Posts Tagged independence
[BLOG POST] Assistive Technology: How specialist gadgets and software have increased my independence.
I can’t use a computer without assistive technology. Over the years as computers have become more powerful assistive technology has become better and better. There are now hundreds of specialist gadgets and software that can make it easier for people with disabilities to operate computers or smartphones.
[WEB SITE] Despite Weakness, Stroke Patients Can Learn New Tasks Through Rehab Training – Rehab Managment
Even though rehab training doesn’t change the neurological deficits resulting from a stroke, it can help patients learn new motor skills and achieve more independence in their daily lives, a recent study suggests.
Pablo Celnik, MD, director of the Department of Physical Medicine and Rehabilitation at Johns Hopkins, explains the finding more specifically, in a study published in Neurorehabilitation and Neural Repair.
“What we found is that physical rehab is not going to change the weakness caused by damaged brain cells in chronic patients, but it is going to change how well they can perform certain tasks, which can have a huge impact on a patient’s daily life,” Celnik says in a media release from Johns Hopkins Medicine.
The study included 10 chronic stroke patients with Fugi-Meyer Assessment (FMA) scores of >50 out of 66, categorized as having “mild to moderate” functional deficits; 10 patients with FMA scores of <50 out of 66, categorized as having “moderate to severe” impairment.; and 10 able-bodied participants who served as a control group.
All of the study participants were trained to control a simple video game using a using a robotic piece of equipment that held their dominant arm at 90 degrees from their bodies. This eliminated gravity as a burden for those whose arms were weakened by their strokes. The subjects were then taught to use the muscles around their elbow to move a cursor across a screen into small target windows, the release explains.
The participants were then asked to move the cursor through the windows in time with a metronome and completed nine blocks of 10 trials at various speeds—24, 30, 38, 45, 60, 80, 100, 110, and 120 beats per minute.
Next, the participants attended 30-minute training sessions for 4 consecutive days, during which time they were asked to complete five blocks of 30 trials, all at their own pace, and were encouraged to improve their speed and accuracy in each consecutive block. Following the training sessions, the participants’ skill levels were tested again in another skill assessment.
Results showed that while each group’s skill level improved by the end of the training, those with greater motor impairment still demonstrated less skill in both the pre- and post-training assessments. All participants reached a plateau in their improvement around experimental days 3 and 4.
However, the study showed that there was considerable overlap between the post-training performance of the stroke patients and the pre-training performance of groups with less impairment, the release continues.
“When you look at the data, the post-training mild-to-moderate group is indistinguishable from the pre-training control group. And the same was true for post-training scores of those in the moderate-to-severe group and the mild-to-moderate group,” says Robert Hardwick, PhD, postdoctoral fellow in the Department of Neurology at the Johns Hopkins University School of Medicine, in the release.
“This is good news for patients because it means that even when there is little likelihood of further neurological recovery, it means I can still teach them new tasks through training,” Celnik states in the release.
“What is important is to not create false expectations of neurological recovery, while at the same time being hopeful that patients can learn within the boundaries of their neurological deficit to improve their lives.”
[Source(s): Johns Hopkins Medicine, Science Daily]
[Abstract] Play-based interventions improve physical function for people with adult-acquired brain injury: a systematic review and meta-analysis of randomised controlled trials [with consumer summary] – PEDro
Saywell N, Taylor N, Rodgers E, Skinner L, Boocock M
Clinical Rehabilitation 2016 Feb 11:Epub ahead of print
OBJECTIVE: To undertake a systematic review and meta-analysis of the effectiveness of play-based interventions compared to traditional therapy in rehabilitation of adults with adult-acquired brain injury.
DATA SOURCES: The search was performed using Medline; CINAHL Plus; Health Source (Nursing/Academic Edition); Psychology and Behavioural Sciences Collection; Biomedical Reference Collection (Basic).
REVIEW METHODS: Studies included were randomised controlled trials that investigated the effect of play-based interventions on physical function of adults with adult acquired brain injury. Two independent reviewers identified eligible studies and assessed methodological quality using a modified Downs and Black. Meta-analysis compared standardised differences in means, to determine effect sizes for grouped functional outcome measures. The GRADE scoring system was used to determine the level of clinical evidence.
RESULTS: Thirty studies met the inclusion criteria, 13 were considered high quality and 17 moderate quality. Studies predominantly involved post-stroke participants, with only three studies including participants with traumatic brain injury. When compared to traditional therapy, dose-matched studies of play-based interventions showed a significant effect on independence (effect size (ES) 0.6) and physical performance (ES 0.43), as measured using the Fugl-Meyer. For non-dose matched studies, play-based interventions showed a significant improvement for balance (ES 0.76) compared with traditional therapy. In all studies that measured participant enjoyment, play-based therapy was rated as more enjoyable than traditional therapy.
CONCLUSION: Play-based interventions for people with adult acquired brain injury are more effective in improving balance and independence, which may be due to them being more enjoyable than traditional therapy.
Full text (sometimes free) may be available at these link(s):
Occupational Therapy: Skills for the Job of Living
Traumatic brain injury (TBI) is caused by an impact to the head from direct blows or sudden movements in other parts of the body, such as severe shaking. TBI can result in physical, cognitive, behavioral, or emotional difficulties. Injuries can range from minor to extremely severe and call for various levels of intervention and treatment.
People with TBI may experience short-term memory loss, have difficulty concentrating or paying attention, become easily disoriented, have impaired judgment, experience headaches or migraines, have slurred speech, experience seizures, become fatigued, depressed, or easily agitated, or experience increased anxiety and impulsive behaviors.
Occupational therapists can help people who have sustained a TBI. The type and duration of intervention depend on how severe the injury.
What can an occupational therapist do?
- Evaluate the client engaging in daily activities at home, such as dressing and eating; at work; and during leisure activities, and facilitate the resumption of those activities.
- Establish and restore (depending on the age of the client) endurance and strength so that a person with TBI can bathe, dress, and feed himself or herself.
- Help the client minimize overstimulation and confusion in his or her environment.
- Help the client perform simple tasks that are meaningful to the person’s life.
- Implement weekly checklists of household chores.
- Recommend equipment that can aid a person in performing daily life activities with greater independence, such as a tub or shower seat to allow bathing without standing when the client has poor balance and grab bars for greater safety when getting in or out of a tub or shower.
- Teach a person with TBI to compensate for problems with thinking, such as memory impairments.
What can families and friends of a person with a TBI do?
- Become educated about the recovery process of a family member with a TBI.
- Provide long-term support to a family member with a TBI.
- Learn techniques to help the person with a TBI manage cognitive and physical problems.
- Help the person adapt his or her home to accommodate the effects of a TBI.
Need more information?
A person with traumatic brain injury and his or her family likely will need long-term assistance. If you would like to consult an occupational therapist, they are available through most hospitals, medical centers, and community clinics.
Occupational therapists and occupational therapy assistants are trained in helping adults and children with a broad range of issues in addition to traumatic brain injury, such as arthritis, stroke, and mood disorders. Practitioners also help clients develop wellness techniques that may prevent injury and disease.