Stroke is the third leading cause of death in Canada. Each year it is estimated that 50,000 Canadians experience a stroke,5 and approximately 315,000 Canadians are living with the effects of stroke today.12 Up to 88% of stroke survivors experience upper-limb hemiparesis,3 which is particularly problematic given its impact on activities of daily living.1 Despite the billions of dollars being spent each year for stroke rehabilitation12 evidence that supports the efficacy of stroke motor rehabilitation is limited, making interventions that reduce the impact of hemiparesis a priority.4 One therapy that has recently gained popularity is known as constraint-induced movement therapy (CIMT). This rehabilitation tool is used to regain lost function in upper extremities following a stroke.7 CIMT involves a restraint of the less-impaired upper extremity to enhance the use of the affected limb in activities of daily living.7,10 The restraint is typically accomplished by placing the entire arm in a sling or placing the less-impaired hand in a mitt for the majority of waking hours during a 2 week period,10 essentially forcing the patient to use the arm that has the most severe impairments.6,7
Previous research investigated the efficacy of a modified constraint-induced movement therapy protocol for patients experiencing hemiparesis following stroke.4 The finding show that CIMT may be an effective method of improving motor function and use of the more affected arms of stroke patients.4 A recent study investigated whether constraint-induced movement therapy would enhance axonal remodeling and functional recovery, and furthermore improve behavioural and motor performance following stroke in rats.12 Consistent with previous studies,9,10 the rats t...
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...emity function among adults recovering from a cerebrovascular stroke. Neurorehabil and Neural Repair. (2003) 17: 137-152.
10. Wolf, S. L., Winstein, C. J., Miller, J. P., Taud, E., Uswatte, G., Morris, D., Giuliani, C., Light, K. E., & Nichols-Larrsen, D. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trail. American Medical Association. (2006) 296: 2095-2104.
11. Wurm, F., Keiner, S., Kunze, A., Witte, O. W., & Redecker, C. Effects of skiller forelimb training on hippocampal neurogenesis and spatial learning after focal cortical infarcts in the adult rat brain. Stroke. (2007) 38: 2833-2840.
12. Zhao, S., Zhao, M, Xiao, T., Jolkkonen, J., & Zhao, C. Constraint-induced movement therapy overcomes the intrinsic growth-inhibitory signals in stroke rats. Stroke. (2013) 44: 1698-1705.
Until recently there was virtually nothing doctors could do for the 500,000 Americans who have strokes each year, the 500,000 to 750,000 who experience severe head injury, or the 10,000 people who are paralyzed after spinal cord damage (3). However, that is about to change. Researchers now think it may be possible to replace destroyed brain cells with new ones to give victims of stroke and brain injury a chance to relearn how to control their body, form new thinking processes, and regain emotions. After demolishing the long-standing myth that brain cells cannot regenerate or proliferate, scientists are developing ways to stimulate cells to do just that. Although stroke, head injury, and paralysis are three of the most devastating things that can happen to anyone, scientists have recently learned that the damage they cause is not preordained. It takes place over minutes, hours, and days, giving them a precious opportunity to develop treatments to halt much of the damage. Most of the new remedies are not yet available, but an explosion of research in the last five to ten years has convinced scientists that some of them will work (8).
As an Occupational Therapist, it is crucial to consider the wellbeing of Martha as a whole person. She is not merely a stroke patient. She is a homemaker, wife, and game enthusiast. Two conditions hindering her accomplishment of these meaningful occupations are her motor planning deficit and the lack of functionality in her right upper extremity (RUE). Martha has difficulty following multi- step commands, and relies heavily on the assistance of others with mobility, transfers, and activities of daily living (ADLs). Despite these, two of her strengths are her abilities to consistently answer yes/no questions by moving her head, and the mobility of her left upper extremity (LUE). She is alert and oriented to herself, and the strength and sensation in her LUE are within functional limits. These factors shape a client’s Occupational Therapy experience.
Stroke and Spinal Cord Injury both have detrimental effects on the body function. Commonly, they result in some levels of muscle weakness and paralysis. The complications after a stroke or a spinal cord injury negatively impact not only the patients’ health, but their quality of life. Therefore, it is important that rehabilitation therapy starts at an early stage after the incidence to enable the patients to adapt to their new conditions and maximise their life. Physical activity and exercise program are one of the most important part of rehabilitation, which help the patients to achieve better health outcomes and lifestyle.
...n the ward or at home. Functional activities may trigger a memory of how the pt’s were once able to perform the activities. (Stroke association)
A Stroke Nurse Practitioner can also be found in areas of both primary and secondary prevention where he or she makes certain that each patient is evaluated and preventative therapies are implemented. Such assessments include brain imaging, dysphagia and hypertension screening. In addition, this NP can act as a coordinator for stroke patients from admission to discharge by meeting with families and rehabilitation centers and providing information and resources to the post stroke patient. This NP is the gateway to educating the nursing staff in recognizing the signs and symptoms of stroke and implementing the facilities stroke protocol.
According to Figure 1.B DCN input signals (proprioceptive signals) are received from two differentiated pathways. The first pathway reaches the DCN cells through the cerebellar cortex. This feedback system has been profusely hypothesized to be the main adaptive pathway in which cerebellar learning takes place (S...
An older person who has had a stroke may simply want rehabilitation to be able to dress or bathe without help. Sometimes physical therapy is required for management of chronic conditions that otherwise would be very expensive to treat using prescription medication.Advantage of physio therapies it has long-term health benefits.One of the smartest reasons to use physical therapy is that it provides a
and forearm could limit the vary of motions and disable their activities of daily living. The intensive rehabilitation medical aid, like physical therapists, activity therapists, is distributed; however it's restricted owing...
“Where am I? How did I get here?” is what many stroke patients say after recovering from an acute or severe stroke. A stroke is also known as a cerebrovascular accident, a life-threatening event where the brain is deprived of adequate oxygen. A physical therapist’s duty is to provide assistance and education that will help patients rehabilitate and return to a normal routine. As of today, there is a new treatment called treadmill training with partial body weight support that facilitates recovery of a patient’s ability to walk sooner after a surgery. Is the expense for treadmill training with partial body weight support which includes expensive equipment and constant physical therapy supervision worth it if it decrease the amount of time it takes a person to get better? Is it ultimately more efficient than traditional physical therapy? My argument will state that treadmill training with partial body weight support is worth the expense and provides better techniques than traditional physical therapy.
In an article by Latham et al. they describe the various therapeutic activities and the intervention techniques that therapist used during treatment sessions in an inpatient setting. What they found is that upper extremity and dressing activities were the most frequently used activates. When the activities were compared basic activities of daily living (ADLs) training such as dressing, grooming and eating versus instrumental activities of daily living (IADLs) such as home maintenance or community integration. The reason for this is because treatment was taking place in a inpatient hospital when patients were still in the early rehabilitation phases and their stay wasn’t extensive so more advanced activities were used less. The most common interventions were neuromuscular, most often used were balance training, postural awareness, and motor learning. Adaptive approaches for ADLs were also frequently reposted with stroke patients whether using one handed techniques or environmental adaptation training such the use of a shower
Stroke is a serious medical condition that affects people of all ages specifically older adults. People suffer from a stroke when there is decreased blood flow to the brain. Blood supply decreases due to a blockage or a rupture of a blood vessel which then leads to brain tissues dying. The two types of stroke are ischemic stroke and hemorrhagic stroke. An ischemic stroke is caused by a blood clot blocking the artery that brings oxygenated blood to the brain. On the other hand, a hemorrhagic stroke is when an artery in the brain leaks or ruptures (“About Stroke,” 2013). According to the Centers for Disease Control and Prevention (CDC), “Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability” (“About Stroke,” 2013). Stroke causes a number of disabilities and also leads to decreased mobility in over half of the victims that are 65 and older. The CDC lists several risk factors of stroke such as heredity, age, gender and ethnicity as well as medical conditions such as high blood pressure, high cholesterol, diabetes and excessive weight gain that in...
There are an estimated 6.5 million stroke survivors in the country. Twenty percent of stroke survivors suffer from foot drop, the inability to raise the foot (WLS-TV Chicago, 2010). Lower limb hemiparesis and foot drop affects gait, which can have an impact on normal daily activities. One of the main goals of patients with hemiparesis is to be able to walk independently and return to their normal activities. Physical therapists know that poor gait from ankle and /or knee joint problems can affect the pelvis, lower back, spine and neck as the body tries to compensate for the defective gait. Using electrical stimulation to treat hemiparesis and foot drop can help a patient achieve functional gait and return to their normal activities.
Traditional physiotherapy has been focusing on the restoration of sensorimotor function (e.g., Muscle strength, movement coordination, spasticity, balance) and performance in certain daily activities such as ambulation. However, relatively less attention is paid to community integration after stroke, which involves several important elements, including participation in activities at home or a homelike setting, engagement in productive activities, and establishment and enjoyment of a social network9. Apart from Concentrating on body and individual dimensions and promoting physical recovery and assisting in activities of daily living, a major challenge in stroke rehabilitation is to minimize psychosocial morbidity and to promote the reintegration of stroke survivors into their community. Despite favorable exercise methods having been achieved for people with stroke, questions remain as to why such exercise benefits are not necessarily linked to good levels of community participation. It may be that rehabilitation efforts need to be refined to achieve a satisfactory level of community.
Strokes are the most common cause of disability and leading cause of death in the United States. Estimates of the number of stroke survivors in the United States exceed 3 million, and nearly 150,000 Americans died from stroke in 1995. The frequency with which strokes occur and the devastating effects they can have on survivors and their families make provision of general information about prevention and management an essential element of public health education. Previous researchers have found that between 14% and 40% of adults cannot name a single risk factor associated with stroke. This is reason for concern among the medical community.
Hemiplegia, a condition in which one-half of a patient's body is paralyzed usually results from stroke or cerebrovascular accident. Individuals affected by hemiplegia have difficulty dealing with frustration, swallowing, walking, forming words, dressing, feeding self and bowel/urine incontinence. Quality of life from the individual’s own perspective is paramount because hemiplegia leads to self denial, self care deficit and need for minimal to total dependence. Therefore the goal of treatment is to help the individual reach his or her fullest potential for independence, functioning and accepting who they are as individuals.