Kinesthetic Awareness Training for Pediatric PTs and OTs

8 hours ago

6 min read

Kinesthetic Awareness Training for Pediatric PTs and OTs

Dr. Jo Shattuck, PhD

Neuroscientist, motor learning researcher, former professional racquetball athlete and coach, founder of PantherTec

Kyle Burrell

Engineer, creative coder and elite basketball coach, PantherTec

" What we like to think is we're adding a little extra sensory information, artificial proprioception if you will, at the exact moment in time that it's the most salient point of information during that movement."

The moment you put your hands on a child to guide a movement, you change their sensory experience, and you change the motor learning that follows. What if you could give feedback on where the body is in space without touching them at all?

That question is why I got so excited when Esther de Ru, a wiredON Collective member and Clinical Excellence Online expert, first showed me the KAT. KAT stands for Kinesthetic Awareness Training device. It is a small sensor that you strap onto a body part, capture a target position, and then set to vibrate, beep, or both when the person reaches that position or moves outside it. It works in three planes (the engineers call them X, Y, and Z, and very kindly print them on the unit so we therapists can translate them into frontal, sagittal, and transverse).

In this interview, I sit down with the two people behind the KAT.

Dr. Jo Shattuck is a former world-class racquetball athlete and coach who earned a PhD in neuroscience, studying how the brain changes as a motor skill becomes automatic.

Kyle Burell is the engineer and coder who builds the KAT's hardware, firmware, and software, and coaches basketball from high school to semi-pro.

Between them, they have used the KAT with elite athletes, seven-year-old softball players, barrel racers, people with Parkinson's, and a stroke survivor who started each session by asking, "Do I get to use the KAT today?"

If you care about the neuroscience of quality of movement and motor learning, you will want to hear this conversation.

Enjoy!

Scroll down to the podcast player to listen or find us on [Spotify], [iTunes] and [Stitcher].

For handy links to things we've discussed in this interview, scroll down to the Resources Section at the bottom of the page.

In This Episode

Kinesthetic dissonance

Jo describes kinesthetic dissonance as the cousin of cognitive dissonance: the moment you realise your body was not where you thought it was. You trip and turn around to look at what caught you. You miss a shot you were sure you'd make. The KAT is designed to bring that contrast to awareness at the exact moment in a movement when it matters most. Jo calls it "artificial proprioception." We talked about how this links to how we are rethinking spasticity as the body's attempt to find itself when sensory information isn't getting through.

Influence, not measurement

Jo was clear that the KAT is not a measuring tool. Better systems exist if you want numbers on a screen. The KAT lets a person experience their own movement. In a clinic in Omaha, they placed it on the affected leg after a motor vehicle accident and set it to the desired stride length, so the patient got a buzz when they reached it during the gait cycle. With Parkinson's, they used it on the wrist for big arm swing, and used rhythmic beeps as an audio cue for bradykinesia.

Simple, neutral feedback

Kyle compared it to TAGteach: the feedback is binary (beep or no beep), requires no language processing, and carries no emotional overlay. For kids who have difficulty with language and movement, that matters. Jo's instruction is simply "move till you find the beep." Kyle also recommends one device, on one body part, for a few minutes at a time. You can connect up to three, and two can help when they are working on one synchronised pattern, such as the forearm and shoulder in a basketball shot.

Compensation is a sign that something changed

One of my favourite stories: a seven-year-old softball player with the KAT on her hip found a way to make it beep by dropping her right knee below her left. Technically correct, and a clear example of the brain solving the movement problem it was given. Kyle saw the same thing with 15 high school baseball players who wore the KAT on their caps. They kept their heads still, lost their balance, and within a few reps found a way to do both. For children with spasticity, who often learn one way to move and then stick with it, the chance to problem-solve without hands-on constraints is exciting.

Positive and negative feedback

You can set the KAT to signal when someone hits the target or moves out of it. Jo uses negative feedback to break an ingrained pattern, then immediately replaces it with the optimal one. Kyle described starting with positive feedback to find a position, then switching to negative so attention can move outward to the hoop. We talked about how this could help children who toe-walk: flat feet in the therapy room, then straight back up on their toes as soon as their attention shifts to where they are going.

Leave and retrieve

Jo explained that it retrieves a motor pattern that creates change, rather than repeating it. At one basketball camp, players used the KAT for about five minutes, went back to drills for 20 to 30 minutes, then returned. Every player except the top three performers found their target positions faster and more accurately the second time. One player with a "chicken wing" elbow came back and went straight into the new position without being reminded. For families heading home after an intensive block, Jo cited her own grant work finding that the main barriers to home programs are "I don't know if I'm doing it right" and "I don't know if it's going to work." A beep answers the first one.

The KAT flow

Jo and Kyle teach four steps in order: eyes open, find the spot; eyes closed, find the spot; prediction, where you say when you think you'll find it; and precision, where you hold the position for a set number of beeps. Even elite athletes start with big corrections and gradually shrink them.

From astronauts to telehealth

We also covered Jo and Kyle's NASA proposals on sensorimotor changes after gravity transitions, a parabolic flight study with amputees, eye-tracking pilots in softball, a telerehab feasibility study for rural patients, and whether the KAT could one day play a dinosaur roar instead of a beep.

Listen, enjoy, share...

Podcast Highlights

00:00:00 - What the KAT is and why hands-off feedback matters
00:03:00 - How Jo and Kyle met
00:07:00 - Kinesthetic dissonance and the brain's need to know where the body is
00:09:00 - Spasticity as the body trying to find itself
00:09:00 - Using the KAT with Parkinson's: LSVT BIG arm swing, stride length and bradykinesia
00:12:00 - Artificial proprioception, and why "influence" rather than "measure"
00:15:00 - Jo's path from racquetball pro to PhD in motor learning
00:18:00 - Jo's EEG research, Kyle's esports study, and what EEG can and can't tell us about skill
00:24:00 - Automaticity and error prediction
00:25:00 - TAGteach, binary feedback and removing the emotional overlay
00:30:00 - One device or three? Synchronising patterns and handling compensation
00:33:00 - The softball hip and baseball cap stories
00:38:00 - Using the KAT with children who have cognitive or language difficulties
00:39:00 - Barrel racing, horses and "off course" saddle training
00:44:00 - Training variability, not one right way
00:46:00 - Positive versus negative feedback, and internal versus external attention
00:51:00 - Toe walking, foot drop and timing the gait cycle
00:53:00 - Custom sounds and moving the device between patients
00:57:00 - Basketball camp results and the "aha face"
01:02:00 - The four-step KAT flow
01:04:00 - Leave and retrieve, intensives and home programs
01:12:00 - Eye tracking, telerehab and visual occlusion
01:20:00 - NASA proposals and parabolic flight
01:20:00 - What movement disorders taught Jo about motor learning
01:28:00 - What Jo and Kyle are most excited about, and where to find them

Biography

Dr. Jo Shattuck, neuroscientist and founder of PantherTec, smiling in tortoiseshell glasses and a black sweater

Dr. Jo Shattuck, PhD

Jo is a former world-class racquetball athlete and coach, and was the racquetball professional at the Denver Athletic Club. After retiring from professional competition in 2010, she worked as a professional research assistant in neurology at the University of Colorado Anschutz Medical Campus before completing a PhD at the University of Nebraska, where she worked in the Athletic Performance Lab and the Center for Brain, Biology and Behavior. Her doctoral research used EEG to study how the brain changes as a motor sequence becomes automatic. She has worked with people with Parkinson's disease, Huntington's disease, and concussion. Jo developed kinesthetic awareness training to close the gap between what we know about how the brain learns movement and how movement is usually taught. She is based in Evergreen, Colorado.

Kyle Burrell

Kyle is an engineer and coder who works across PantherTec's hardware, firmware, and software and has taken on an increasing share of the business. He founded Neuralytics AI LLC, researching consumer EEG and fNIRS devices to analyse brainwave patterns in athletes and esports players, and built neuro training protocols for collegiate Rocket League players. He coaches basketball from high school to semi-pro level and tests every idea on his own athletes first. He is based in Scranton, Pennsylvania.

People Mentioned

Esther de Ru, therapeutic taping specialist and Clinical Excellence Online expert
Dr. Benzi Kluger, neurologist, University of Colorado Anschutz
Dr. Rachael Seidler and Jess Zendler NASA proposal collaborators