Quite a few years ago I was treating a youngster who had been in a motorcycle
accident. He was left with
right upper extremity paresis from both peripheral and CNS injuries. While he could
move the arm
voluntarily, he tended to use the left arm almost exclusively for spontaneous
activity. With his approval,
we tied a shoelace to his wrist and attached it to his belt buckle. He could use both
hands for bilateral
tasks, but he could reach only with his right arm. It was very effective in serving
as a reminder to him to
use the right arm. As to whether it is PT or OT, I can't imagine a PT who would think
of this, nor was it
used during treatment. It was used during his entire occupational life. Estelle
Breines
Susanne wrote:
> -----Oprindelig meddelelse-----
> Fra: Katherine L. Hardigan <[EMAIL PROTECTED]>
> Til: [EMAIL PROTECTED] <[EMAIL PROTECTED]>
> Dato: 20. marts 2001 13:43
> Emne: Re: Is Constrainted-Induced Movement Legitimate
> Occupational Therapy
>
> >It sounds barbaric. Why not tell a person with a spinal cord
> injury to
> >get up and walk?
>
> Not exactly - but then Ron's explanation IS over-simplyfied. The
> clients are provided with a sling for their non-effected UE -
> it's NOT tied up. And the clients are not "taken" and "placed in
> situations requiríng......." etc etc. They should be informed and
> consenting.
> Basicly it's just a lot of training for the effected UE - both
> function and every ADL-skill that is needed for several hours
> every day. And I have considered presenting the idea (a modified
> version) to a few of my clients - only one problem kept me from
> doing it:
>
> I have yet to meet a client that wouldn't be "grounded" during
> CI-training sessions due to their need for their non-affected UE
> for locomotion (balancing, using cane, crutch,
> wheelchair-propelling etc). And then the natural/overall/global
> aproach sort of disapears - and this becomes again just another
> training session while we sit here at the table..........
>
> Another thing to consider is: This doesn't take away the
> importance of "grading/graduating" (what do you say?) the
> difficulty of the activities and tasks presented while the client
> is in constrained mode.
> I'm rather sure nobody will grow, learn or improve from
> unsuccessfully trying to wipe their behind after toilet due to
> lack of ROM.....
>
> But I'll go look for some articles I might still have somewhere
> on my pc - so we'll better know what we're discussing!
>
> susanne, denmark
>
> >On Mon, 19 Mar 2001, Ron Carson wrote:
> >
> >> Hello All:
> >>
> >> The recent surge in interest regarding CI Movement is making
> me wonder if
> >> this is a legitimate form of OT practice?
> >>
> >> As I understand it, CI therapy's design is to take clients
> with
> >> neurological damage but with some residual UE function, bind
> their
> >> non-effected UE and place in them in situations requiring use
> of their
> >> effected UE to perform daily tasks. This is an extremely
> over-simplified
> >> explanation so I hope more knowledgeable readers will "fill in
> any
> >> missing blanks"
> >>
> >> Some research indicates that for selected patients, there is
> marked and
> >> lasting improvement in ROM, strength and 'functional' use of
> the
> >> effected extremity.
> >>
> >> As it is currently understood, is this research and treatment
> something that
> >> should excite OT's and something we should practice? Or is
> this something
> >> best left to PT?
> >>
> >> Ron
>
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