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Effective Interventions to Promote Participation and Functional Use of the Affected Upper Extremity for Clients Post-Stroke Spalding University Jodi Combs, OTS jcombs01@spalding.edu
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Why Clients Post-Stroke? It is estimated there are approximately three million stroke survivors in this country, 70 percent of whom experience “significant functional disability” ( Hayner, Gibson, & Giles, 2010)
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Occupational Therapy and Stroke Occupational therapy practitioners address the physical, cognitive, and mental challenges brought on by a stroke The effects of stroke can be devastating but most can be improved with rehabilitation. Some of these effects include: loss of balance, paralysis, vision problems, loss of coordination, and also decreased sensation
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Level II FW Experience
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Focused Question What is the evidence for effective occupational therapy interventions to promote participation and functional use of the affected upper extremity for clients post-stroke?
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Effective Treatments Constraint-Induced Movement Therapy Meaningful Task-Specific Training Mirror Box Therapy Gaming Systems Mental Practice Bilateral Treatment
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Constraint- Induced Movement Therapy Constraint-induced movement therapy (CIMT) consist of the sound arm being restrained, typically in a sling, mitt, or both, for an established percentage of the day. During restraint, the patient performs selected activities using the affected upper extremity.
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Meaningful Task-Specific Training Task-specific training provides goal-directed repetitive practice of motor tasks to improve functional abilities.
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Mirror Box Therapy Patients who engage in mirror therapy realize greater recovery of function in their upper extremities than those who receive conventional therapy alone.
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Other Effective Treatments Gaming Systems Mental Practice Bilateral Treatment
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Questions? Thank You!!!
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References Arya, K., Verma, R., Garg, R. K., Sharma, V. P., Agarwal, M., & Aggarwal, G. G. (2012). Meaningful Task- Specific Training (MTST) for Stroke Rehabilitation: A Randomized Controlled Trial. Topics In Stroke Rehabilitation, 19 (3), 193-211. doi: 10.1310/tsr1903-193 Cameiraoa, M.S., Badiaa, S.B., Duartee, E., & Verschure, P. (2011). Virtual reality based rehabilitation speeds up functional recovery of the upper extremities after stroke: A randomized controlled pilot study in the acute phase of stroke using the Rehabilitation Gaming System. Restorative Neurology and Neuroscience, 29, 287–298. doi:10.3233/RNN-2011-0599 Christian, D., MPhil, J. P., Antje, N., Jutta, K., Christian, R., & Hans, K. (2008). Mirror therapy promotes recovery from severe hemiparesis: A randomized controlled trial. Neurorehabilitation and Neural Repair, 23 (3), 209-217. doi: 10.1177/1545968308324786 Hayner, K., Gibson, G., & Giles, G. M. (2010). Research Scholars Initiative Comparison of constraint-induced movement therapy and bilateral treatment of equal intensity in people with chronic upper-extremity dysfunction after cerebrovascular accident. American Journal of Occupational Therapy, 64, 528–539. doi: 10.5014/ajot.2010.08027 McCall, M., McEwen, S., Colantonio, A., Streiner, D., & Dawson, D. R. (2011). Modified constraint-induced movement therapy for elderly clients with subacute stroke. American Journal of Occupational Therapy 65, 409–418. doi: 10.5014/ajot.2011.002063 Nilsen, D. M., Gillen, G., DiRusso, T., & Gordon, A. M. (2012). Effect of imageryperspective on occupational performance after stroke: A randomized controlled trial. American Journal of Occupational Therapy, 66, 320–329. http://dx.doi.org/10.5014/ajot.2012.003475 Wu CY, Lin KC, Chen HC, et al. (2007). Effects of modified constraint-induced movement therapy on movement kinematics and daily function in patients with stroke: A kinematic study of motor control mechanisms. Neurorehabiltation Neural Repair,21, 460–466. DOI: 10.1177/1545968307303411
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