Symposium “Evidence for Upper Extremity Training for the lower func<oning post-‐stroke pa<ent” Sandy McCombe Waller PT, PhD, NCS Stroke Forum Morning Symposium - Thursday 2nd December, FORTH ROOM 08:00 to 08:50
Introduction: Finding effective interventions to improve arm and hand function for patients with more severe paresis after stroke is an ongoing challenge for physical therapists and other health care professionals. Several studies to improve upper extremity function include only higher functioning patients with some degree of preserved wrist or finger extension. There is an ongoing need to identify new strategies to improve the functional outcomes in those with more severe arm and hand paresis. In this educational session we will present evidence related to two interventions that target the unique needs of patients with more severe deficits in motor performance and function of the upper extremity and hand. Objectives: Upon completion of this session you will be able to: 1. Describe the unique challenges of working with a patient with severe motor impairment from a neurophysiological and clinical perspective 2. Describe the benefits and limitations of bilateral arm training and combination training with dynamic orthotics with individuals with more severe paresis 3. Describe the evidence for the use of bilateral arm training and training with dynamic orthotics in individuals with more severe paresis 4. Discuss how these interventions could be integrated into clinical practice Symposium Outline:
I. Defining the population A. Neurophysiology of moderate to severe motor impairment in stroke B. Clinical presentation of the patient with moderate to severe motor impairment II. Upper Extremity Interventions: What is the Evidence? A. Bilateral arm training with rhythmic auditory cueing (using BATRAC/ Tailwind ®) B. Dynamic orthotic and combination approaches III. Integration of these interventions into clinical practice
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References: Luft, A., McCombe Waller, S., Whitall, J, Smith, G., Forrester, L, Macko, R., Hauser, T., Goldberg, A., Hanley, D. (2004) Interhemispheric Reorganization of Motor Activity is Necessary for Successful Rehabilitation. JAMA Oct 20; 292(15):1853-61. ! ! McCombe Waller, S. & Whitall, J (2008) â€œBilateral Arm Training: Why and Who Benefits? Journal of Neurorehabilitation. 23(1):29-41. Review McCombe Waller, S., Wei, L., Whitall, J. (2008) Temporal and Spatial Control following Bilateral versus Unilateral Training, Human Movement Science. Jul 16. [Epub ahead of print] PMID: 18639360 [PubMed - as supplied by publisher Whitall, J., McCombe Waller, S., Silver, K.H.C., Macko, R.F. (2000) Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke. Stroke 31, 2390-2395. Whitall, J. Savin Jr., D., Harris-Love, M., McCombe Waller, S. (2006) Extending the applicability of the Wolf Motor Function Test. Archives of Physical Medicine and Rehabilitation 87, 656-660.
Biographical Information: Sandy McCombe Waller PhD, PT, NCS is an Associate Professor in the Department of Physical Therapy and Rehabilitation Science at the University of Maryland School of Medicine. She graduated with her BS in PT from the University of Maryland in 1985, received her MS from Johns Hopkins University in 1991, and completed her PhD in Physical Rehabilitation Science at UMB in 2004 focused in Neuromotor Control. She has over 20 years teaching the clinical neurology content in the physical therapy program and joined the faculty full time in 1994. Her current research is funded by NIH to study combined training for arm function and balance in patients post stroke and the underlying neural mechanisms associated with integrated control of arm function and balance.
Event is sponsored by Anatomical Concepts (UK) Ltd! 8-10 Dunrobin Court Clydebank Business Park Clydebank G81 2QP T: 0141-952-2323 F: 0141-952-3434
Tailwind is Manufactured by Encore Path Inc and represented in the UK by Anatomical Concepts (UK) Ltd
Web: ! anatomicalconcepts.com ! armexerciser.com
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