Examination & Tx of UE Function Flashcards
Model:
- Define pt’s roles [participation]
- What skills are needed [activities]
- What resources does the pt have/lacks
- Set goals related to functional recovery
Enablement Model
List factors that affect reach-and-grasp movements (6)
- Size
- Shape
- Surface Texture
- Object orientation
- Distance form body
- Location with respect to body
List the functional roles of the UE (6)
- Balance [arm swing w/gait]
- Point/Gesturing
- WB
- Reaching
- Grasping
- Manipulation
Theory: The process by which various brain and spinal centers work cooperatively to accommodate the demands of intended movements
Systems theory
When ___1___ movement is necessary to look at an object, the ____2____ of __3__ movement is usually only about ____4____ of the distance to the target.
- Head
- Amplitude
- Head
- 60-75%
The dorsal stream controls ___1___ of reaching and manual estimation tasks while the ventral stream controls ____2____.
- Action
- Perception
List the sensory systems involved in normal UE function (2)
- Somatosensory input
- Visual feedback
List the motor systems involved in normal UE function (8)
- Multiple degrees of freedome
- Reach/Grasp
- ROM/Strength/Tone/Coordination
- Posture [Scapula and Grasp Patterns]
- Eye movement [Saccades]
- Head/Trunk movement
- Transport Hand {Thumbs, Hand Shape]
- Postural Support
Movement during reaching is ___1___ than pointing. Preparing to __2__ an object entails the acceleration of reaching being ___3____ than the deceleration. While ___4___ entails the acceleration being ___5___ than deceleration [__6__ velocity when finishing movement.
- Longer
- Grasp
- Shorter
- Pointing
- Longer
- High
Coordination of Grasp (3)
- Close on an object by moving fingers [thumb stabilizes]
- Sensory info on object characteristics [weight, firm, slick, shape]
- Grasp patterns
Explain the trade off of Fitt’s Law
Speed-Accuracy Trade Off
UE Dysfunctions - Impairments (4)
- Vision
- Perception
- Sensation
- Proprioception
UE Dysfunctions - Abnormalities (2)
- Tone [Syndergies and Stages]
- Voluntary Movement [Strength and Coordination]
Reach Dysfunction (3)
- Timing problems
- Impaired inter-limb coordination [elbow/shld DoF]
- Proximal weakness
Grasp Dysfunction (5)
- Anticipatory hand shape
- Grip force
- Precision grip
- Premature finger closure
- Slow release
Neuro Recovery (3)
- Proximal vs. distal motor control
- Unilateral vs. bilateral function
- Driven by active movement, task goals
Neuro Assessment: Functional Performance Scales (6)
- Motor Activity Log
- Wolf Motor Function Test
- Chedoke-McMaster Stroke/Hand and Arm Inventory
- Box and Block Test
- Arm Reaction Arm Test
- Nine Hole Peg Test
Shoulder Complications Post CVA (4)
- Pain {RC, capsulitits, scap position, S/H rhythm, repeated trauma]
- Learned non-use
- Subluxation
- CRPS [10-25%]
Condition:
- Chronic pain condition affecting te paretic arm/leg
- Hand tenderness
- Hypersensitivity
- Swelling, warm, red, glossy skin
CRPS
Tx for reduced scapular mobility post CVA (3)
- Soft tissue scapular mobilization
- Side-lying
- Add active movements and/or PNF diagonals
Tx of Hand Impairments (6)
- Control swelling
- Work on grasp function
- Work on release function
- Alien hand syndrome
- Mm faciliation/inhibition
- Hand positioning/splinting
Task-Oriented Training (TOT) (3)
- Treat impairments
- Retrain strategy [eye/head coordination, reach, grasp, relese, manip]
- Restore function
Describe why the uninvolved UE may present with deficits in coordinatio, timing/speed, grip strength (4)
- Bilateral cortical control
- Component or corticospinal tract that doesnt not decussate
- Cognitive deficits
- Visual-perceptual deficits
Constrained Induced Movement Therapy (CIMT) (4)
- Overcome learned nonuse in stroke
- Show changes in brain mapping
- Restrict less-affected limb during waking hours
- Improved motor and function that is maintained
Cons of CIMT (3)
- Pt. compliance
- Safety
- Reimbursement
