Interactive Metronome - neurological assessment and treatment tool

interactive metronome

Interactive Metronome (IM) is a cutting-edge neurological assessment and treatment tool that is redefining traditional expectations for pediatric and adult therapy outcomes.

IM was developed in the early 1990s and first used to help children with learning and developmental disorders, such as:

  • Sensory Integration Disorder
  • Autism Spectrum Disorder
  • Cerebral Palsy
  • Non-verbal Learning Disorder
  • Through years of clinical research and the efforts of innovative therapists, IM was soon being implemented as part of a therapy program with older patients who also exhibited the same deficits as pediatric patients, such as:

  • Traumatic Brain Injury (TBI)
  • Cerebral Vascular Accident (CVA)
  • Balance Disorders
  • Limb Amputation
  • Parkinson’s Disease
  • Multiple Sclerosis (MS)
  • Today, Occupational Therapists, Speech Language Pathologists, Physical Therapists, Educators, Athletic Trainers, Licensed Rehabilitation Medical and Mental Health Professionals Neurologists, Psychiatrists, Psychologists and Chiropractic Care Professionals are enhancing traditional therapy approaches with IM and achieving measurably improved outcomes. IM has been shown to improve:

  • Attention & Concentration
  • Motor Planning & Sequencing
  • Language Processing
  • Behavior (Aggression & Impulsivity)
  • Balance and Gait
  • Endurance
  • Strength
  • Motor Skills
  • Coordination

    The Interactive Metronome is an advanced brain-based assessment & treatment program developed to directly improve the processing abilities that affect motor planning and sequencing.  Motor planning and sequencing are central to human activity – from the coordinated movements needed to walk or climb stairs, to the order of words in a sentence to provide meaning. Interactive Metronome (IM) is the only therapy tool that improves those human capacities by using innovative neurosensory and neuromotor exercises developed to improve the brain's inherent ability to repair or remodel itself through a process called neuroplasticity.

    Clinical Foundation
    The human brain's efficiency and performance depend on the seamless transition of neuronetwork signals from one area of the brain to another. Findings in a recent study by Neal Alpiner, MD, “Functional MRI Study of the Effects of IM on Auditory-Motor Processing Networks”, suggest that IM works by augmenting internal processing speed within the neuroaxis. The key regions affected appear to include the cerebellum, prefrontal cortex, cingulate gyrus and basal ganglia.

    The IM program provides a structured, goal-oriented process that challenges the patient to synchronize a range of hand and foot exercises to a precise computer-generated reference tone heard through headphones. The patient attempts to match the rhythmic beat with repetitive motor actions.

    A patented audio or audio and visual guidance system provides immediate feedback measured in milliseconds, and a score is provided.

    Over the course of the treatment, patients learn to:

    • Focus and attend for longer periods of time
    • Increase physical endurance and stamina
    • Filter out internal and external distractions
    • Improve ability to monitor mental and physical actions as they are occurring
    • Progressively improve performance

    The Interactive Metronome is an advanced brain-based treatment program designed to promote and enhance brain performance and recovery. This is accomplished by using innovative neurosensory and neuromotor exercises developed to improve the brain's inherent ability to repair or remodel itself through a process called neuroplasticity.


    Because IM works on the core brain functions of motor planning and sequencing, it is being used successfully by occupational therapists, physical therapists, and speech therapists.

    Occupational Therapy:
    For many years, occupational therapists have observed the significant role that motor planning and sequencing play in helping patients become more functionally independent in the activities of daily living (ADLs).

    Published research shows that improving rhythmicity and timing through Interactive Metronome (IM) may also result in significant improvements in the development of cognitive and physical skills that are important for performance in many areas including:

    • Motor function
    • Bilateral coordination
    • Sensory integration
    • Motor planning and sequencing
    • Balance

    According to an article published in the American Journal of Occupational Therapy entitled "Theoretical and Clinical Perspectives on the Interactive Metronome – A View from Clinical Occupational Therapy Practice," “Many of the individuals [who] occupational therapists evaluate from a sensory integrative frame of reference are ‘out of sync’ with the spatio-temporal aspects of their environments. They often lack the internal sense of timing that is necessary to regulate sleep as well as physical and social interactions with the world. In addition, they often have difficulty with visuospatial and constructional skills that are highly dependent on accurate perception of temporal and spatial cues."

    "Clinical experience suggests that if IM is used as a technique along with sensory integration, there may be an improved ability to more fully benefit from the sensory integration approach. If IM is done when no further gains are seen with a sensory integrative approach, it is possible that IM may be effective in creating further gains."

    Speech Therapy:
    Practitioners in the field of speech-language pathology recognize the role of motor planning and sequencing in the acquisition of speech, language, communication skills, and cognition.

    IM is a unique application of technology that can improve those underlying capacities, which are essential to patients’ development of speech-language and cognitive skills. Through neuroplasticity, the cognitive-motor exercises that make up IM tasks stimulate the brain to adapt or create new neural pathways that compensate for injury or developmental delay, which results in functional outcomes.

    IM can result in or contribute to improvements in:

    • Language processing
    • Social communication
    • Planning and sequencing
    • Attention and concentration
    • Control of impulsivity and aggression

    Physical Therapy:
    Physical therapists use Interactive Metronome to assess and improve patients’ motor planning and sequencing. This interactive process enhances the patient’s mobility and gross motor function, which helps him/her become more functionally independent.

    The IM program involves repeated hand, toe, and heel exercises as well as weight shifting, and bilateral lower extremity coordination. These exercises are performed during therapy visits and are increasingly varied and extended so that most patients are able to perform thousands of repetitions. Since the treatment provides engaging feedback and requires a high level of concentration, it provides the patient an opportunity to maintain a level of endurance not typically reached other repetitive exercises.

    Those with limb amputations and other balance-related diagnoses are also helped by the repetition of IM exercises, which bring about progressive improvements in their balance and gait. Functional motor control gains are achieved within a short period of time.

    IM neurological and motor rehabilitation helps improve patients’:

    • Endurance and strength
    • Gait Symmetry
    • Coordination
    • Motor skills
    • Balance


    • Creighton University Medical Center
    • Medical College of Georgia (MCG Health)
    • Rusk Institute (NYU)
    • University of North Carolina
    • University of Notre Dame
    • Duke University
    • Louisiana State University
    • University of Kansas Medical Center
    • University of Rochester
    • East Carolina University
    • Arizona State University
    • University of Washington
    • The University of Utah
    • College of Staten Island
    • Cerritos College
    • Nova Southeastern University
    • Youngstown State University
    • Widener University
    • Marquette University
    • Boston University
    • Grand Valley State University
    • University on Nevada
    • University of Miami
    • Johns Hopkins University
    • MCP - Hahnemann University
    • Texas Womens University
    • California State University
    • Rider University
    • Richard Stockdon College

    More Information and Demo is available at Interactive Metronome site