressure to wearers. Although the wearing of weighted garments is increasing in such treatment programs, the outcomes are largely anecdotal and few parameters exist to guide the use of such techniques. Furthermore, weighted garments are generally sized creating an expense and specialized fitting to properly apply the correct amount of pressure to the selected regions.  
      But perhaps foremost, weighted garments do not provide targeted therapy inputs for the treatment of autism spectrum disorders and other neurological and/or neuromuscular disorders.  
      Thus, there remains a need for improved methods and devices for providing desirable somatosensory inputs for the treatment of motor control dysfunction, including those afflicted with autism spectrum disorders.  
     SUMMARY OF THE INVENTION  
      Those needs and others are obtained by the present invention by a human motor control device having a pressure attachment that can provide a pressure on a wearer&#39;s digit, joint, ligament and/or tendon. The digit can be a finger, thumb or toe. The pressure attachment has a pliable pressure member that can receive a wearer&#39;s digit, and has flap that has a proximal end coupled to the pressure member, and a distal end having a fastener. The pressure member is disposed around the base of the wearer&#39;s digit and can provide a pressure thereon. The pressure creates an increased and organized somatosensory input assisting the wearer in motor control.  
      A human motor control device can have a pressure attachment and a cuff that can be wrapped around a limb of the wearer. The limb can be a hand, forearm, foot, or ankle area. The pressure attachment is disposed on a digit, and the flap is tensioned and its distal end is fastened to the cuff. A plurality of pressure attachments can be applied to the wearer, each disposed around or near the same or different digits. The cuff and pressure attachment create a pressure on the wearer, and somatosensory input is increased and organized.  
      A further cuff or cuffs can be disposed on the wearer&#39;s limb in proximity or adjacent to the first cuff, and can be coupled thereto. And thus, multiple cuffs can increase the area of the wearer to which pressure is applied creating a further increase and organization of somatosensory input.  
      The cuff or cuffs can be disposed around the limb of a wearer and secured thereon using releasable means, e.g., flaps coupled to the cuff. The pressure attachment has a pliable pressure member that is disposed on or around a selected region of the wearer such as the wearer&#39;s digit, wrist or forearm. A flap coupled to the pliable pressure member can be tensioned and releasably coupled to the cuff. The tension is transmitted to the pliable pressure member creating a pressure between the pliable pressure member and the wearer.  
      The pressure member can have an open center portion for receiving the digit of the wearer, and can be slid over the digit and disposed at or near the base of the digit. In one embodiment, the pressure member can be wrapped around the digit and fastened thereto via fasteners and/or flaps. In another embodiment, the pressure member can be pre-formed of a flexible material and can slide over the digit providing a stretch fit.  
      A pressure attachment can provide pressure to intermetacarpal regions of the wearer. A pliable pressure member can have a plurality of open center portions, each adapted to slide over a digit and be disposed at or near the base of its respective digit. Pressure is applied to the pressure attachment via one or more flaps tensioned and coupled to a cuff, creating a pressure between the pressure member and the intermetacarpal region(s). The cuff, pressure member and flap can be combined into a unibody design, or can be separate elements. In any case or combination of the cuff, pressure member and flap, an increase and organization of somatosensory input is created assisting the wearer in motor control.  
      Methods and devices are disclosed for providing somatosensory input to hands, wrists and/or forearm that can alter a wearer&#39;s motor control. The invention can be particularly useful for treating motor control dysfunctions such as autism spectrum disorders.  
      In use, the device applies pressure on the wearer&#39;s skin, thereby activating receptors in the nerves, joints and/or tendons which can cause sensory information including location information to be sent to the brain via the thalamus and spinal cord resulting in increased sensory awareness of the user.  
      One embodiment of the present invention provides a human motor control device having a pliable pressure member adapted to surround a digit and at least one flap extending therefrom and adapted to secure the pressure member to a base of the digit wherein the device is effective to provide somatosensory input for assisting the motor control of the wearer.  
      Another embodiment of the present invention provides a system for altering somatosensory input including a first cuff member adapted to be positioned around a first portion of a limb and to provide continuous pressure thereon, and a pliable pressure member adapted for applying continuous pressure to the base of a digit. When positioned on a wearer, the elements are connected to one another such that the continuous application of pressure to a wearer provides increased and organized somatosensory input to the wearer.  
      Another embodiment of the present invention provides a method for somatosensory stimulation including a means for providing pressure without causing a loss of circulation wherein the pressure causes sensory input to nerves in the hand, wrist or forearm such that the sensory input alters motor control of the hand, wrists or forearm.  
      Therefore, various embodiments of the present invention address current problems associated with conventional treatment methods of persons afflicted with neurological and neuromuscular disorders by providing targeted and increased pressure to afflicted areas causing location information to be sent to the brain for altering motor control in the hand, fingers, wrist, and/or forearm. 
    
    
     BRIEF DESCRIPTION OF THE INVENTION  
      The invention can be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:  
       FIG. 1A  is an embodiment of a human motor control device having a cuff disposed around a wearer&#39;s hand and a pressure attachment disposed around the wearer&#39;s thumb;  
       FIG. 1B  is a top view of the pressure attachment of  FIG. 1A  having flaps extending from a pliable pressure member and adapted to couple to the cuff;  
       FIG. 1C  is a perspective view of the pressure attachment illustrated in  FIGS. 1A and 1B ;  
       FIG. 2A  is an embodiment of a pressure attachment suitable for use with a cuff, and has two flaps each having distal ends adapted to coupled to the cuff;  
       FIG. 2B  is another embodiment of a pressure attachment suitable for use with a cuff and has two flaps each having distal end extrusions adapted to couple to the cuff;  
       FIG. 3A  is a further embodiment of an variable sized pressure attachment having a pliable pressure member coupled to a flap;  
       FIG. 3B  is another embodiment of a pressure attachment having a pliable pressure member coupled to two flaps;  
       FIG. 4A  shows an embodiment of a human motor control device of unibody construction having a intermetacarpal pressure attachment adapted to apply a pressure to one or more intermetacarpal regions of a wearer;  
       FIG. 4B  shows the pressure attachment of  FIG. 4A  disposed on a wearer;  
       FIG. 5  shows an embodiment of a human motor control device having a cuff disposed around a wearer&#39;s hand and a combination of pressure attachments; and  
       FIG. 6  shows an embodiment of a human motor control device having first and second cuffs, the first cuff having a combination of pressure attachments. 
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
      The present invention relates to devices and methods for treating human motor control dysfunction that can apply controlled and sustained pressure to a wearer&#39;s extremities. The invention is particularly useful for treatment of human motor control dysfunctions such as those related to autism spectrum disorders, and is also useful for dysfunctions associated with other disorders. The devices can apply pressure on the wearer&#39;s skin, joints, ligaments and or tendons, activating receptors therein causing sensory information input to the wearer such as location information. Those inputs are processed by the wearer&#39;s brain via the thalamus and spinal cord. That results in increased and more organized sensory awareness by the user.  
      In general, the motor control devices have a cuff that is wrapped or otherwise secured around a wearer&#39;s limb, such as a hand, forearm, foot or ankle area, and herein, the term “limb” or “extremity” refers to any of the above. A pressure attachment has a pliable pressure member that can be disposed in proximity to a selected portion a of the wearer&#39;s skin, joint, ligament or tendon, such as around the base of a finger or thumb. Herein, the term “digit” refers to fingers, thumbs and toes. The term “extremity” refers to hands, forearms, ankles and lower legs. A flap coupled to the pliable pressure member is tensioned, causing the pressure member to conform to the wearer creating a pressure on the wearer&#39;s selected extremity. The flap can be attached to the cuff providing a continuous pressure to the wearer via the pliable pressure member. Thus, a constant pressure is applied to the wearer resulting in an increase in somatosensory information.  
       FIG. 1A  shows an embodiment of a human motor control device  100  applied to a wearer&#39;s hand having a cuff member  102  and a pressure attachment  104 . Cuff member  102  is disposed over, or wrapped around, the wearer&#39;s hand providing a foundation for applying pressure attachment  104 . Pressure attachment  104  has a pliable pressure member  106  disposed around a thumb of the wearer, preferably in proximity to the base of that thumb. A first flap  108  has a proximal end  110  coupled to the pliable pressure member  106 , and a distal end  112  having a fastener  112  adapted to releasably couple to cuff  102 . A second flap  120  ( FIG. 1B ), similar to the first flap  108 , is also coupled at a proximal end  122  to the pliable pressure member  106 , and has a distal end  124  adapted to releasably attach to cuff  102  via a fastener  128 . Tension can be applied to flaps  108   120  causing a generally constant pressure between the pliable pressure member  106  and the wearer resulting in increased somatosensory information available to the wearer.  
      Although cuff member  102  can be a variety of shapes and sizes, it is preferably adapted to be secured to part or all of a wearer&#39;s hand, forearm or other extremity. As shown, the cuff member  102  is a wrap that can be applied to the wearer&#39;s hand and secured using various forms of fasteners (not shown). In other embodiments, cuff member  102  can be fashioned of a glove design. Other configurations of cuff member  102  are envisioned that provide ease of application to a wearer, and can be secured thereon. Fasteners suitable for the cuff member  102  include such means as hook and loop, zipper(s), buttons and the like.  
      Cuff member  102  can have separate or integrally separated cuff sections provided thereon in order to adjust and secure the cuff member  102  in position on the wearer. Cuff member  102  can also provide a pressure to the wearer&#39;s skin, working in conjunction with, or separately from, pressure attachment  104  to provide increased somatosensory information to the wearer. A wide variety of shapes and sizes are possible allowing a cuff member to be applied to a hand as illustrated, as well a forearm, leg, ankle and other regions of a wearer.  
      Preferably, cuff member  102  is pliable and flexible. It can be constructed from a variety of materials, such as elastomeric polymer or elastomeric fabrics, or materials having properties thereof. Cuff member  102  can include a combination of materials such as an outer side or portion having a LYCRA® type material, and an inner side or portion having a compliant foam type material. Such combination of materials allows the cuff member  102  to be compliant in order to adjust and secure to the wearer and providing increased pressure thereto, yet also soft and tactilely functional against a wearer&#39;s skin. Another example of a type of material which can be used for the cuff member  102  is NuStim Wrap® manufactured by Fabrifoam Corporation of Exton, Pa., or modifications thereof.  
       FIG. 1B  shows the pressure attachment  104  illustrated in  FIG. 1A . As described above, pressure attachment  104  has two flaps  108   120  and a pliable pressure attachment  106 . Each of the two flaps  108   120  has a proximal end  110   122 , respectively, coupled to the pliable pressure member  106 , and each flap has a distal end  112   124 , each having a fastener  114   128  adapted to releasably couple or attach to the cuff member  102 .  
      Pliable pressure member  106  illustrated is sized and shaped to be disposed around the base of a wearer&#39;s thumb, and has an open center portion  130  sized to allow it to be disposed over and around that thumb. For that purpose, open center portion  130  has an inner dimension id sufficiently large to allow for positioning over the wearer&#39;s digit and can be positioned near the base of that digit to apply pressure to the joints and/or nerves there around. Accordingly, open center portion  130  has an inner dimension id between approximately 0.2 and 1.0 inch, preferably between approximately 0.3 and 0.75 inch, and more preferably approximately 0.5 inch. In other embodiments, open center portion  130  can be sized and shaped to be disposed on or near a selected joint, digit, nerve, tendon or combination thereof, of a selected digit, thumb or other extremity, and can be larger or smaller than shown in the illustrated embodiment.  
      Open center portion  130  can have a variety of shapes but is preferably substantially circular in shape and adapted to fit over a wearer&#39;s digit such that it can apply continuous pressure to a wearer. In one embodiment, the open center portion  130  of the pressure attachment  104  can be shaped such that it deforms, either temporarily or permanently, into a different pre-determined or non pre-determined shape. For example, an oval shaped open center portion can deform into a circular shape when positioned over the base of a wearer&#39;s digit and pulled into position by the flaps  108   120 .  
      Outer dimension od of the pliable pressure member  106  is sized to allow the pliable pressure member  106  to be disposed between digits of the wearer without causing discomfort or adversely restricting circulation. In one embodiment, pliable pressure member  106  can apply pressure to both the joints and nerves at the base of the digit, and also to the intermetacarpal region between digits. In the illustrated embodiment, outer dimension od is between approximately 0.5 to 1.5 inches, preferably between approximately 0.7 to 1.0 inches, and more preferably approximately 0.75 inch. In other embodiments, outer dimension od can be sized smaller or later depending on the size of the region of the wearer whereon the pressure member  106  will be applied.  
      As already noted, pliable pressure member  106  is preferably sufficiently pliable to be comfortable while providing a continuous pressure. Numerous materials are suitable for its construction including those consisting of elastomeric polymers, preferably those hypoallergenic properties and easily sterilized or cleaned. In one embodiment, the pliable pressure member can have a soft covering or coating to provide increased comfort.  
      Flaps  108   120  are generally elongate in shape, each one having a proximal end  110   122  coupled to the pliable pressure member  106 , and each a distal end  112   124  having fasteners  114   128  for attachment to the cuff member  102 . Flaps  108   120  are illustrated as extending from the pliable pressure member  106  in opposing directions. Thereby, flaps  108   120  can be tensioned by pulling in opposing directions away from the pliable pressure member  106  to position and hold it in place around the base of a digit and to secure it in position around the digit. Other configurations are possible including one where the flaps can be positioned on a single side or portion of the pliable pressure member. In other embodiments, there can be one flap coupled to a pliable pressure member, or multiple flaps connected thereto in other embodiments.  
      Flaps  108   120  can be secured to the pliable pressure member  106  using a variety of attachment methods such as gluing, sewing, riveting, integrally molding or attaching, or other methods of attachment known to those skilled in the art. Flaps  108   120  can warped around a portion of the pliable pressure member  106  through the open center portion  130 , and each attached to itself by adhesive or other means. Attachment of the flaps  108   120  to the pressure member  106  can be provided such that each flap is free to slide on the pressure member  106  for alternate positioning and adjusting thereof. As illustrated, flaps  108   120  are fixedly secured to the pressure member  106  to provide an opposing force when the pressure member  106  is disposed on the wearer&#39;s digit and the flaps tensioned.  
      Flaps  108   120  can have a variety of shapes and sizes but preferably extend from the pliable pressure member  106  such that they can induce the pliable pressure member  106  to provide increased pressure to joints, digits, nerves or tendons of a wearer&#39;s digit. Flaps  108   120  can be made of a variety of materials such that they may or may not be adapted to stretch, but preferably allow for the positioning of the pressure member  106  to the base of a wearer&#39;s digit and provide tension as described above. Thus, flaps  108   120  can be made from a polymer material molded into a variety of shapes. Non-flexible flaps  108   120  can also be integrally attached to the pliable pressure member  106  or can have a fastening means known to those skilled in the art to facilitate attachment of the flaps  108   120  to the pliable pressure member  106 .  
      Flaps  108   120  are adjusted by tensioning or otherwise pulling them in a direction away from the pliable pressure member  106  generally toward the wearer&#39;s wrist, for example, and attaching the fasteners  114   128 , respectively, to cuff  102 . A resulting increase in pressure between the pliable pressure member  106  and the wearer creates an increase in somatosensory information.  
       FIG. 1C  is a perspective view of pressure attachment  104 . Proximal ends  110   122  of flaps  108   120  are coupled to the pliable pressure member  106  through the open center portion  130 . As illustrated, pliable pressure member  106  has a thickness that can be selected according to an intended application. For example, a thicker pliable pressure member  106  is suitable for application involving a thumb, as opposed to a thinner pressure member that is suitable for smaller digits. Those skilled in the art will appreciate that more pressure should be applied to thicker pressure members, and conversely, less pressure for less thick pressure members is required.  
       FIG. 2A  shows a different embodiment of a pressure attachment  200  suitable for use with a cuff  102 . Pressure attachment  200  has flaps  208   220 , each having a distal end  212   224  that has fastening means that are integral to a respective flap  208   200 . Fastening means can be hook and loop, glue or adhesive, snaps or other fastening means that can secure distal ends  212   224  to a cuff. This illustrated embodiment provides a larger area for the fastening means and thus, can apply a stronger pressure or force to pliable pressure member than flaps having less area for fastening means. Of course, a force that can be transmitted to the pressure member is also a function of the size of the pressure member, as well as the type of fastening means used at the distal ends of the flaps.  
       FIG. 2B  shows another embodiment of a pressure attachment  260  generally as described above, albeit with flaps  262   264  having distal end protrusion fasteners  266   268 . Distal end protrusion fasteners  266   268  can have a variety of shapes and sizes, but preferably are shaped such that they can facilitate the position of pliable pressure member to the base of a wearer&#39;s digit. Furthermore, distal end protrusion fasteners  266   268  of flaps  262   264  can be fashioned from a fastening means such as hook and loop material, glue or adhesive, snaps or other fastening means, as stated above. Thus, flaps  262   264  and extrusions  266   268  can be manufactured from the same material with fastening means provided thereafter.  
       FIGS. 3A and 3B  show embodiments of pressure attachments  300   360 , respectively, that can be used with a cuff  102 , and can surround a region of a wearer&#39;s digit or forearm, for example, to provide pressure around that region. Pressure attachment  300  ( FIG. 3A ) has pliable pressure member  302  that is adjustable in size and can be wrapped around a desired digit or other portion of the wearer. Fastener  306  can secure the pliable pressure member  306  in a desired location. Flap  304  has a proximal end attached to the pliable pressure member  306 , and a distal end having a fastener adapted to couple to a cuff, e.g.,  102 . Thus, pressure attachment  300  can be used for a variety of different wearer&#39;s having differing sizes of digits and/or forearms. Pliable pressure member  302  and flap  304  can be a unibody construction, or can be manufactured of differing materials joined together along a seam or other junctions. In general, pliable pressure member  302  is constructed from a material that can transfer a tension to a region of a wearer&#39;s digit, such as Lycra, NuStim Wrap (as noted above) or neoprene and the like as long has it has an elastic-like property. Pliable pressure member  302  can be constructed of a plurality of materials, e.g., a foam inner surface and an elastomeric outer surface. Advantageously, pressure attachment  300  can be used for a variety of applications since by its nature it has an adjustable center open portion when wrapped around a digit. Further, pressure attachment  300  can be used to apply pressure to other parts of the body due to its open design, such as forearm, legs, upper arms and other limbs.  
       FIG. 3B  shows a pressure attachment  360  having two flaps  364   366  that can be integral or otherwise attached to a pliable pressure member  362 . Pliable pressure member  362  has a fixed-sized open center portion  370 . Flaps  364   366  each have a proximal end coupled to the pliable pressure member  362 , and each has a distal end with a fastener thereon or therein suitable or adapted to couple to a cuff.  
      In one embodiment, flaps, e.g.,  346   366 , can be removably coupled to pliable pressure member, e.g.,  362 , providing replacement with flaps of differing dimensions or fastening means. Thus, longer or shorter flaps may be used rather than having fixed length ones as illustrated. In the event that flaps  364   366  are removably coupled to pliable pressure member  362 , they can attach thereto in a variety of ways such as hook and loop, gluing, sewing or other attachment means known to those skilled in the art.  
      In the illustrated embodiment, pliable pressure member  362  is a continuous portion of material such that it slips over a digit or hand, and is further secured to the base of the digit or forearm via fasteners on or integral to flaps  364   366  to provide a constant and increased pressure to the joints where contact is made therewith. The continuous portion of material can be a variety of shapes and sizes, but preferably, it is substantially circular and sized to slide over a digit or hand (with stretching) of the material. As already noted, it can be constructed of a plurality of materials or combination thereof. Open center portion  370  can be selected to be a variety of sizes depending on whether, for example, the pressure attachment  360  is intended for a digit, forearm, or other extremity.  
       FIG. 4A  shows an embodiment of a human motor control device  400  having an intermetacarpal pressure attachment  402  non-releasably coupled to a cuff  404 . The intermetacarpal pressure attachment  402  has a pliable pressure member  406  having open center portions  408   410  each sized to receive a wearer&#39;s digit and be disposed in proximity to the base of those digits. Intermetacarpal portions  416   418   420  of pressure member  406  can create a pressure on intermetacarpal regions between those digits of the wearer. That pressure creates an increase and organization of somatosensory input to the wearer.  
      Those skilled in the art will appreciated that pressure member  406 , flaps  412   414  and cuff  404  can be manufactured as a single piece, or they can be constructed separately or in any combination thereof using the same or differing materials. When manufactured separately, they can be coupled together using a variety of means, both permanently or releasably, using hook and loop fasteners, glue or adhesives, sewing or otherwise.  
      The illustrated pliable pressure member  406  has two (2) open center portions  408   410 , but in other embodiments it can have more or fewer open center portions. Intermetacarpal portions  416   418   420  are located adjacent to open center portions such that each intermetacarpal portion can be disposed over an intermetacarpal region of the wearer and apply a pressure thereon. Intermetacarpal portions  416   418   420  can be of a variety of shapes and sizes, but are preferably adapted to apply a pressure between digits of the wearer, that is, on the intermetacarpal regions between adjacent digits.  
      Cutouts  426   428  facilitate placement of digits adjacent to those received via open center portions  408   410 , and can be of various shape and sizes depending on which digits are to be received by the pressure member  406 . Open center portions  408   410  can be of the same or differing sizes, each size selected according to the size of the wearer&#39;s digit that will be received there through.  
      Flaps  412   414  each have a proximal end coupled to the pliable pressure member  406 , and each flap has a distal end having a fastener  422   424  as already noted above. Fasteners  422   424  can have different configurations, materials and means of fastening such as already described above. In the illustrated embodiment, flaps  412  have sufficient length to wrap around a portion of the wearer&#39;s limb and releasable couple to the cuff  404 .  
      The human motor control device  400  can include a combination of materials such as a LYCRA® type material for a outer surface, and a compliant foam type material for an inner surface in contact with the wearer&#39;s skin. A combination of materials can allow the pliable pressure member  406  to be compliant in order to allow adjustment and to be secured between the wearer&#39;s digits providing increased pressure thereto, yet also soft and tactilely functional against a wearer&#39;s skin. One example of a type of material which can be used is NuStim Wrap® previously mentioned above. The intermetacarpal pressure attachment  402  can be attached to a cuff to create a pressure between the pliable pressure member  404  and the wearer, or it can be used without a cuff and still provide such pressure, as now illustrated.  
       FIG. 4B  illustrates the human motor control device  400  of  FIG. 4A  disposed on a wearer&#39;s hand. Digits of the wearer&#39;s hand are received via open center portions  408   410 , and cutouts  426   428  allow placement of the pliable pressure member  406  in proximity to those digits. Cuff  404  is disposed on the palm side of the wearer&#39;s hand, and flaps  412   414 , extending around the outside of the hand, are releasably coupled to the cuff  404  via fasteners  422   424 . Because the intermetacarpal pressure member  406  is constructed of a pliable material, tension provided via the flaps  412   414  is transmitted to intermetacarpal portions  416   418   420  causing a pressure on the wearer&#39;s intermetacarpal regions.  
       FIG. 5  shows an application of a human control device  500  secured on a wearer&#39;s hand. The device  500  has a cuff  502 , first and second pressure attachments  504   506 , and an intermetacarpal pressure attachment  508 . It will thus be appreciated by those skilled in the art that various combinations of pressure attachments can be applied to simultaneously apply pressure to various digits, joints, ligaments and tendons of a wearer to increase and organize somatosensory stimuli that, in turn, can increase the desired response from the wearer  
      As illustrated, intermetacarpal pressure attachment  508  is coupled or otherwise integrated to cuff  502 , although in one embodiment, an intermetacarpal pressure attachment can be separate therefrom. Cuff  502  is as generally described above and is illustrated as surrounding the wearer&#39;s hand. Cuff  502  is disposed thereon by sliding the wearer&#39;s digits through open center portions of the intermetacarpal pressure attachment  508  as already described, and disposing the attachment at or near the base of the digits. Securing the cuff  502  to the wearer is and the intermetacarpal attachment  508  is accomplished by pulling flaps  514 A  514 B around the hand in a direction opposed to a proximal end  510 A  510 B of each flap, and fastening each to cuff  502  using fasteners  516 A  516 B, respectively.  
      Pressure attachments  504   506  illustrated are as generally described above, and each has a pliable pressure member and flaps coupled thereto. Each pliable pressure member receives a digit and is disposed in proximity to the base of that digit. For example, pressure attachment  504  has a pliable pressure member  520  that is disposed near the base of the wearer&#39;s digit. Flat  518  has a distal end coupled to the pressure member  520 , and has a distal end having a fastener  512  that is coupled to the cuff  502 .  
       FIG. 6  shows a further embodiment of a human motor control device  600  having a first cuff  602 , a second cuff  604  and pliable pressure attachments  606 A-F. First cuff  602  is illustrated as sized and shaped to be a glove type structure, and can be of seamless construction incorporating materials such as those already described. A seamless construction negates a need for fastening flaps to be incorporated within the cuff, however, such construction also increases a need to ensure a proper sizing of the first cuff  602 , and second cuff  604  if also of a glove type structure, to ensure proper placement to a wearer&#39;s hand, e.g., a stretch fit. Second cuff  604  is also illustrated as a seamless cuff; however, it can be of a wrap variety with fastening flaps as described above. In any event, first cuff  602  and second cuff  604  can be separate, or they can be joined together via any number of joining means such as unibody construction, hook and loop arrangement, glue or adhesive, or other means with will be appreciated by those skilled in the art.  
      Pressure attachments  606 A-E are as generally described above, and each has a pliable pressure member sized and shaped to receive a digit, and flaps having fasteners, such that the flaps can be tensioned and releasably coupled to one or both of the cuffs  602   604 . It will be appreciated by those skilled in the art that pressure attachments  606 B-E can also have one or more further flaps on a back side of the first cuff (not shown), and that such configurations are envisioned. Further, it will be appreciated that first cuff  602  can have one or more integrated intermetacarpal pressure attachments, as described above.  
      Pressure attachment  606 F has a first pliable pressure member  612 A and a second pliable pressure member (not shown) that is disposed on an opposing side of the wearer&#39;s forearm. Flaps  614   618  each couple the first pressure member  612  to the second pressure member, thereby creating tension between the two pressure members that, in turn, create a pressure on the wearer&#39;s forearm. Flaps  614   618  can have fasteners disposed on one or more ends that are reliably coupled to one of the pressure members, and are constructed of materials as described above. It will be appreciated by those skilled in the art that this embodiment of a pressure attachment provides increased and organized somatosensory input to the wearer.  
      A method for somatosensory stimulation is provided, including a means for providing pressure without causing a loss of circulation wherein the pressure causes sensory input to nerves in the hand, wrist, or forearm and wherein the sensory input alters motor control of the hand, wrist, or forearm. The means for providing the pressure can include, but is not limited to, the device  10  described above, and the system  15  for altering proprioceptive sensory input which is also described above.  
      In practice, one or more locations or regions of a wearer&#39;s extremity or extremities are selected for application of pressure attachments. One or more cuffs are applied to those areas and secured thereon using any of the means described above. Selected pressure attachments, including any intermetacarpal pressure attachments, are applied to the wearer at the selected locations. Flaps coupled to pliable pressure members of those pressure attachments are tensioned and attached at distal ends to the cuff(s).  
      The present invention is further described with reference to the following three examples, each of which is intended to be illustrative rather than limiting.  
     EXAMPLE 1  
      The patient is approximately 5-years-old boy with a moderate autism disorder. He presented with echolalic speech, low tone throughout upper extremities, lower extremities, and trunk. He shows decreased ability to interact socially with adults and peers, and exhibits stereotypical self-stimulatory behaviors including hand flapping. A system of the present invention was applied to the patient, including a first cuff member on the hand, a second cuff member on the forearm, a pliable intermetacarpal attachment, and pressure attachments to the digits of the hand.  
      After the system was applied, flaps were tensioned for optimal fit and to provide a constant pressure. The first and second cuff members, and pliable intermetacarpal attachment were each adjusted to provide a tactile input through increased pressure to nerves thereabout, but without significantly affecting circulation. Pressure attachments were then applied to the patient&#39;s thumb and index finger and the flaps of each pressure attachment were tensioned and attached to the first cuff. Attention was given to placement of the flaps relative to the thumb and index finger to provide correct joint approximations at the first and second metacarpalphalangeal joints. The first cuff member was stretched in a direction toward the second cuff and joined thereto via Velcro® hook and loop fasteners.  
      After several hours, the stereotypical/self-stimulatory behaviors noted above noticeably decreased. The patient was still functional while the system of the present invention applied and was observed coloring and attempting to interact with other children.  
     EXAMPLE 2  
      The patient is a 6-year-old boy with severe autistic disorder. He presented with little to no speech, decreased ability to interact socially with adults and peers, and posturing of upper extremities into awkward positions with visual fixation on his upper extremities, primarily hands. A system of the present invention was applied to the patient, including a first cuff member on the hand, a second cuff member on the forearm, and a pliable intermetacarpal attachment to the right hand of the patient. The system was secured and adjusted using flaps as described above.  
      After several hours the patient showed an increase aware of his right hand, and ceased his prior posturing positions. His right had appeared in a relaxed position at the side of his body while he was observed sitting on the floor.  
     EXAMPLE 3  
      The patient is a 13-month-old boy with a right middle cerebral artery cerebrovascular accident (perinatal stroke) that affected primarily his left upper and lower extremities. A main concern related his left upper thumb that he would present in a flexor pattern similar to a child with cerebral palsy or an adult who suffered a stroke. The patient had decreased function of his hand/finger complex because of the thumb flexor pattern. Further, the patient had extreme difficulty forming a pincer and cylindrical grasps.  
      The system of the present invention was applied to the patient, including a first cuff member on the hand and pliable intermetacarpal member to the left upper extremity. It was adjusted as described above using flaps and fasteners coupled to the cuff. The system included a pliable pressure attachment applied to the patient&#39;s left thumb, the flaps tensioned to pull the thumb into a slight extension. The pressure attachment was attached to a pliable intermetacarpal member to provided to correct joint approximation(s) at the first metacarpalphalangeal joints and facilitate extension of thumb.  
      After approximately three tries of grabbing a large crayon, the patient, with the system of the present invention applied, was able to reach for the crayon, extend his thumb and grasp the crayon with correct cylindrical grip. After the system of the present invention was taken off he was still able to reach for the crayon, extend his thumb and grasp the crayon although the effect was only transient.  
      The invention being thus disclosed and illustrative embodiments thereof described, further variations and modifications will occur to those skilled in the art and all such variations and modifications are considered to lie within the scope of the invention as defined by the claims appended hereto and equivalents thereof.