Neurologically impaired UE Flashcards
Biomechanical alignment
After CVS lose ability to posturally adjust and maintain postural alignment.
Will impact scapular alignment
Subluxation
measure with finger
Palpating the subacromial space and superior aspect of humeral head. seated with neutral rotation.
-score by finger= 0,1,2,3
Shoulder impingement
result of trauma,
improper handling or poor positioning,
most common during “mixed tone” phase of recovery.
caused from not doing anything, Soft tissue tightness and loss of ROM
UE spasticity
a motor disorder that is velocity dependent. It is the exaggeration of the stretch reflex.
normal ins CVA recovery.
Clasp knife syndrome
severe rigidity- sustained stretch will relax muscle group and give way.
Clonus
Uncontrolled oscillation in spastic muscle groups,
repetitive contractions in the antagonist muscles in response to rapid stretch,
Weight bear actively can stop it.
Cogwheel rigidity
Jerky resistance.
treatment of UE spasticity
Move limb quickly and feel for resistance,
- grade with the ashworth scale
sustained stretch of 10 minutes lead to decrease in spasticity of elbow, hand, and fingers
nerve blocks or botox
avoid using excessive effort during movement.
encourage slow and controlled movements.
teach specific functional synergies during tasks
Spasticity management
ROM and positioning,
increase awareness of exacerbating factors so patient can avoid or take advantage,
Neurorehabilitiative techniques.
Shoulder hand syndrome
severe pain which progresses to stiffness in shoulder, pain throughout extremity, moderate swelling of wrist/hand, vasomotor changes, atrophy.
can become frozen shoulder if not treated.
Preserving UE function
- adequate support and positioning in bed
- avoid positions of impingement,
- vary weight shift technique,
- incorporate flexibility into exercise program,
- incorporate resistance training.
Building UE function
Address:
- Weakness
- ROM (PROM, AROM, AAROM)
- Muscle strength
- Muscle endurance
- Coordination and motor control
