Posts Tagged ADLs

[BLOG POST] Home After a Stroke: ADLs Are Where the Repetitions Are

ADLs Are Where the Repetitions Are

Brain plasticity is amazing, but rewiring the brain requires thousands of repetitions (reps).   Activities of Daily Living (ADLs) are a great way to get the reps needed to retrain the brain.
Four examples show why three sets of ten each day cannot compete with ADLs.

1) Twice a day I open my hemiplegic (paralyzed) hand to grasp a tube of toothpaste so my sound hand can remove the cap.  My hand opens again to hold the tube while I put the cap back on.  In nine years I have opened my hand over 5000 times before brushing my teeth.

2)  I have to turn 14 times to prepare cereal with a sliced banana.  I have made this same breakfast for nine years so I have made over 45,000 turns.  Add making a sandwich for lunch and preparing a hot meal for dinner and the number of turns I have made in the kitchen are in the hundreds of thousands.

3)  Shopping is therapy for my hand.  I open my hemiplegic hand to let go of the cart and reach for items with my sound hand.  My hemiplegic hand opens a 2nd time when I grab the cart to move on. My hemiplegic hand opens a 3rd time so I can let go of the cart so I can maneuver to empty the cart in the check-out lane and again to load food into my car.  Pick up 30 items + empty cart + load car means I open my hand 60 + 2 + 2 = 64 times.  64 x 2 visits a week x 9 years means I have opened my hemiplegic hand 59,904 times in the grocery store.

4)  The distance I have walked at the grocery store is huge.  I step away from the shopping cart and bend down or reach up to get items I want.  The S-shaped curves I make to detour around people and other carts require more steps than walking in a straight line.  According to my pedometer I walk 2,000+ steps each time I visit the grocery store.  2,000 x 2 visits a week x nine years = 1,872,000 steps!

via Home After a Stroke: ADLs Are Where the Repetitions Are

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[Abstract] Motor Impairment–Related Alterations in Biceps and Triceps Brachii Fascicle Lengths in Chronic Hemiparetic Stroke

Poststroke deficits in upper extremity function occur during activities of daily living due to motor impairments of the paretic arm, including weakness and abnormal synergies, both of which result in altered use of the paretic arm. Over time, chronic disuse and a resultant flexed elbow posture may result in secondary changes in the musculoskeletal system that may limit use of the arm and impact functional mobility.

This study utilized extended field-of-view ultrasound to measure fascicle lengths of the biceps (long head) and triceps (distal portion of the lateral head) brachii in order to investigate secondary alterations in muscles of the paretic elbow.

Data were collected from both arms in 11 individuals with chronic hemiparetic stroke, with moderate to severe impairment as classified by the Fugl-Meyer assessment score. Across all participants, significantly shorter fascicles were observed in both biceps and triceps brachii (P < .0005) in the paretic limb under passive conditions. The shortening in paretic fascicle length relative to the nonparetic arm measured under passive conditions remained observable during active muscle contraction for the biceps but not for the triceps brachii.

Finally, average fascicle length differences between arms were significantly correlated to impairment level, with more severely impaired participants showing greater shortening of paretic biceps fascicle length relative to changes seen in the triceps across all elbow positions (r= −0.82, P = .002). Characterization of this secondary adaptation is necessary to facilitate development of interventions designed to reduce or prevent the shortening from occurring in the acute stages of recovery poststroke.

 

via Motor Impairment–Related Alterations in Biceps and Triceps Brachii Fascicle Lengths in Chronic Hemiparetic Stroke – Christa M. Nelson, Wendy M. Murray, Julius P. A. Dewald, 2018

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[BLOG] Home After a Stroke – Work Smarter Instead of Harder

 

About Me

I am an occupational therapist (OT) who specialized in stroke rehab.  I continued my education by having a stroke in 2004 that paralyzed my dominant right side.  I still walk with a brace and cane, regained only partial use of my hemiplegic hand, and still have slurred speech when I’m tired.

I live alone so I am both the caregiver and the stroke survivor.  I am divorced and was not able to have children.  My two middle-aged bachelor brothers live 800 miles away and two life-long friends live 1,200 miles away.  My parents are dead.  Thank goodness I have a small army of local friends.

I had my stroke a year after I completed my doctorate in cognitive psychology.  My stroke rehab felt like my last major learning experience so I wrote a book called My Last Degree: A Therapist Goes Home After a StrokeMy sense of purpose continued to grow as I developed Power Point presentations for stroke survivor support groups, rehab professionals, and OT students.  I live in New Jersey, U.S.A.  E-mail me at homeafterastroke3@verizon.net.

The 2nd edition has 44 photos that make it easier to understand what I am describing.  This edition includes solutions to challenges that occur long after formal rehab is over.

There are reports of Amazon listing books as “out of stock” and imposing long delivery times.  You can order this book from the publisher at www.booklocker.com.

Source: Home After a Stroke

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[Abstract] Range of Motion Requirements for Upper-Limb Activities of Daily Living – AJOT

December 2015

Abstract

OBJECTIVE. We quantified the range of motion (ROM) required for eight upper-extremity activities of daily living (ADLs) in healthy participants.

METHOD. Fifteen right-handed participants completed several bimanual and unilateral basic ADLs while joint kinematics were monitored using a motion capture system. Peak motions of the pelvis, trunk, shoulder, elbow, and wrist were quantified for each task.

RESULTS. To complete all activities tested, participants needed a minimum ROM of −65°/0°/105° for humeral plane angle (horizontal abduction–adduction), 0°–108° for humeral elevation, −55°/0°/79° for humeral rotation, 0°–121° for elbow flexion, −53°/0°/13° for forearm rotation, −40°/0°/38° for wrist flexion–extension, and −28°/0°/38° for wrist ulnar–radial deviation. Peak trunk ROM was 23° lean, 32° axial rotation, and 59° flexion–extension.

CONCLUSION. Full upper-limb kinematics were calculated for several ADLs. This methodology can be used in future studies as a basis for developing normative databases of upper-extremity motions and evaluating pathology in populations.

Source: Range of Motion Requirements for Upper-Limb Activities of Daily Living

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[ARTICLE] Effectiveness of Virtual Reality Game on Functional Movement and Activities of Daily Living in Hemiparetic Stroke Patients.

Abstract:

Independent activities of daily living (ADLs) performance are recognized as a major goal of stroke rehabilitation. Recently, virtual reality training using a video game is considered as an effective approach to improve functional activity of stroke patients.

The purpose of this study is to investigate the effects of virtual reality game using a wii fit balance board on functional movement and ADLs of hemiparetic stroke patients.

20 subjects were randomly allocated into two groups: the virtual reality game training (n = 10) and control groups (n = 10). Both groups participated in standard rehabilitation program for 6 weeks. In addition, virtual reality game training group participated in virtual reality game training for 30 minutes per day, 3 times a week, for 6 weeks.

Virtual reality game training program consisted of balance bubble, ski slalom, ski jump, soccer heading, table tiling, and the penguin slide was conducted with the Wii-Fit balance board. After 6 weeks virtual reality game training, significant improvement observed in functional movement and ADL performance in the virtual reality game training group compared to the control group.

Findings of this study demonstrated that the virtual reality game training has an effective on functional movement and ADL performance in hemiparetic stroke patients when added to standard rehabilitation.

Source: Effectiveness of Virtual Reality Game on Functional Movement and …: ingentaconnect

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