The Neurological Hand Flashcards

1
Q

common diagnoses associated with the neurological hand (8)

A
  1. CVA 2. TBI 3. CP 4. MS 5. Parkinson’s disease 6. SCI 7. dystonia 8. hemiplegia/hemiparesis
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2
Q

neurological hand: spasticity

A

one of the most common barriers for the neurological hand *can be managed by oral medication or injections *spasticity changes over time *not uncommon to go untreated

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3
Q

neurological hand: pain

A

obvious barrier in client’s ability to effectively incorporate affected hand in meaningful tasks *can be at hand or shoulder

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4
Q

neurological hand: edema

A

utilize edema control techniques *severe cases may need to be referred to lymphedema therapist

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5
Q

neurological hand tips: addressing spasticity

A

spasticity in the hand may assist a client to achieve a functional grasp, and if reduced/removed, the client’s grasp may be too weak to continue its role in functional tasks *regardless of function, spasticity has the potential to lead to other barriers such as deformities, pain, and inadequate hygiene

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6
Q

neurological hand tips: sensory reeducation (10)

A

no protocol identified as being superior over another 1. contrast baths 2. thermal stimulation 3. intermittent pneumatic compression 4. sensory training using robotics 5. brushing 6. WB 7. TENS/NMES 8. stereognosis 9. vibration 10 tactile input

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7
Q

neurological hand tips: edema (8)

A
  1. compression glove 2. kinesiotaping 3. contrast bathing 4. soft-tissue mobilization 5. positioning 6. fist pumps above heart 7. caregiver education 8. continuous passive motion and e-stim are potentially more effective treatments for hand edema than intermittent pneumatic compression
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8
Q

neurological hand tips: increase attention to the affected UE (7)

A
  1. proprioceptive feedback 2. blend of AAROM and resistance 3. resistance 4. vibration 5. perturbations 6. visual regard 7. mirror box therapy
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9
Q

neurological hand tips: hand dominance

A

with an ipsilateral brain injury, RH dominant individuals prefer to use R UE, whereas LH dominant individuals prefer more bilateral UE involvement

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10
Q

neurological hand tips: weight bearing

A

incorporation of UE WB activities is an important and common practice for normalizing muscle tone in clients following a brain injury

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11
Q

neurological hand tips: CIT/mCIT

A

proven effective at improving UE function in clients but if not supervised properly, poor compliance with the protocol can result, yielding less than desirable outcomes

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12
Q

neurological hand tips: bilateral training

A

theoretically the use of the intact limb helps to promote functional recovery of the impaired limb through facilitative coupling effects between the upper limbs

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13
Q

neurological hand tips: NMES/FES/TENS

A

often used with the neurological hand FES refers to the application of NMES to help achieve a functional task

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14
Q

neurological hand tips: hand/palmar shaping (5)

A

it is important to consider positioning and shape of the hand when assessing and treating reach-to-grasp movements 1. open/closed kinetic chain exercises 2. positioning to support distal movement 3. grading the force of movement 4. closing the sensory loop 5. working in/out of synergistic patterns

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15
Q

neurological hand tips: adaptive movements

A
  1. pre-grasp: no terminal extension of digits, disproportionate opening of the hand to compensate for muscle imbalance, and/or decreased wrist control 2. grasping: if client has ability to extend digits, excessive force can be observed due to difficulty gauging force needed to grasp 3. releasing objects: clients may attempt to utilize grasp driven by tenodesis
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16
Q

neurological hand tips: mirror box therapy

A

can assist in reducing unilateral neglect because it brings attention to the affected UE *requires ability to maintain sustained attention

17
Q

neurological hand tips: SaeboFlex

A

dynamic custom-fabricated wrist, hand, finger orthosis designed to strengthen grip and assist in release as needed highly repetitive task-specific training “distal to proximal” recovery concept

18
Q

neurological hand tips: Bioness H200

A

an advanced FES system intended to provide clients with a mechanism to regain function an movement of their affected UE allows precise delivery of patterned FES to selected muscles to facilitate various grasp and release patterns

19
Q

neurological hand tips: TheraTogs

A

an elasticized orthosis garment and strapping system which can be used to position the hand and wrist for grasp and release

20
Q

neurological hand tips: robotics/VR/telerehabilitation

A

robotics can be used for ROM VR may enhance cortical reorganization telerehab programs are remote retraining of arm movement using software that records and analyzes participant performance

21
Q

neurological hand tips: complementary medicine

A

focuses on noninvasive and stress-reducing techniques that can supplement or be used in conjunction with more conventional treatment methods, such as acupuncture

22
Q

indications for orthosis in the neurological hand (4)

A
  1. soft tissue restrictions into digit flexion or extension 2. joint contractures 3. decreases ROM, muscle weakness, tendon laxity, and decreased coordination causing difficulty with functional grasp 4. hygiene issues due to spasticity and contractures