Re: [OTlist] Massive new CVA patient
Interestingly, I just noticed that the EBRSR article actually sites the Cochrane article... - Original Message - From: Sue Doyle sue...@hotmail.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient SD Ron, SD While that is the current Cochrane one it is over 3 years old. SD The one from EBRSR is this last year. As a Cochrane author I SD prefer the Cochrane methodology to some of the others and think it SD produces a more accurate and thorough outcome but in this case I SD think the EBSR is a little more current. SD Sue D Date: Thu, 6 Aug 2009 17:27:58 -0400 From: rdcar...@otnow.com To: OTlist@OTnow.com Subject: Re: [OTlist] Massive new CVA patient From Cochrane.org: http://www.cochrane.org/reviews/en/ab003586.html The benefit of cognitive rehabilitation for unilateral spatial neglect, a condition that can affect stroke survivors, is unclear. Unilateral spatial neglect is a condition which reduces a person's ability to look, listen or make movements in one half of their environment. This can affect their ability to carry out many everyday tasks such as eating, reading and getting dressed, and restricts a person's independence. Our review of 12 studies involving306participants found that rehabilitation specifically targeted at neglect appeared to improve a person's ability to complete tests such as finding visual targets and marking the mid-point of a line. However, its effect on their ability to carry out a meaningful everyday task or to live independently was not clear. Patients with neglect should continue to receive general stroke rehabilitation services but better quality research is needed to identify optimal treatments. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Linda Stovall lstov...@mhg.com Sent: Thursday, August 06, 2009 To: otlist@OTnow.com otlist@OTnow.com Subj: [OTlist] Massive new CVA patient LS In contrast to Ron, I think there are some things to be done to address LS the neglect...and it is important to work on this, so that function can LS become a reality. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com SD -- SD Options? SD www.otnow.com/mailman/options/otlist_otnow.com SD Archive? SD www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
Good observation and very good point. This topic has been a good learning experience for me. My experience with neglect is still the same, but based on some of the research, others have more success. Thanks for all the comments. Ron - Original Message - From: Sue Doyle sue...@hotmail.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient SD Ron, SD While that is the current Cochrane one it is over 3 years old. SD The one from EBRSR is this last year. As a Cochrane author I SD prefer the Cochrane methodology to some of the others and think it SD produces a more accurate and thorough outcome but in this case I SD think the EBSR is a little more current. SD Sue D Date: Thu, 6 Aug 2009 17:27:58 -0400 From: rdcar...@otnow.com To: OTlist@OTnow.com Subject: Re: [OTlist] Massive new CVA patient From Cochrane.org: http://www.cochrane.org/reviews/en/ab003586.html The benefit of cognitive rehabilitation for unilateral spatial neglect, a condition that can affect stroke survivors, is unclear. Unilateral spatial neglect is a condition which reduces a person's ability to look, listen or make movements in one half of their environment. This can affect their ability to carry out many everyday tasks such as eating, reading and getting dressed, and restricts a person's independence. Our review of 12 studies involving306participants found that rehabilitation specifically targeted at neglect appeared to improve a person's ability to complete tests such as finding visual targets and marking the mid-point of a line. However, its effect on their ability to carry out a meaningful everyday task or to live independently was not clear. Patients with neglect should continue to receive general stroke rehabilitation services but better quality research is needed to identify optimal treatments. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Linda Stovall lstov...@mhg.com Sent: Thursday, August 06, 2009 To: otlist@OTnow.com otlist@OTnow.com Subj: [OTlist] Massive new CVA patient LS In contrast to Ron, I think there are some things to be done to address LS the neglect...and it is important to work on this, so that function can LS become a reality. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com SD -- SD Options? SD www.otnow.com/mailman/options/otlist_otnow.com SD Archive? SD www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
I want to thank everyone for thier responses. It has been very usefull Diane Randall COTA/L -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on Behalf Of Ron Carson Sent: Friday, August 07, 2009 05:54 To: Sue Doyle Subject: Re: [OTlist] Massive new CVA patient Good observation and very good point. This topic has been a good learning experience for me. My experience with neglect is still the same, but based on some of the research, others have more success. Thanks for all the comments. Ron - Original Message - From: Sue Doyle sue...@hotmail.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient SD Ron, SD While that is the current Cochrane one it is over 3 years old. SD The one from EBRSR is this last year. As a Cochrane author I SD prefer the Cochrane methodology to some of the others and think it SD produces a more accurate and thorough outcome but in this case I SD think the EBSR is a little more current. SD Sue D Date: Thu, 6 Aug 2009 17:27:58 -0400 From: rdcar...@otnow.com To: OTlist@OTnow.com Subject: Re: [OTlist] Massive new CVA patient From Cochrane.org: http://www.cochrane.org/reviews/en/ab003586.html The benefit of cognitive rehabilitation for unilateral spatial neglect, a condition that can affect stroke survivors, is unclear. Unilateral spatial neglect is a condition which reduces a person's ability to look, listen or make movements in one half of their environment. This can affect their ability to carry out many everyday tasks such as eating, reading and getting dressed, and restricts a person's independence. Our review of 12 studies involving306participants found that rehabilitation specifically targeted at neglect appeared to improve a person's ability to complete tests such as finding visual targets and marking the mid-point of a line. However, its effect on their ability to carry out a meaningful everyday task or to live independently was not clear. Patients with neglect should continue to receive general stroke rehabilitation services but better quality research is needed to identify optimal treatments. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Linda Stovall lstov...@mhg.com Sent: Thursday, August 06, 2009 To: otlist@OTnow.com otlist@OTnow.com Subj: [OTlist] Massive new CVA patient LS In contrast to Ron, I think there are some things to be done to address LS the neglect...and it is important to work on this, so that function can LS become a reality. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com SD -- SD Options? SD www.otnow.com/mailman/options/otlist_otnow.com SD Archive? SD www.mail-archive.com/otlist@otnow.com -- 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
[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
Re: [OTlist] Massive new CVA patient
Great patient to work with. At this point, there is nothing YOU can do to SIGNIFICANTLY increase his awareness. I would educate him, if appropriate, and family, if available, about visual and verbal cueing, but I would NOT waste a lot of time doing this. Over time, the neglect may subside but I believe this is one of those areas that takes a great deal of time and sort of spontaneous recovery. Are you a COTA or OT (this is why I ask people to include their credentials in messages). If you are the OT, I would change the goal to: Patient will perform basic ADL's Don't limit the patient and your treatment to the neglect. Surely there are other things inhibiting the patient's independence. Make a list of the patient's problems: physical, mental, emotional, environmental. Prioritize which of these problems are most significant AND that you have the ability to significantly improve. There is no use working on something that will not likely show significant change. My suspicion, is that you should be working on sitting balance. If the patient can sit, then work on standing balance, if the patient can stand, work on mobility. And no matter what, you must address the patient's emotional needs to be in control and have self-worth and dignity. In my opinion, this is best done through an honest therapeutic relationship. I believe that in complicated situations, the therapist MUST organize available information in a manner that allows them to address the most salient issues. We only have limited time with patients, so we MUST make best use of that time by addressing those issues which most impair patient's occupations. Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Diane Randall spark...@rcn.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient DR Hello, I have been given (along with 11 other patients I have) a new CVA DR patient. I have never worked with someone tis impaired and i don't know DR where to start. I am in a SNF and pt had been in an acute rehab for about a DR month prior for therapy. He is Dependent for all ADL's and DR transfers...sometimes hard to get his attention at all. Total left neglect. DR Trouble following simple commands. 1 finger sublux. Just not sure where to DR even begin. Goals are to increase attention to the left to perform ADL's DR but is this relistic at this point and what activites can I do with him that DR will encourge attention to left or attention to anything at all. Thanks DR Diane DR -- DR Options? DR www.otnow.com/mailman/options/otlist_otnow.com DR Archive? DR www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
Diane, you could try engaging him in very basic ADL's, such as combing hair, washing face, brushing teeth. This will focus on following one step commands, engaging in ADL's, which would hopefully improve is self-worth, maybe some neglect issues (where you would cue him to comb the left side of his head,etc. ~ Miranda ~ 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 _ Express your personality in color! Preview and select themes for Hotmail®. http://www.windowslive-hotmail.com/LearnMore/personalize.aspx?ocid=PID23391::T:WLMTAGL:ON:WL:en-US:WM_HYGN_express:082009 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
In contrast to Ron, I think there are some things to be done to address the neglect...and it is important to work on this, so that function can become a reality. Positioning in the wheelchair (where the patient will spend most of his day) is very important. Use of some type of arm board, or support, so that the left arm has some weight bearing through the shoulder (also helps with the shoulder problems), provides some stimulation to this side of the body, and keeping the arm as much as possible in the visual field of the patient help the patient regain awareness of it. Consistently encourage the patient to be responsible for where his left arm/leg are, and to take care of those parts of his body. Positioning of the bed and in the bed is also important. If everything is kept to the right side in his room, and he is never positioned where he has to look to the left, then the room is just a place to be rather than the room itself being therapeutic. If he likes to watch tv, and it is able to be moved...place it in his field of vision and then day by day move it farther to the left. Encourage and educate the family to provide stimulation from the left also... I do agree that sitting balance and trunk control are the beginning of a lot of functionso I would do a lot of work on basic bed mobility, rolling, bridging, transfers, trunk control, balance, weight shift, etc...all with functional components...while sitting you can practice grooming, dressing, etc. that all challenge balance. You can also do some higher level reaching tasks (without cones !)...by having him maybe writing on a write-on wipe off board with his good hand while balancing on the mat...and this can be encouraging the awareness of the left also...weight bearing through the left arm/hand while sitting will help with balance and increase awareness...basic NDT techniques are a lot of what I would be doing...especially to facilitate the trunk control, weight shift, balance, etc that will allow for better function... Hope that helps.. Linda Linda Stovall, OTR/L lstov...@mhg.com Program Manager Memorial Hospital at Gulfport Comprehensive Medical Rehabilitation Program 228-867-4179 228-867-5357 (fax) 228-883-8443 (beeper) A CARF (Three-Year) Accreditation was awarded to MHG for the following programs: Inpatient Rehab - Adults, Adolescents, and Children Inpatient Rehab- Stroke Specialty Miranda Hayek mltaylo...@hotmail.com 8/6/2009 6:05 AM Diane, you could try engaging him in very basic ADL's, such as combing hair, washing face, brushing teeth. This will focus on following one step commands, engaging in ADL's, which would hopefully improve is self-worth, maybe some neglect issues (where you would cue him to comb the left side of his head,etc. ~ Miranda ~ 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 _ Express your personality in color! Preview and select themes for Hotmail®. http://www.windowslive-hotmail.com/LearnMore/pe rsonalize.aspx?ocid=PID23391::T:WLMTAGL:ON:WL:en-US:WM_HYGN_express:082009 -- 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
Re: [OTlist] Massive new CVA patient
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
Re: [OTlist] Massive new CVA patient
there is nothing YOU can do to SIGNIFICANTLY increase his awareness. Agree with everything except this statement, because of what research has taught us. Check out strokengine.com for specific evidence based reviews on neglect training. Chris Nahrwold MS, OTR -Original Message- From: Ron Carson rdcar...@otnow.com To: Diane Randall OTlist@OTnow.com Sent: Thu, Aug 6, 2009 6:59 am Subject: Re: [OTlist] Massive new CVA patient Great patient to work with. At this point, there is nothing YOU can do to SIGNIFICANTLY increase his awareness. I would educate him, if appropriate, and family, if available, about visual and verbal cueing, but I would NOT waste a lot of time doing this. Over time, the neglect may subside but I believe this is one of those areas that takes a great deal of time and sort of spontaneous recovery. Are you a COTA or OT (this is why I ask people to include their credentials in messages). If you are the OT, I would change the goal to: Patient will perform basic ADL's Don't limit the patient and your treatment to the neglect. Surely there are other things inhibiting the patient's independence. Make a list of the patient's problems: physical, mental, emotional, environmental. Prioritize which of these problems are most significant AND that you have the ability to significantly improve. There is no use working on something that will not likely show significant change. My suspicion, is that you should be working on sitting balance. If the patient can sit, then work on standing balance, if the patient can stand, work on mobility. And no matter what, you must address the patient's emotional needs to be in control and have self-worth and dignity. In my opinion, this is best done through an honest therapeutic relationship. I believe that in complicated situations, the therapist MUST organize available information in a manner that allows them to address the most salient issues. We only have limited time with patients, so we MUST make best use of that time by addressing those issues which most impair patient's occupations. Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Diane Randall spark...@rcn.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient DR Hello, I have been given (along with 11 other patients I have) a new CVA DR patient. I have never worked with someone tis impaired and i don't know DR where to start. I am in a SNF and pt had been in an acute rehab for about a DR month prior for therapy. He is Dependent for all ADL's and DR transfers...sometimes hard to get his attention at all. Total left neglect. DR Trouble following simple commands. 1 finger sublux. Just not sure where to DR even begin. Goals are to increase attention to the left to perform ADL's DR but is this relistic at this point and what activites can I do with him that DR will encourge attention to left or attention to anything at all. Thanks DR Diane DR -- DR Options? DR www.otnow.com/mailman/options/otlist_otnow.com DR Archive? DR www.mail-archive.com/otlist@otnow.com -- 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
Re: [OTlist] Massive new CVA patient
Great input everyone. I must concur that there are lots of things that you can do. The ebrsr is a terrific resource for evidence based intervention for stroke. I really don't have much to add other than using a watch with an alarm and or hourly chime to be placed on the left UE. This will encourage him to attend to the left arm even if it is to locate an annoying watch alarm that he keeps on hearing. He also has to engage in a bit of bilateral movement to turn the alarm off (if he will initiate this). This movement would be more automatic as far as his initiation to attempt to move the left arm to meet the right arm to silence the watch alarm. Hope this helps too. Michael A. Holmes MSOTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
I agree with what the other posts have suggested. It is difficult when there is very little response from the patient. I would start with making sure his environment is therapeutic to him. Inculding wheelchair positioning, bed positioning, room changes, education to patient, family, and staff to encourage patients attention to the left. Activities that encourage crossing midline with the right side of his body, even if this is done passively. Sitting balance, weightbearing through the shoulder, tactile stimulation to the left side of his body, visual tracking exercises. During dressing he may be dependent, but verbal education throughout making him a part of the activity is important. Instead of having staff doing stuff TO him, they will be doing these activities FOR him. Make sure there is good lines of communication between all staff and family. Hope everyones suggestions gives you somewhere to start, let us know if you have any other specific questions as time goes on. :) Amber Date: Thu, 6 Aug 2009 07:44:45 -0500 From: lstov...@mhg.com To: otlist@OTnow.com Subject: Re: [OTlist] Massive new CVA patient In contrast to Ron, I think there are some things to be done to address the neglect...and it is important to work on this, so that function can become a reality. Positioning in the wheelchair (where the patient will spend most of his day) is very important. Use of some type of arm board, or support, so that the left arm has some weight bearing through the shoulder (also helps with the shoulder problems), provides some stimulation to this side of the body, and keeping the arm as much as possible in the visual field of the patient help the patient regain awareness of it. Consistently encourage the patient to be responsible for where his left arm/leg are, and to take care of those parts of his body. Positioning of the bed and in the bed is also important. If everything is kept to the right side in his room, and he is never positioned where he has to look to the left, then the room is just a place to be rather than the room itself being therapeutic. If he likes to watch tv, and it is able to be moved...place it in his field of vision and then day by day move it farther to the left. Encourage and educate the family to provide stimulation from the left also... I do agree that sitting balance and trunk control are the beginning of a lot of functionso I would do a lot of work on basic bed mobility, rolling, bridging, transfers, trunk control, balance, weight shift, etc...all with functional components...while sitting you can practice grooming, dressing, etc. that all challenge balance. You can also do some higher level reaching tasks (without cones !)...by having him maybe writing on a write-on wipe off board with his good hand while balancing on the mat...and this can be encouraging the awareness of the left also...weight bearing through the left arm/hand while sitting will help with balance and increase awareness...basic NDT techniques are a lot of what I would be doing...especially to facilitate the trunk control, weight shift, balance, etc that will allow for better function... Hope that helps.. Linda Linda Stovall, OTR/L lstov...@mhg.com Program Manager Memorial Hospital at Gulfport Comprehensive Medical Rehabilitation Program 228-867-4179 228-867-5357 (fax) 228-883-8443 (beeper) A CARF (Three-Year) Accreditation was awarded to MHG for the following programs: Inpatient Rehab - Adults, Adolescents, and Children Inpatient Rehab- Stroke Specialty Miranda Hayek mltaylo...@hotmail.com 8/6/2009 6:05 AM Diane, you could try engaging him in very basic ADL's, such as combing hair, washing face, brushing teeth. This will focus on following one step commands, engaging in ADL's, which would hopefully improve is self-worth, maybe some neglect issues (where you would cue him to comb the left side of his head,etc. ~ Miranda ~ 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
Re: [OTlist] Massive new CVA patient
From Cochrane.org: http://www.cochrane.org/reviews/en/ab003586.html The benefit of cognitive rehabilitation for unilateral spatial neglect, a condition that can affect stroke survivors, is unclear. Unilateral spatial neglect is a condition which reduces a person's ability to look, listen or make movements in one half of their environment. This can affect their ability to carry out many everyday tasks such as eating, reading and getting dressed, and restricts a person's independence. Our review of 12 studies involving306participants found that rehabilitation specifically targeted at neglect appeared to improve a person's ability to complete tests such as finding visual targets and marking the mid-point of a line. However, its effect on their ability to carry out a meaningful everyday task or to live independently was not clear. Patients with neglect should continue to receive general stroke rehabilitation services but better quality research is needed to identify optimal treatments. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Linda Stovall lstov...@mhg.com Sent: Thursday, August 06, 2009 To: otlist@OTnow.com otlist@OTnow.com Subj: [OTlist] Massive new CVA patient LS In contrast to Ron, I think there are some things to be done to address LS the neglect...and it is important to work on this, so that function can LS become a reality. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
Just a short reference list 1 http://www.springerlink.com/content/t1lp7wh87wm71t70/ Motor and functional recovery of stroke patients with neglect seems to be significantly improved by the simultaneous presence of a treatment specifically focused on neglect. 2.http://cat.inist.fr/?aModele=afficheNcpsidt=2126247 3. http://brain.oxfordjournals.org/cgi/content/abstract/125/3/608 4. http://linkinghub.elsevier.com/retrieve/pii/S0003999397902367 The Bon Saint Come method seems to significantly improve recent and chronic UNS, as well as ADL function. These encouraging results could have resulted from a synergistic effect of spatial reconditioning and voluntary trunk rotation. It must be assessed by a new study with more patients. 5.http://linkinghub.elsevier.com/retrieve/pii/S0003999305003308 Thanks, Chris -Original Message- From: Ron Carson rdcar...@otnow.com To: Linda Stovall OTlist@OTnow.com Sent: Thu, Aug 6, 2009 4:27 pm Subject: Re: [OTlist] Massive new CVA patient From Cochrane.org: http://www.cochrane.org/reviews/en/ab003586.html The benefit of cognitive rehabilitation for unilateral spatial neglect, a condition that can affect stroke survivors, is unclear. Unilateral spatial neglect is a condition which reduces a person's ability to look, listen or make movements in one half of their environment. This can affect their ability to carry out many everyday tasks such as eating, reading and getting dressed, and restricts a person's independence. Our review of 12 studies involving306participants found that rehabilitation specifically targeted at neglect appeared to improve a person's ability to complete tests such as finding visual targets and marking the mid-point of a line. However, its effect on their ability to carry out a meaningful everyday task or to live independently was not clear. Patients with neglect should continue to receive general stroke rehabilitation services but better quality research is needed to identify optimal treatments. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Linda Stovall lstov...@mhg.com Sent: Thursday, August 06, 2009 To: otlist@OTnow.com otlist@OTnow.com Subj: [OTlist] Massive new CVA patient LS In contrast to Ron, I think there are some things to be done to address LS the neglect...and it is important to work on this, so that function can LS become a reality. -- 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
Re: [OTlist] Massive new CVA patient
Interesting website. Thanks for the link... Ron - Original Message - From: Sue Doyle sue...@hotmail.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient SD Diane, SD I am going to comment here rather than Lurking. SD There are some great resources to help you with evidence-based interventions SD Treatment of Neglect etc. SD Go to www.ebrsr.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
Ron, While that is the current Cochrane one it is over 3 years old. The one from EBRSR is this last year. As a Cochrane author I prefer the Cochrane methodology to some of the others and think it produces a more accurate and thorough outcome but in this case I think the EBSR is a little more current. Sue D Date: Thu, 6 Aug 2009 17:27:58 -0400 From: rdcar...@otnow.com To: OTlist@OTnow.com Subject: Re: [OTlist] Massive new CVA patient From Cochrane.org: http://www.cochrane.org/reviews/en/ab003586.html The benefit of cognitive rehabilitation for unilateral spatial neglect, a condition that can affect stroke survivors, is unclear. Unilateral spatial neglect is a condition which reduces a person's ability to look, listen or make movements in one half of their environment. This can affect their ability to carry out many everyday tasks such as eating, reading and getting dressed, and restricts a person's independence. Our review of 12 studies involving306participants found that rehabilitation specifically targeted at neglect appeared to improve a person's ability to complete tests such as finding visual targets and marking the mid-point of a line. However, its effect on their ability to carry out a meaningful everyday task or to live independently was not clear. Patients with neglect should continue to receive general stroke rehabilitation services but better quality research is needed to identify optimal treatments. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Linda Stovall lstov...@mhg.com Sent: Thursday, August 06, 2009 To: otlist@OTnow.com otlist@OTnow.com Subj: [OTlist] Massive new CVA patient LS In contrast to Ron, I think there are some things to be done to address LS the neglect...and it is important to work on this, so that function can LS become a reality. -- 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
