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nkarman
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Posted: Mon May 3rd, 2010 12:43 am |
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Isn't that always the case? Bummer. I keep promising myself that I will religiously videotape, but never get the camera out.
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Lesley Smith
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| Joined: | Wed Aug 29th, 2007 |
| Location: | Humarock, MA |
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Posted: Sun May 2nd, 2010 11:06 pm |
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| The second time I tried this with the patient I got my camera out for such a purpose - but he'd made so much improvement with the first attempt that there really wasn't too much of a difference!
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nkarman
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Posted: Sun May 2nd, 2010 10:23 pm |
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| Excellent. At times like this I always wish I had pre & post video.
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Lesley Smith
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Posted: Sun Mar 28th, 2010 05:52 pm |
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Re my patient below, we no longer need to use the hand rails nor the canes...
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Lesley Smith
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Posted: Sun Mar 28th, 2010 05:50 pm |
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An interesting article to add to the discussion:-
[url=javascript:AL_get(this, 'jour', 'Gait Posture.');]Gait Posture.[/url] 2010 Jan;31(1):109-15. Epub 2009 Oct 24.
The effect of arm movements on the lower limb during gait after a stroke.
Stephenson JL, De Serres SJ, Lamontagne A.
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada. jennifer.stephenson@ucdenver.edu
The purpose of this study was to examine the influence of arm movements on lower limb movement and muscle activation during treadmill walking after a stroke. Ten high functioning stroke and 10 healthy subjects walked on a treadmill while swinging their arms naturally, and while holding onto handles that were either fixed in place or allowed to slide along horizontal handrails. Full-body kinematics were recorded, along with bilateral surface electromyography from lower limb muscles. Arm movements influenced lower limb muscle activity but had little effect on movement patterns at the joints. When handrails were present a small amount of weight was borne through the upper limbs, and for stroke subjects this was reduced when the handles were free to slide. Activity of proximal leg muscles during stance was affected by the weight borne through the upper limbs, increasing when arm movements were performed. Soleus activity during stance was greatest with unsupported arm movements. In stroke subjects, early stance tibialis anterior activity in the paretic leg was greatest with no arm movements, and early swing tibialis anterior activity in both legs was greatest with unsupported arm movements. Many of the changes in muscle activation appeared to be due to changes in postural stability that occurred when performing arm movements. Overall, results support further study of the long-term changes associated with the inclusion of arm movements in gait rehabilitation protocols. Copyright 2009 Elsevier B.V. All rights reserved.
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nkarman
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Posted: Tue Mar 9th, 2010 04:20 pm |
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| I am so happy... This is why I love this forum!!!
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Lesley Smith
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Posted: Mon Mar 8th, 2010 11:11 pm |
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It worked REALLY well!! His knee flexion looked better and the pt felt as though he was walking better and with less effort. There was also good carry-over with overground ambulation (w/o any AD) and he reported that he felt that he was "in synch for the first time," since his stroke (18 months ago).
Thank you, Nikki!
Last edited on Mon Mar 8th, 2010 11:12 pm by Lesley Smith
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nkarman
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Posted: Sun Mar 7th, 2010 12:32 am |
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| Please let me (us) know how it goes
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Lesley Smith
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Posted: Sat Mar 6th, 2010 10:00 pm |
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What an interesting idea! I use that technique with PD patients but I've never thought to use it with this pt. I can't wait to try it on Monday morning.
Thanks!
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nkarman
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Posted: Sat Mar 6th, 2010 09:12 pm |
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| During a demo earlier this week, there was a client with similar presentation. I facilitated arm swing by having him hold onto the bottom of a crutch in each hand, and got the arms swinging reciprocally. I made sure not to cut the swing short, but to allow full forward movement on each side. It was impressive: tone in LEs gone in a second, along with longer stance phase so knee flexed naturally in late stance.
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Lesley Smith
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Posted: Fri Feb 26th, 2010 03:18 pm |
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I'm currently treating a fairly high level CVA pt. He can tolerate approx 30 minutes of treadmill walking at 2mph. However, w/o UE support , he has a very "stiff knee" gait which req's a lot of effort on my behalf to break and I fatigue way before he does!! With B UE support he requires occassional 'facilitation' and it's more like a coffee-break protocol for me. I try to wean him off the B UE protocol but I'm unsure if I should persevere through non UE treatment approach or whether I should favor the UE support approach until his gait pattern (without supprt) improves.
Any suggestions?
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