A discuss ion on developmental coordination disorder testing to show the capacity in activities of daily living in children with developmental coordination disorder in seen in Clinical Rehabilitation, 05/01/2013. Dr. van der Linde BW et al. from Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands report on the use of the DCD Daily as a valid and reliable instrument for clinical assessment of capacity in ADL, that is feasible for use in clinical practice.
Posts Tagged ‘Medicine’
Published in BMC Musculoskeletal Disorders 03/13/2013 Dr. Okoro T et al from Department of Orthopaedics and Physiotherapy Bangor University, Bangor, UK look at ’standard’ rehabilitation care in the UK after total hip replacement (THR). Because Total hip replacement (THR) is one of the most widely performed procedures in orthopaedic practice with the number of primary total hip replacements (THR) over 79413 in the UK (according to the National joint registry) undergoing THR. This number will increase with the rising age of the population.
THR for patients with end stage joint disease is shown to give pain relief, and substantial improvement in quality of life. However studies show that, even in the absence of pain, there is still movement impairments and functional limitation in post surgery patients including reduced muscle strength, reduced postural stability, and limited flexibility. These impairments cause functional limitations including reduced walking speed, and less functional ability. The group present evidence of prolonged poor function in patients following total hip replacement (THR) in the UK. Patients with poor functional outcome measures 2 years post-operatively after THR are five times more likely to require assistance with ADLs compared to those who have good function. Therefore it is important to avoid long-term impairment and to optimise functional recovery.
Baby boomers – those of us born between 1946 and 1964 are susceptible to orthopedic conditions like tendinitis, tears, fractures and arthritis. Arthritis affects both men and woman but statistics suggests that the number of women undergoing knee replacement is outpacing men. Looking over the past decade, knee replacement surgeries in the USA have doubled however in woman the number has almost tripled – 2009 National Institute of health figures show that almost 63 percent of knee replacement patients between the ages of 40 and 80 were women.
In Archives of neurology Engelmann KY et al.Department of Neurology, Division of Pediatric Neurology Johns Hopkins University School of Medicine look at what outcome measures have been used in clinical trails to assess pediatric stroke study outcomes .
Accreditation by the Joint commission allows a a rehabilitation hospital or Health System to say that their orthopedic joint replacement programs are effective and underscored by the consistent use of appropriate, evidence-based clinical practice guidelines for the hip, knee or shoulder replacement patient population.The hospital has proved that it holds a commitment to a higher standard of service, infrastructure and management.
Following orthopedic surgery the patient will need to undergo physical rehabilitation in order to increase the range of movement of the operated hip, knee, elbow or shoulder and increase muscle strength and speed and accuracy of movement. The Tutor system including the ArmTutor and LegTutor is a tool used by physical therapists in rehabilitation hospitals that allows customization of the intensive exercise practice that the patient will need to undergo in order to improve functional movement ability. The ArmTutor and LegTutor are CE and FDA certified and used in many rehabilitation hospitals in the US and abroad.
For further information go to http://www.meditouch.co.il
Wrist drop, which is also known as Saturday night palsy, radial neuropathy or radial nerve palsy, is a condition where a person cannot extend their wrist and it hangs down loosly or flaccidly. A person with wrist drop would be unable to move his wrist from that to a normal or neutral straight position .
Drunkenness and being in love have something in common. Both may result in an injury called radial neuropathy which can produce this ”wrist drop’” condition.
Waking up to find that your hand is ”dead” is why this condition is nicknamed Saturday Night Palsy or Honeymooner’s Palsy.
In Wrist drop you may feel sensation in the hand, yet not be able to move your hand or fingers one millimeter.
Though there are various causes of wrist drop it frequently results from a compression injury that includes damage or death of radial nerve cells within the arm.
Pain is usually a warning sign before radial neuropathy develops as the arm builds up pressure over an extended period. But, the pain may be unnoticed, or even ignored, when one is in an intoxicated stupor.
An example would be sleeping on your extended arm or having it swung over a chair after consumption of alcohol, hence the name Saturday Night Palsy. Another example is when one lover falls asleep on the arm of the other and head pressure compresses and thereby damages the radial nerve.
Wrist Drop Diagnosis
Usually an MRI and a neurological consult is how a diagnosis would be made in order to determine the extent of damage but also to rule out other possibilities like carpal tunnel syndrome.
Recovery from Wrist Drop
A doctor may be able to predict if there will be a long or short recovery period but he will not be able to quantify it in days, weeks or months. The nerves may heal gradually and movement may be restored. The wrist may heal faster than the fingers. Nerve cell destruction will make the healing time even longer until regeneration can occur.
Treatment for Wrist Drop
While using a hand splint and the healthy hand for support together with a proper diet may help there is no real treatment for wrist drop. However daily exercising is recommended to keep the tendons and muscles from tightening and atrophy.
Fortunately, today there are physical therapy solutions that can provide an excellent exercise program that can begin to alleviate symptoms leading to complete recovery. The HANDTUTOR by MEDITOUCH is one such product that is in use today for other limb disabling issues but that can be adapted as well to wrist drop. The HANDTUTOR, specifically, can be used to actively exercise extensor muscles of the wrist and therefore strengthen it so the hand does not drop.
The HANDTUTOR together with its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) was originally created to provide an intensive exercise system for patients recovering from a stroke, brain or spinal injury, Parkinson’s, MS, CP, knee and hip replacement surgeries and other upper or lower limb disabilities.
The TUTOR system consists of ergonomically designed gloves or braces containing sensors connected to dedicated software. Physical and occupational therapists monitor the progress and design a customized exercise program for that patient. The TUTORs are one of the most cost effective limb exercise products available. They are fully certified by the FDA and CE and can be used by adults and children from the age of 5 and up. The TUTORs can also be used at home through telerehabilitation.
See WWW.MEDITOUCH.CO.IL for further information.
Two-thirds of the 700,000 Americans who have a stroke each year survive and require rehabilitation. But fewer than one in three post-stroke patients undergoing physical therapy perform the at-home exercises their physical therapists recommend.
A team of researchers at Ohio State University is using a $653,000 grant from the Patient-Centered Outcomes Research Institute to develop a more fun and effective way for patients to work on regaining movement and mobility in their upper limbs.
Lynne Gauthier, an assistant professor of physical medicine and rehabilitation, is leading the team creating a video game for the Microsoft Kinect that the team hopes could expand access to a specific kind of rehabilitation called constraint-induced movement therapy. The game would allow patients with mild-to-moderate upper-limb impairment to perform guided CI therapy in their homes.
Studies have demonstrated the ability of CI therapy to improve upper extremity function in patients shortly after stroke and after time has passed. Several studies have also shown changes in brain activity associated with the therapy.
Despite a body of research that suggests CI therapy is more effective than standard rehabilitation, it hasn’t become standard of care because it costs about $6,000 and isn’t typically covered by insurance, Gauthier said, so only a small number of specialty clinics offer it. Less than one percent of patients who are eligible for it are able to travel to those clinics and pay for it, she added.
Gauthier said her team’s objective is to develop and pilot a home-based program that retains the fundamental principles of CI therapy but changes the way it’s delivered, so more patients can access it for a lower cost ($500 or less). The video game the team is developing targets both subacute stroke patients who have completed inpatient rehabilitation as well as patients with chronic post-stroke impairment.
The game uses Microsoft Kinect’s motion capture technology to guide patients through a series of therapeutic exercises set in a river adventure theme, Gauthier said. Patients would visit a clinic for initial consultation and the game would act as a consultant to guide them through exercises at home. Patients would also be given a restraint mitt to encourage them to use their affected side more often in daily activities.
“A lot of these kinds of rehab games are basically about just getting the person to move a lot,” she said. “But we’re trying to make it so that the game would stimulate what the therapist would do. Just as a therapist would make a task harder when the person improves, the game would do the same thing.”
To do that, Gauthier is working with a cross-disciplinary team made up of a computer scientist, an electrical engineer, a biomechanist, two physical therapists and Gauthier, a psychologist and neuroscientist.
Eventually the team will create computer algorithms that would allow the program to track patients’ progress over time and provide performance feedback to patients and therapists. For the first year of the grant, though, it’s focused on game design.
Over the next several months, the team will work with patients and therapists to refine the game; the second year of the grant will focus on testing it in patients’ homes. “We feel it’s very important to involve stakeholders,” she said. “We don’t really know what the therapist response is going to be, but we are trying to involve them to make sure that we design a product that they would actually use.”
Kinect joins other physical therapy solutions already helping patients recover their lost mobility strengths. One such product is the TUTOR family of products. The HANDTUTOR, ARMTUTOR,LEGTUTOR and 3DTUTOR are ergonomically designed comfortable gloves and braces which are placed strategically on affected limbs and allows the patient to get intensive self initiated exercises via sensors that are connected to dedicated software.
The ARMTUTOR specifically trains the upper limb through dedicated software games such as : snowman, asteroid attack, car race and others. The exercises are designed to increase brain activity. Therapists monitor progress and then design a customized exercise program for that patient giving him appropriate feedback. The TUTORs are currently in use in leading U.S. and European hospitals and clinics and are available through telerehabilitation in the patient’s home.
The TUTORs can be used by adults as well as children from the age of 5 and up and are fully certified by the FDA and CE.
See WWW.MEDITOUCH.CO.IL for further information.