OT and Stroke Recovery Through Technology

Question 1

List common stroke

Answer 1

• Right CVA: L hemiparesis, impulsive, L visual deficits, spatial/perceptual
• Left CVA: R hemiparesis, aphasia, slow/cautious behavior, R visual deficit
• MCA: affects UE
• ACA: affects LE
• Occipital: vision
• Parietal: sensory, attention
• Temporal: language, dysarthria
• Cerebellum: limb ataxia
• Frontal: LOC, gaze, motor arm, motor leg, language, dysarthria

Question 2

OT scope

Answer 2

• ADLs and IADLs
• Motor skills
• Cognition
• Deficits
• Coordination
• Balance
• Sensation
• Proprioception
• Perception

Question 3

Classification of stroke in rehab

Answer 3

• Mild (58-66): mild to minimal impairment & are able to perform movements out of synergy with most of movement apparent
• Moderate (28-57): marked impairment with no movement out of synergy & limited movement from single joint extensor synergies, hand, wrist
• Severe (0-27): profound impairment with no hand, wrist, or multi joint movement

Question 4

Components of maximal functional motor recovery of the arm

Answer 4

• Task oriented
• Intensive
• Repetitive

Question 5

What to focus on in the acute phase

Answer 5

• Protect: positioning, awareness
• Support: slings, splints, kinesiotape
• Balance: typically seated
• ADLs: hemiplegia dressing

Question 6

Where to start

Answer 6

• Trunk control: static –> dynamic, midline, visual feedback
• Shoulder: WBing, Estim, scapular mobs, ROM, Seabo glide, Saebo MAS, Reo

Question 7

What can be done in recovery continuation

Answer 7

• Mirror box
• Incorporating bilateral UE use
• Constraint induced movement therapy
• Coordination: Armed, Saebo flex/Saebo glove, Bioness, vibration

Question 8

Low tech multi sensory approaches

Answer 8

• Mirror therapy
• Mental imagery
• Estim
• Vibration
• Constraint induced movement therapy
• Visual feedback
• Use of orthoses
• Therapeutic taping for functional positioning

Question 9

Advanced tech multi sensory approaches

Answer 9

• Robotics
• Functional Estim
• Virtual reality devices
• Spring assisted therapy

Question 10

What can robotic devices provide

Answer 10

• High intensity
• Repetitions
• Task specific
• Interactive training

Question 11

What does virtual reality allow/provide

Answer 11

• Allows for high repetition movement practice
• Meant to be utilized in conjunction with traditional therapies
• Addresses balance, speed, coordination, accuracy, ROM, functional reaching, & weight shift
• Can be controller based on camera tracking based

Question 12

What do spring assisted therapy allow/provide

Answer 12

• Allows for arm weight support via & adjustable suspension system
• Training is based on active movement
• Can be stand alone or interfaced with software
• Can be applied to hand, forearm, or entire arm

Question 13

Well know benefits of Estim FES

Answer 13

• Reversal of muscle atrophy
• Improved local blood circulation
• Increased ROM
• Reduced muscle spasticity
• Neuromuscular re-education