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Look at pg 65 for notes on primary moves for various activities
In a pt who has had a stoke what will you notice with their hand?
- they will have a flattening of the three arches in their hand
Repetition of UL tasks why important?
- - 15-40min/ day for several weeks help retrain brain and mm how to do activity
- - can increase by doing in a large group- competitive and pts are pushed
- - make sure the activity is challenging but achievable
- - ensure training is task sepcific
- - whole and part practise can be used- whole is thought to be best
- - there is a deceleration phase when grasping
- - neural pathways will adapt according to what is practiced
What do you need to think about when setting a task for a pt?
- - type of contraction
- - range of movement
- Speed of contraction
- Synergic muscle activity
- Relationship to gravity
- Short or sustained contraction
- Overall motor schema
Pts post stroke usually have shoulder pain: info
- - 33-85%
- FROM- IMMOBILITY, MM, CAPSULE, LIG LENGHTM JT STIFFNESS
- - do not use pully- as it produces incorrect range
- - manage by strapping, education and training
- - 80% stroke survivors have a shoulder that subluxes- inferior most common- results in loss function etc
What are the risk factors for shoulder sublux?
- - severe arm paralysis/ complete loss of function
- - decrease supraspinatus contraction
- - sensory imapirement
- - decreased proprioceptio
- - haemorrhagic stroke
Management of shoulder sublux?
- - positioning
- - supportive dvices
- - ES
- - task specific functional activities
- - stregnthen RC mm