Frequently Asked Questions

What is stroke, what are its symptoms, and how prevalent is it in the United States?
According to the National Stroke Association, a stroke is a “brain attack” that occurs when a blood clot blocks an artery or a blood vessel breaks, which interrupts blood flow to an area of the brain. When either of these happens, brain cells begin to die, causing brain damage. As brain cells die, the area of the brain that controls certain abilities throughout the body is also lost. These abilities include speech, movement and memory. More than two-thirds of stroke survivors experience some type of disability.

Stroke ranks as the third leading cause of death, and the number one cause of disability among adults in the United States. Stroke symptoms include:
- Sudden numbness or weakness of the face, arm or leg—especially on one side of the body.
- Sudden confusion, trouble speaking or understanding.
- Sudden trouble seeing in one or both eyes.
- Sudden trouble walking, dizziness, loss of balance or coordination.
- Sudden severe headache with no known cause.
More than 750,000 Americans will suffer a stroke this year, while more than 5,500,000 Americans currently live with disabilities associated with stroke.
What or who is Encore Path?
Encore Path, Inc. is a woman-owned medical device company that was founded by entrepreneur Kristen Appel in 2006. It is based in Baltimore, Maryland. The mission of Encore Path is to improve the quality of life for stroke survivors by producing and selling science-proven technologies, devices and therapies—developed at the University of Maryland School of Medicine—that make stroke rehabilitation faster, safer, and more affordable.

Encore Path’s debut product, which will launch and be available to patients in 2009, is called Tailwind™, formerly BATRAC™ (Bilateral Arm Trainer with Rhythmic Auditory Cueing). Encore Path holds exclusive license to market BATRAC worldwide from the University of Maryland, which holds the patent.
How else does Encore Path support the stroke survivor?
The Tailwind treatment program was developed by Ph.D. physical therapy researchers working with stroke patients over many years. Encore Path encourages Tailwind users to share their experiences with us. We encourage you to join our mailing list for periodic updates on stroke recovery. We send out information for stroke survivors – new stroke research, new product updates and other useful information. In addition, Encore Path has brand-new stroke rehabilitation devices under development, and we’ll share updates with you.
What is Encore Path’s scientific background and support?
In addition to President and CEO Kristen Appel, Encore Path has leaders in health care, technology, physical therapy and stroke care serving as key advisors since she developed the company including:

Scientific Advisory Board
- Daniel F. Hanley, MD, Encore Path Chief Medical Officer; Vice Chairman of the Board, National Stroke Association; and Director, Brain Injury Outcomes Program, Johns Hopkins Medicine
- Jill Whitall, PhD, BATRAC co-inventor and Professor, Physical Therapy and Rehabilitative Science, University of Maryland, Baltimore
- Sandy McCombe Waller, PhD, BATRAC co-inventor and Assistant Professor, Physical Therapy and Rehabilitative Science, University of Maryland, Baltimore
How does a start-up company like Encore Path obtain its funding?
As a clinically-proven medical device with many attributes, Tailwind has attracted the interest of public and private investors. In early 2008, Encore Path received public funding from the National Institutes of Health to further develop stroke rehabilitation technologies. In addition, the Company has also received funding from the Maryland Technology Development Corporation, the Maryland Department of Business and Economic Development, the University of Maryland, and has won several business plan competitions around the country. Private investors, including specialists in physical therapy, have also invested in the company.
What is Tailwind and how is it backed by science?
Tailwind is Encore Path’s first-of-its-kind patented stroke rehabilitation device that clinical studies have shown can permanently improve arm movement in patients who have lost upper extremity function due to stroke or other brain injury.

An article in the October 2004 Journal of American Medical Association, “Repetitive Bilateral Arm Training and Motor Cortex Activation in Chronic Stroke – A Randomized Controlled Trial,” reported the results of the clinical study that examined the association between brain re-organization and improved arm function.

After several training sessions over a six-week period working with the device, stroke patients showed marked improvement in movement and function. These changes were also noticeable in patients who had their stroke as many as 20 years ago.

Study investigators Drs. Jill Whitall and Sandy McCombe Waller, from the University of Maryland, Baltimore Department of Physical Therapy and Rehabilitation Science, invented and developed the BATRAC device.

Click here for additional information about BATRAC clinical studies.
How does Tailwind work?
Tailwind is a non-invasive, portable and practical device that stroke patients can use on a flat surface at home. The device consists of two handles that move along independent resistance-free tracks. The patient moves the handles along each track at a certain starting mark, in response to auditory cues. The combination of the repetitive arm movement with sound and visual cues is thought to trigger the part of the brain that controls mobility in the arm. The retraining program includes instruction in adjusting the track further away from the patient’s body as more arm mobility is gained over time. There are progressively more difficult positions for the patient that can be performed with the Tailwind device, including increased range of motion and angled arm work. Patients chart their progress over weeks and months.

As a table-top device, stroke patients can continue using Tailwind until they’ve reached their optimal level of gain in arm movement.
How is this different from an exercise machine?
The U.S. Food and Drug Administration has designated Tailwind as an exercise device for stroke patients. It is an exercise for people who want to improve their arm function and range of motion. Specifically, it is a therapy for stroke survivors or others who have experienced moderate arm paralysis on one side of the body. Other exercise devices and machines may work the muscles, which Tailwind does, but they don’t have the combined benefits of three different exercise therapies in one device. Tailwind has been researched in clinical trials with real stroke patients. Trained Ph.D. researchers developed the arm exercise regimen and the progressive range of motion angles, with an understanding of muscles, stroke damage, and the expertise to guide patients toward improvement. The consistent movement performed with Tailwind, when synchronized with a sound cue, is believed useful in that proper Tailwind use results in permanent improvement of arm function in some patients.
How does the stroke patient benefit from Tailwind?
Tailwind offers several key benefits to the stroke patient, including:
- Significant improvement in motor skills function, giving way to a wider range of motion and improved strength at minimal risk.
- Clinically-proven treatment that can be ordered by patients, without a prescription, physician referral, or the need to be fitted.
- Ability to take recovery in their own hands by managing their own therapy in the comfort of home without the assistance of a physical therapist or caregiver.
- Durable and lasting results.
- For many patients, a noticeable improvement in the quality of life, such as restoring arm movement to once again perform everyday activities at work and at home with greater ease.
Can Tailwind help patients who have reached a “plateau?”
Many caregivers tell us that they have a friend or family member who had their stroke many years ago, and they are no longer eligible for rehabilitation or therapy programs. Yet the stroke survivor has not regained the kind of control in their arm that her or she would like. Tailwind is particularly helpful for people who cannot do other therapies or haven’t regained the control in their arm that they desire.
Can I get reimbursed for buying Tailwind?
Currently, there is no insurance reimbursement for Tailwind.
How can stroke patients obtain Tailwind?
Tailwind does not require a prescription or doctor’s referral. Patients can order Tailwind directly from its maker, Encore Path, via phone at 410-522-8709 or on the Web at www.tailwindtherapy.com
Will I be able to use my stroke-affected arm after using Tailwind?
In clinical studies, patients who have used this device steadily improved the movement and function in their affected arm.
What does the Tailwind treatment feel like?
At first, it may feel very challenging to reach your affected arm along the track, but it should not be painful. As you work your initial setting, it should feel increasingly smoother and easier to accomplish. Then you will be setting your stops further along the track, and your reach will be gradually increasing.
What is it like working on therapy at home?
Working on a therapy program at home, on your own, IS a challenge! Sometimes getting transportation to a therapy session in a hospital is difficult and so working on a program at home is very appealing. But you do have to stay motivated. Here are a few suggestions that we have heard from other stroke survivors:
- Involve your friends or family to encourage you. Make them aware of your program – maybe they can help you set it up or ask you about your progress regularly.
- When you work with Tailwind, it should have your total concentration so that you can see that you are making the moves along the track correctly. Proper posture and positioning are critical for maximum results.
- Included with your Tailwind is a progress report. Fill in your treatment schedule and see how you are improving week to week.
- Set a few realistic goals that you want to achieve – do you want to be able to hold up a newspaper or push a grocery cart? See if you are feeling any improvements week to week.
- Share your experiences with Encore Path via our website, www.tailwindtherapy.com.
Can Tailwind help patients who had a stroke many years ago?
Tailwind is particularly helpful for people who cannot do other therapies or haven’t regained the control in their arm that they desire up to that point. Tailwind clinical studies were conducted with patients who had their strokes many years ago—some as many as 10 years earlier—and they were still able to improve their arm function and range of motion. There is no time limit for patients to try the Tailwind stroke rehabilitation device.
What are the advantages for using the Tailwind?
Tailwind offers several key benefits, including:
- A statistically significant improvement in motor skills function, giving way to a wider range of motion at minimal risk.
- A clinically proven treatment that can be ordered by patients, without a prescription or without being fitted.
- The ability to take recovery in your own hands by managing your own therapy in the comfort of home, on your schedule, without needing to travel to another location for treatment.
- Durable and lasting results.
- A noticeable improvement in your quality of life, such as improving arm movement which may enable you to perform everyday activities at work and at home with greater ease.
Is it safe?
The Tailwind is a very low-risk device. Over years of clinical study and research, no one has been injured using the device.
Can it be used anywhere?
You can use Tailwind anywhere! Just be sure to make sure your posture is correct as depicted in the training manual. You can use it the kitchen table or another table, or even standing up with the device on the kitchen counter. Anywhere you can get proper posture, you can use the Tailwind.
How long do the results last?
Improvements in arm function and range of motion achieved using the Tailwind are considered permanent.
How often do I use it?
You can use Tailwind as often as you like. We recommend using it for about 20 minutes per day, but you can use it more if you wish. Detailed instructions are included in the training manual and DVD provided with the Tailwind.
Where is it made?
The Tailwind device is made from parts manufactured in many locations around the world, and it is assembled, packaged and mailed from Maryland.
Do I need to do anything before I begin?
As with any exercise program, always consult with your health care professional before beginning the Tailwind exercise program.
Does it hurt?
You should not experience pain using Tailwind. If you do, please consult with your training manual and DVD to ensure that you are using the proper posture. If you are still experiencing pain, please consult with your healthcare professional. Sometimes simple stretches will help reduce or eliminate any pain you may be feeling.
How much does it cost?
Please see the product ordering page for updated information on Tailwind pricing and payment plans.