Sunday, October 17, 2010

Two therapeutic interventions used in both Physical Therapy (PT) and Occupational Therapy(OT):

1)`` Constraint-induced movement therapy (CIMT) is an intervention for patients with hemiplegia in which they wear are straining mitt on the less-affected hand while engaging in repetitive task practice and behavioural shaping with the hemiplegic hand.”(Johnson 2009) CIMT requires the patients to have some functions of the affected hand which is placed a sling for at 6 hours a day. The idea is to encourage use of the weaker hand to do daily activities; this therapy uses neuroplasticity by making new connections in the brain, releasing neuroplasticity and using new or different neurons within the brain. In using the affected hand to perform daily tasks such as picking up a cup, filling it with water and taking a drink the part of the brain responsible for motor functions, memory and sequencing which may have been affected is now been stimulated. Not only is CIMT used to improve function of the weaker but it is also dependent on the environment where activities are done because it can enhance neuroplasticity. Repetitive stimulation is the basis of neuroplasticity.

2) “Motor impairments following stroke ... leading cause of disability in adults. Motor therapies involve ... motor functions by minimising impairment or developing suitable adaptation strategies skill learning must be present to promote... plasticity when using motor learning as an activity most of the recovery of function after a stroke may represent actual relearning of the skills with the injured brain (Moskowitz,C. 2009).”

Neuromuscular Electrical Stimulation (NMES) is used in both PT and OT to recover motor function. NMES is the application of electrical stimuli to a group of muscles by passing an electrical impulse through electrodes placed on the skin over the targeted muscle or muscles. This therapy can be used on both the upper and lower extremity. NMES is to activate muscles in early rehabilitation but can later be progressed with repetitive functional activity. NMES promote neuroplasticity in the early stages of rehab using electricity to recruit new neurons within the affect area of the brain. Plasticity using NMES is a means to achieve active, repetitive movement.

For this patient with right side weakness in both his shoulder and ankle NMES was used to regain normal functional movement such as picking up a cup or walking.

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