kisntel
1 post
Feb 16, 2010
7:08 AM
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Well actually, my patient never had stroke. She had tumor instead with complications there has been clot on the brain. Now, I am treating her Left paralysis. Can I apply TMR? How can I address UE tx? She can do only few exercises on Left UE; elbow flexion 2+/5 and horizontal abd/add 2+/5. Nothing from the shoulder.
Please help me, im very frustrated with the results. Been treating px as of nov. 2009.
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SusanPEDPT
78 posts
Feb 16, 2010
5:09 PM
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You can use TMR to treat patients with neurological problems to address their functional issues very effectively We ask the patient the same questions " What is hard" or we identify the issue by observation if the patient is unable to express their issue (that's what the parent's do with the children I see)
There are many similarities between an adult with a brain injury and an child with CP. In the peds course we cover this information looking at improving function.
We first check the FAB5 to see if any restrictions in mobility are hanging up her potential to move symmetrically with ease. Something that APPEARS unrelated to the L UE (eg: ankle flexion on the right) might be pulling on the trunk and indirectly limiting the L UE from moving a bit better. First balance the body by working on the top ranking motions and going for symmetry.
Next anything she can't do on the left do on the right. Do it with EFFORT (EG: pick up a weighted ball to flex the right elbow multiple reps) Have her NAIL it on the right so that her brain is given information about what easy motion is in that activity. Then gently try to do active assist on the left to copy what she did on the right (EG: try to flex the left elbow with a tennis ball in her hand)
Can't tell you what to do on a specific patient, but can tell you how this works and talk you though it if you'd like.
Call me if you have any questions. 717 309-1354
Susan
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kisntel
2 posts
Feb 17, 2010
5:13 AM
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thanks for the information Susan. Will definitely apply this to my patient tomorrow. I have tried letting her do arm raises and trunk rotation the first month been treating her but every time she comes back to the rehab, always c/o pain and stiffness on L shoulder. Made me doubt if I'm doing the right thing or if it's applicable to her case.. I also gave her PRE's on R UE using dumbbell. I hope I could get better results tomorrow. Wish me luck :D
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