Reconnecting With Your Hand After Stroke Part 2 cover art

Reconnecting With Your Hand After Stroke Part 2

Reconnecting With Your Hand After Stroke Part 2

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EPISODE TITLE: Reconnecting With Your Hand After Stroke Parts 1 & 2 EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Deb and her level II fieldwork student Zoe talk with two D’Youville students Abigail and Olivia about all topics regarding hands after stroke with emphasis on recovery. We covered: Introduction from Deb’s level II fieldwork students Zoe: D’Youville student introductionsTopic introduction: Students discuss different hand impairments discussed seen during fieldwork placements Introduction of flaccidity and static splinting: Use as natural as possible if using oneDeb and students discussed shoulder girdle for upper extremity during therapy and uses during fieldwork Deb made note to “never pull on arm/upper extremity during activities or transfers”Schedules and proper don-doff proceduresDeb made note about not liking low muscle tone splinting unless possibility for subluxation (popping out of shoulder socket) or injury prone with neglect/forgetfullness of that limbNeglect and sensory impairment briefly noted with concern for injuryStrategies with slings for the upper extremity to prevent subluxation of limb if applicableAbigail discussed use of trays for UE positioning to prevent injuryFear of transferring: getting limb with low sensation and muscle tone stuckDiscussion of injury prevention seen with untrained providers in hospital settings and the need to train mobilization of patients during transfers for safetyDeb and students mention the use of kinesiotape (KT) tape for incorporating sensory and awareness of hand positioning for strategy in joint positioning and decrease contractureSlight introduction and awareness of preparatory activities and how they are used in OTImportance of education for any strategies or interventions is needed for families/caregivers and patients Spasticity introduction with a statistic found from students research provided (https://www.mdpi.com/2077-0383/12/23/7497) One combined flexed pattern (shoulder lift, bend elbow, wrist bends) causes shortening of muscles --> possible leading to contractureDue to weak extensors flexors dominate leading to limitations of opening the hand for fine motor/precise movements 80 % of post-stroke patients present with Upper limb limitations, motor deficits, and hemiplegia (https://www.mdpi.com/2077-0383/12/23/7497)”Upper limb spasticity affects 17–40% of people” Abigail and Olivia discuss about patient treatment with spasticity post stroke seen in fieldwork placementOlivia and Deb describe vibration technique use within clinics to facilitate muscles that were not activating during movements that were considered “stuck” in this phase of recoveryFlexors are stronger more often than extensors causing contractures within hands and development of flexion synergyGross grasp/release patterns and statistic found from students research provided Introduction of electrical stimulation (ESTIM): Examples: lifting and dropping towels during cleaning activity; picking up blocks and moving from one side of table to otherDeb and students explain how electrical stimulation (ESTIM/FES) was used within an intervention/prep activity for gross motor grasp/release patterns and how these can be used during ADL activities Range of motion (ROM) education and activities to maintain muscle length in order to prevent contractures within the hand and shoulder/upper extremity Took not how important to not over work or stretch muscles with force, it can cause more harm than good Theraputty is a good tool to use for hand strengthening exercisesImportance of handouts, caregiver training, and education/mass practice Discussed that if patient is bored within room during recovery, to increase mass practice of exercises to regain range of motion (ROM) and strength Deb mentioned strategies to improve active movement using hand-over-hand (HOH) techniques and resistive training Corticospinal tract (26:30) introduction and how it is important with movement within the hand/upper extremityThis is how flexion synergy can occur due to this impairment Deb mentioned use of mirror therapy for these patients as a form of intervention to improve fine motor movements using repetition for brain to create neuroplasticity and reorganize brain patterns Importance of evidence-based practice for motor relearning strategies and excitement for participation in activities with patientsAbigail discussed use of mirror therapy in fieldwork placement with shoulder/upper extremity strategiesOlivia discussed her use of seeing mirror therapy in her fieldwork placements including applying a mirror therapy activity presentation for her final project at her fieldwork placement How important is to look back at our biases based on interventions and research to make sure up-to-date and specifically changing Range of motion (ROM) and thumb exercise importance to regain function within hand Conclusion of first episode ...
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