6580134
Description
Mind Map by Tegan Rance, updated more than 1 year ago
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Created by Tegan Rance
about 9 years ago
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UL Hand Therapy.
- Negative Impairments:
- Paralysis
- Weakness
- Loss of Coordination
- Loss of dexterity
- Paralysis
- positive impairments
- Abnormal postures
- Exaggerated proprioceptive reflexes - Spasticity
- Exaggerated cutaneous reflexes.
- Abnormal postures
- Secondary motor impairments
Preventable deficits that develop
over time
- Occur due to
- Immobility
- inactivity
- Changes to postural alignment
- - Learned non
use - decreased
joint range of
motion/contractures
-
shoulder
subluxation
Annotations:
- t
- Immobility
- Occur due to
- UL recovery after stroke
- 3/4 of stroker survivors will have
upper limb symptoms after acute
stroke
- initial severity of UL
paresis is a significant
predictor of long term
outcomes.
- Only 50% will regain some
functional use of affected UL
- UL recovery is viewed by stroke
patients as 'critical but
neglected issue'.
- 3/4 of stroker survivors will have
upper limb symptoms after acute
stroke
- How do we treat people after stroke
- Decrease focus on UL recovery during rehab
- Increase initial focus on
improving functional
mobility
- Lack of spontaneous
use of UL for function
- Complexity of UL function
necessitates greater recovery of
motor control to achieve
function.
- Decrease focus on UL recovery during rehab
- Task specific training
- Therapy involving
intentional practice of a
specific movement,
action or task.
- practice real-life
tasks...with the intention
of acquiring 7 reacquiring a
skill.
- tasks should be meaniginful,
challenging and progressively
adapted to tap into
neuroplasticity/revocery
mechanisms.
- 1. Uses clients goals as
basis for intervention
planning.
- 2. analyse essential
components of a task.
- 3. use this information to
structure task-specific practice
of component parts.
- 4. reassemble into
whole task practice.
- 5. practice, practice and
more practice.
- Therapy involving
intentional practice of a
specific movement,
action or task.
- Constraint induced Movement Therapy (CIMT)
- Developed to
overcome learned
non-use.
- Constraint of
unaffected
hand/arm
- Encourages increased
practice & use of
affected hand/arm
- Key Elements of CIMT
- 1. intensive
task-specific trying,
practice &
repetitions.
- 2. Shaping, feedback &
coaching
- 3. restraint for 90% of
the day
- 4. transfer package of
homework + contract for
carryover.
- 1. intensive
task-specific trying,
practice &
repetitions.
- Developed to
overcome learned
non-use.
- Modified Constraint Induced Movement Therapy (mCIMT)
- Wear constraint for 5/24, 5/7 & 10/52
- Shorter practice sessions
- Group practice sessions.
- Increase self monitoring practice.
- Wear constraint for 5/24, 5/7 & 10/52
- Mental Practice
- Mentally rehearse a
task being practices in
therapy.
- Visualise the image of performing
the task, the movements , the
associated sensations.
- Can be used to supplement
conventional therapy.
- Can be used at any stage of
recovery.
- Mentally rehearse a
task being practices in
therapy.
- Mirror therapy
- Uses visual feedback about motor
performance as a means to enhance
upper-limb function following stroke
and to reduce pain.
- Move non-paretic arm while
looking in a mirror
- Gives the illusion that
both limbs are working
normally
- Uses visual feedback about motor
performance as a means to enhance
upper-limb function following stroke
and to reduce pain.
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