M1-L14b: Ax Tactile - Clinical Reasoning (NOT IN MS EXAM)

Question 1

ADD

Answer 1

A

Question 2

Apartment Block Theory (or a severely simplified way to think about tactile treatment…)

You’re stuck at the front door, the buzzer doesn’t work and your friend on the 5th floor can’t hear you knocking… what do you do??!

Answer 2

1. Keep pressing buzzer
2. Sneak in the door (as someone leaves)
3. Connect a different way (let Shannon know)

Question 3

What is the Apartment Block Theory for treating the tactile system in children with cerebral palsy?

Answer 3

Question 4

What is the pressing the buzzer repeatedly approach in the tactile treatment? What is the evidence?

Answer 4

1. Provide the child with repeated passive tactile stimuli with the hope that they eventually feel something
2. No evidence in the literature that this works.

Question 5

What is the sneaking in the door approach in the tactile treatment? What is the evidence?

Answer 5

• Three studies demonstrate little to no significant in tactile function
• Success of approach requires congruence between position, timing and attention.
• New study: Bimanual training with 8hrs of directed tactile training without vision vs Bimanual training with exploration of tactile toys with vision. –> Has some improvement
• No difference between groups, all improved in texture perception and tended to improve in stereognosis. Dose: 90hrs over 3 weeks
• ?role of visio

Question 6

What is the connect a different way approach in the tactile treatment? What is the evidence?

Answer 6

1. Visually Enhanced Touch (VET) – vision of body modulates early processing in S1, thereby reducing neurons’ tactile field size and increasing acuity
2. Bimodal neurons in frontal and parietal cortices have tactile receptive fields with corresponding visual receptive fields in area just above tactile

Question 7

What is the Visually Enahnced Touch (VET)?

Answer 7

vision of body modulates early processing in S1, thereby reducing neurons’ tactile field size and increasing acuity

Question 8

What are 7 conditions/circumstances when VET is shown to be most effective as tactile treatment?

Answer 8

1. Body part is identified as belonging to individual Significant portion of body part can be seen
2. The body part is magnified
3. The task is spatial and at the limits of performance
4. Involving body parts that are commonly viewed
5. Individual has lower baseline performance
6. Can involve mirror-based training

Question 9

________ in children with unilateral CP – single session improved spatial tactile perception

Answer 9

Mirror-based training

• When looking at impaired hand –> see the mirror image of unimpaired hand
• Asks the child to look at and pay attention to - Sustaining visual attention

Question 10

What population is most appropriate for the connecting another way approach for tactile treatment?

Answer 10

Question 11

What population is most appropriate for the sneaking in the door approach for tactile treatment?

Answer 11

Question 12

What population is most appropriate for the pressing the buzzer repeatedly tractile treatment?

Answer 12

Question 13

What is the most important thing about treatment (eg. for tactile)?

Answer 13

Must be play-based! (most fun and enjoyable experience)