Diane, I am going to comment here rather than "Lurking". There are some great resources to help you with "evidence-based interventions"
Treatment of Neglect etc. Go to www.ebrsr.com and read module 11. The treatments for neglect that has been demonstrated to have some impact on reducing the neglect and improving performance in self care tasks are: 1. TENS 2. Neck muscle vibration therapy 3. Bilateral half field eye patches 4. feedback strategies 5. limb activation strategies They are described in the module. These interventions combined with basic initiation of early self care tasks and balance with improve the outcomes. In this patient the results will require time and persistence. Subluxation 1. The only evidence for improving and preventing subluxation is with the use of an electrical stimulation program. This involves 2 channel deltoid and triceps stim for most effective not supra spinatus Upper extremtity return (by the way here the outcomes are focused on occupation and use occupation for an effective intervention strategy so I treat UE as part of my overall intervention program not in isolation) See module at above website on upper extremity. 1. Electrical stimulation 2. begin the early stages of visualization and mental imagery focusing on attention to task with this patient. 3. follow some of the other strategies in the module. Need to run so cannot elaborate further. Sue Sue D > From: spark...@rcn.com > To: otlist@otnow.com > Date: Thu, 6 Aug 2009 05:43:33 -0400 > Subject: [OTlist] Massive new CVA patient > > Hello, I have been given (along with 11 other patients I have) a new CVA > patient. I have never worked with someone tis impaired and i don't know > where to start. I am in a SNF and pt had been in an acute rehab for about a > month prior for therapy. He is Dependent for all ADL's and > transfers...sometimes hard to get his attention at all. Total left neglect. > Trouble following simple commands. 1 finger sublux. Just not sure where to > even begin. Goals are to increase attention to the left to perform ADL's > but is this relistic at this point and what activites can I do with him that > will encourge attention to left or attention to anything at all. Thanks > Diane > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
