VIDEO ANALYSIS PRESENTATION OCCT 502: ANALYSIS OF MOVEMENT IN OCCUPATION Stephanie Perry-Brideau Anna Suchy JP Kriel

STROKE STATS  Stroke is the third leading cause of death in the United States  Stroke is the leading cause of serious, long-term disability in the United States  Strokes can—and do—occur at ANY age. Nearly one quarter of strokes occur in people under the age of 65  On average, every 40 seconds someone in the United States has a stroke US Stroke deaths: 35+ ( ) Stroke Statistics, 2011

“Last year I had a stroke. It left me in bad shape. I had to teach myself how to walk and talk again. It’s been a long, hard fight. My speech is not perfect but I’m getting there.“ – Dick Clark People, 2006

CLIENT DESCRIPTION  Young stroke survivor  Difficulties with ADLs and upper extremity techniques  Exhibits expressive aphasia, cognitive/perceptual deficits and right hemiplegia. Self-Care, 2008

OCCUPATIONS AFFECTED BY IMPAIRMENTS  ADLs  IADLs  Rest & Sleep  Education  Work  Play  Leisure  Social Participation Occupational Therapy Practice, 2008

HOW IS THE WRIST JOINT AFFECTED BY THE CLIENT’S IMPAIRMENT?  Skeletal Considerations  Articular Considerations  Arthrokinematics  Muscular Considerations  Innervating Nerves  Servicing Arteries Lippert, L.S., 2006

BIOMECHANICS NEEDED FOR CLIENT’S MOVEMENTS  Static o COG o BOS o Stability/Balance o Posture o Thoracic support  Dynamic o Trunk flexion/extension o Lifting impaired arm o Torsional/Rotary movement o Using functional hand Lippert, L.S., 2006

BIOMECHANICAL FRAME OF REFERENCE  Reduce impairment/teach new skills  Improve ROM and flexibility in impaired arm, also preventing contractures  Improve strength of both impaired arm and compensating arm  Improve endurance of impaired arm to perform task for long duration  Improve structural stability with COG and BOS  Improve coordination

REHABILITATION FRAME OF REFERENCE  Improving independence with adaptive equipment  Choosing methods by collaborating with client  Dysfunction due to stroke  Teaching how to use adaptive equipment  Modifying client’s home environment  Adapting tasks and activities

INFLUENCE OF MOTOR CONTROL/MOTOR LEARNING  Impaired fine motor skills (ie: issues buttoning)  Paralysis of right arm and hand  Spasticity could lead to possible contracture; splinting may be necessary  Poor reflexes  Lack of balance and coordination; trunk stability devices may be necessary  Spatial and perceptual impairment affecting ability to judge distances (ie: placing impaired arm into sleeve, looking down to button shirt)

INFLUENCE OF ENVIRONMENTAL DEMANDS  Person: o Impaired sensory and cognitive abilities o Expressive aphasia o Right hemiplegia  Tasks: o ADL and IADL assistance o Son/father/boyfriend roles o Ability to perform tasks will lead to future role performance  Context: o Temporal: late 20s, dependent on caregiver, tasks performed in hospital before returning home o Environmental/Social: assistive devices, home modification, relationships at home, religious practice  Personal-Context-Task Transaction: o Use of assistive devices and routine modification before becoming independent o Independence will allow client to better perform tasks in any setting

CLIENT RECAP!

REFERENCES Lippert, L.S. (2006). Clinical kinesiology and anatomy. Philadelphia: F.A. Davis Company. Occupational therapy practice framework: domain and process 2nd edition. (2008). Bethesda, MD: American Occupational Therapy Association, Inc. Self-care: dressing in acute care part two. (2008). [Web]. Retrieved from Silverman, S. M. (2006, January 2). Dick Clark Makes New Year's Return - Dick Clark : People.com. People.com : The #1 Celebrity Site for breaking news, celebrity pictures and star style. Retrieved October 4, 2011, from Stroke Statistics. (2011, September 02). Retrieved from Ways of living: intervention strategies to enable participation (4th ed.). (2011). Bethesda: American Occupational Therapy Association.