Motor control problems

Question 1

Ataxia of the arm or trunk

Answer 1

PNF: light resistance, “ sitting then say to pt. “ push into my hands”. Bridging for the trunk and apply resistance at asis. NDT: WB on affected arm.
Functional task: weighted cuff less than 1#, empty dish washer, play balloon volleyball, laundry, go to bathroom sink and wash face,
Grading these activities could include, more or less weight, stand or sit depending on balance, weighted cups and utensils.

Question 2

Hypertonicity of arm, hand and trunk:

Answer 2

Trunk: Inhibitory focus ( relax the muscle): NDT: disassociation with therapy ball, pt sits on plinth and holds ball while therapist guides from left to right. Therapist can put pts hands therapists shoulders and then walks side to side to do same stretch. another NDT approach side lying then therapist twists the trunk.
Arm: Inhibitory focus: shaking of the limb, maintain stretch . WB on arm while playing cards.
Hand: joint compression to wrist and fingers. Brunnstrom technique, raise arm in air to promote extension.
Functional task: rotate trunk grab shirt and fold it.
Arm: stand at bathroom sink WB on hand to groom and brush teeth.

Question 3

Hypotonicity of arm hand and trunk

Answer 3

Trunk: facilitate focus: sitting on air disk practice ws. Can sit on therapy ball with red matt ws fw/bw with resistance from therapist at lower back and hip.
Arm: tapping bicep for flexion while bringing an object to mouth. Tap the triceps to bring back into extension.
Hand: quick stretch place wrist into flexion then apply quick stretch, this stimulates hand into extension.
can also do quick icing to facilitate thumb abduction.
Functional tasks: Trunk: Lower body dressing
Arm/hand: tap arm while they grab wash cloth

Question 4

Decreased dissociation between shoulder girdle and lower trunk and pelvis

Answer 4

sit on plinth and hold ball then OT moves ball back/forth.
MRP: beanbag pick up from floor and toss them into
a bin.
NDT: supine on plinth then OT protects the shoulder girdle ( GH) have pt. initiate reach. ( dishes off shelf)
PNF: D1 and D2 simulates dishes in and out of dish washer. Bridging
Functional: putting shoes on and dishes

Question 5

Decreased dissociation b/w UE and trunk

Answer 5

PNF: bridging with resistance at ASIS. D1 and D2.
MRP: bowling if grading use resting stool
Rood: use vibrations if low tone
Functional task; while sitting down, rotate to fold shirt.

Question 6

Weight Bear and Weight Shift problems

Answer 6

sitting on disk while ws by tapping balloon to another or playing volleyball. Could also bowl or do bean bag toss.
Functional: shoes and socks

Question 7

Flaccid UE or no motor return

Answer 7

Rood: vibration over biceps for flexion and triceps for extension alternate it with towel underneath arm to help them slide. or can use skate board underneath arm.
Brunnstrom: homolateral flexion on strong side to cause overflow on weak side.
NDT: tapping bicep and tricep to normalize tone then do WB while OT pushes them into it, then ball toss.
Functional task: incorporate weak arm as gross assist (helping hand)

Question 8

Flexor synergy ( spastic or extreme hypertoncity)

Answer 8

shake limb ( oscillations) then place  limb up onto a
  small ball  can use air splint use deep pressure rolling side to side back and forth, in circles.
using air splint with prolonged stretch while playing cards,
Functional: with air splint,  ADLs, Cooking and stirring with bowl on dyson.

Question 9

Poor standing balance

Answer 9

standing on bocu board ( on red matt) therapist will stand behind pt. as contact guard using gate belt while they toss bean bag into garbage can or bin.
Bridging with resistance at trunk.
Functional task: put dishes away.

Question 10

Poor sitting balance

Answer 10

sit on disk ws anything LB

Question 11

Poor trunk movement in rotation, lateral flexion, and straight plane ( fw/bw motion) and extension.

Answer 11

Trunk rotation with ball while sit
Table slides with towel underneath arm.
Bowling and bean bag toss
Functional tasks: grab a shirt and fold, tie shoes

Question 12

Mixed tone situations such as hypertoncity in arm and hypotonicty in trunk and vice versa.

Answer 12

Hyper in arm and hypo in the trunk: inhibitory techniques for arm ie quick shake, WB, joint compression
hypo in the trunk- resistance side lying. resistance on ball while sitting therapist hands on waist “ do not let me move you” go fw/bw.
hypo hands and hyper trunk:
hypo hands: facilitate by tapping, use vibrations, resistance quick stretch.
hyper trunk: inhibitory techniques: slow stroking by having pt. side lye then stroke paraspinals with up and down hand motion. ( flat hand)
Functional task: put on socks.