Lecture 10: Upper Extremity Assessment + Management Flashcards
do impairments of the upper extremity only happen on the contralateral side
no, they can happen in both upper extremities
what are some examples of occupational performance components post stroke
loss of individuation (inability to control each joint separately)
paresis
excessive use of trunk
what are the 3 levels of the chedoke McMaster stroke assessment
low level arm (stages 1-2) - severely impaired
Intermediate level arm (3-5) - moderately impaired
High level arm (6-7) - mildly impaired
is the chedoke McMaster stroke assessment for the arm and hand a functional assessment?
no it looks at motor control during different movements
is the chedoke arm and hand activity inventory a functional assessment?
yes, looks at activity the client views as meaningful
should be used alongside chedoke McMaster stroke assessment for the arm and hand
what would a Chedoke arm and hand stages 1 – 2 look like
severely impaired
no or very little active movement (flaccid)
primarily used for stabilization/weight bearing
what would a Chedoke arm and hand stages 3 – 5 look like
moderately impaired
Some functioning – some active but limited selective movement due to tone
Transitioning from stabilization to manipulation tasks
what would a Chedoke arm and hand stages 6 – 7 look like
mildly impaired
Fairly high functioning – selective movement but some problems with dexterity, strength, or coordination
Primarily used in manipulation tasks with emphasis on speed, accuracy, quality of movement
what is the most important thing to keep in mind when a client has Low Functioning UE (Category 1)
ALWAYS have the arm supported. It should never be hanging
what interventions might you do with someone with the Low Functioning UE (Category 1)
use a sling for transitional movements
gentle weight bearing
Active-assisted ROM
Scapular mobilizations
what interventions might you do with someone with the Moderate Impaired UE (category 2)
Stabilizing activities
Task-oriented training
Facilitation in weight bearing
mental imagery
what interventions might you do with someone with the Mildly Impaired UE
(Category 3)
Task-oriented training
Fine motor training
Strength training
Constraint-Induced Movement Therapy (CIMT)
what is original Constraint-Induced Movement Therapy
Therapy for 6 hours per day, 5 days per week for 2-3 weeks
Less affected limb constrained for 90% of waking hours
what is what is modified Constraint-Induced Movement Therapy
Dose varies considerably to make it more appropriate for clients
- 30 mins-3 hours therapy per day, 5 days per week
- Less affected limb constrained for < 6 hours per day
what is the 10-10 eligibility criteria for constraint induced movement therapy
10 degrees active wrist extension
10 degrees active finger extension
Intact cognition and minimal spasticity
