...31 October 2014 Modified and Traditional Constraint-Induced Movement Therapy In 50-70 year-old individuals who has suffered a stroke (either hemorrhagic or ischemic) at least 1 month from onset of accident, how does modified or traditional constraint-induced movement therapy (CIMT) compared to a more traditional therapy approach in allowing patients to return to performing functional activities of daily living? According to Go et al1, an American dies from a stroke every 4 minutes. In the United States, stroke is the 4th leading cause of death and major cause of a serious and long-term disability.1 A stroke occurs when the blood supply is disrupted to the brain or a blood vessel ruptures in the brain, which can defined as an ischemic stroke...
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...The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) Carotid endarterectomy has been considered as the typical treatment for stroke prevention. Stenting on the other hand is a new and less aggressive procedure. The procedure involves inserting an expandable metal stent (tube) into the carotid artery, keeping it wide with balloon dilation. The safety and effectiveness of the two procedures was basically the same according to the study. The study also showed that both men and women benefitted equally as well as those persons who had stroke before as well as those who did not. Extremity Constraint-Induced Therapy Evaluation (EXCITE) One of the major consequences of stroke is impaired movement in the arms and legs Constant induced movement therapy (CIMT) has revealed capabilities for movement rehabilitation after a stroke. Constant induced movement therapy involves restricting the stronger arm and putting the weaker arm through a series of repetitive exercises. Warfarin verse Aspirin for Intracranial Arterial Stenosis (WASID) This trial aimed at comparing the efficiency of warfarin to aspirin in subsequent stroke prevention. The trial was terminated when warfarin showed adverse side effects....
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...arm and hand functions that interfere with accomplishing goal oriented activities and vocational needs (Richards, Stewart, Woodbury, Senesac, & Cauraugh, 2008a). Knowing the best methods to promote motor recovery in arm and hand functioning is therefore critical in stroke rehabilitation. Lori Gage Richards, (PhD, OTR/L) is an active researcher and educator seeking to uncover which therapies drive neural reorganization after a stroke, and what are the most effective strategies leading to improvements is UE function. Richards is currently Associate Professor and Chair of the Occupational Therapy Department at the University of Utah. She was recently appointed editor-in-chief of the American Journal of Occupational Therapy and serves as Chair of the Nursing and Rehabilitation Committee-Stroke Council, of the American Heart Association. Additionally at the American Heart Association, she is a member of both the Leadership Council - Stroke Council and the Stroke Rehabilitation and Recovery Committee - Stroke Council. Her current professional affiliations include the American Occupational Therapy Association (AOTA), Society for Neuroscience, and the American Congress of Rehabilitation Medicine. Motor rehabilitation is premised on the belief that behavior (e.g., practice and motor-based intervention) forces neuroplastic changes in the central nervous system (CNS) which lead to better motor function. According to Richards, Hanson, Wellborn, & Sethi (2008b) the current evidence...
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...Farber (1989) discusses how it is important to educate students in a variety of ways regarding neurobiology to enhance skills and application to occupational therapy. She discusses how the traditional learning style in memorization of concepts does not carry over into clinical practice (Farber, 1989). She also states that current practicing occupational therapists continue to explore the literature as it is constantly changing (Farber, 1989). Although this article was written almost 30 years ago, I find the statements regarding education and remaining current still applicable today. On the idea of the ever-changing neuroscience literature, I cannot help but think about the information that is presented in the article and the...
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...Your brain sends signals to your muscles, through your nerves, to make them move. A stroke can damage your brain and affect these signals. A stroke can also affect your eyes, ears, muscles and joints. Stroke will affect all of these things as well as the way they work together. After a stroke muscles will become weaker which then cause problems with your movements. This may also include whole side of your body to become weak, Furthermore; Muscle weakness affects how well you can move your body. Sometimes it can be severe and stop you from being able to move parts of your body at all. This is called paralysis. There are many other things that may affect your movement this includes, drop foot: this is when your toes catch on the ground when you step forward because the muscles that lift your toes are weak, problems with stamina: you may find it difficult to keep moving for a long time. So if you’ve been active for a while and start to feel tired, you may find that you become more clumsy and find it more difficult to control your movements. Lastly, these problems will be affecting a person by, making you feel dizzy or...
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...in Brunnstrom stage one. After flaccidity, spasticity began to set in. Occupational therapy worked with her on stretches, range of motion exercises, constraint induced therapy and orthosis at night to maintain the range of motion and flexibility available. According to, (Saebo, 2017), “One way to relax muscles affected by spasticity is taking oral medications that block the neurotransmitters causing the muscles to tighten. These medications are commonly known as muscle relaxers. Baclofen is often prescribed as it acts on the central nervous system, reducing spasms and allowing for greater range of motion.” Emma is very independent and wants to be living in her two story home as soon as possible. She is a widow and lives on her own. She has a son and a daughter, but they both live out of state. Emma is persistent about returning home. Her goal is working on ADL’s and IADL’s she did prior to her CVA. In order to go home she needs to be safe and regain independence in her ADL’s. Emma has been educated on the safety of living alone in a two story house. Emma and the therapist are working on modifying her home environment to prevent falls or accidents. Our plan when she returns home is to remove throw rugs and clear pathways to every room in her house. Emma has trouble with balance and coordination. Her two story house is not accessible for someone who just had a stroke. Important factors therapy focused on to decrease fall risks were installing grab bars, using nonslip footwear,...
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...Narrative Report - Left sided hemiparesis due to an ischemic stroke by Clifford Choi on Saturday, December 3, 2011 at 12:47am · I thank my mentors in neurology, integrative medicine, and my patient for his determination to overcome this. He is an atheist but believed in me and himself. The patient reports full recovery. Here is his letter 4 months later. He has given permission to publish the report. He is back to work, travelling, driving, and has no known deficits. 80% of ischemic strokes survive the stroke, but it is uncertain how many fully recover 100% function. _________________________________________________ Dear Dr. Clifford Choi, I tried to call the number you once gave me, but they told at the hospital SEIMC that you were not working there anymore. Anyway I just wanted to touch base and say hello to you and thank you and the colleagues you had at the hospital. The recovery has been very amazing. I was last week at this intensive rehabilitation (or so it was called) session at the _________ University hospital. I was supposed to be there the whole week, but they said that I’m actually in too good shape to gain anything from this anymore, so I left Wednesday morning. I’m allowed to drive now, and officially I will be back to work on August 26th. I can call you, if you want. But then I would need your phone number. The world is a small place, so maybe we some day run into each other. You never know. Best regards, patient x The report below was submitted...
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...environment to engage patients for longer periods of time. Students at the School of Art and Design, University of Illinois at Chicago collaborated with engineers to develop an art-empowered system to increase motivation, and increase the patient’s repetitive practice. Their goal was to grab the patient’s attention and hold it longer than in standard protocols. They did this by creating and immersive and interesting environments. The system was made up of two 30-inch LCD screens positioned at optimal viewing angle, and a tracking system. The tracking system consisted of magnetic trackers to capture head and arm movement, and the PneuGlove. The magnetic trackers were in a head mounted device and the head mounted device was later taken out due to reports of patient discomfort. The PneuGlove was developed at RIC previously. It is a pneumatically actuated glove that tracks finger movement. This feature allows the patient to feel a sensation of grabbing a solid object as well as aided in extension of the...
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...October 27, 2013 Uswatte at el. (Use all the authors names the first time and always include the date) set out to improve, and find the accuracy, of the Pediatric Motor Activity Log-Revised (PMAL-R) when compared to other measurements, such as the Motor Activity Log (MAL), used on adults. The MAL has patients rate their ability to perform 30 activities, designed for use of the upper extremities, with the arm that is more affected. The MAL tends to be more accurate because the patient is reporting the usage versus the caregiver that gives the report in the PMAL-R. “. . .four developments have contributed to the generation of methods for assessing activity of an impaired upper extremity in daily life” (p 149). Constraint-Induced Movement Therapy (CIMT) supports the movement of upper limbs to help improve arm use. CIMT has been proven to be more beneficial than compensatory tactics, and patients using CIMT have shown greater brain plasticity (include name and date, p. 149). The researchers here wanted to interview the participants in person rather than via a paper survey. This is the way the test was meant to be performed, and they felt as though it would prove to be more accurate. The main goal of this article was to study the convergent validity, the test-retest reliability, and various characteristics of the PMAL-R in children with upper extremity hemiparesis due to CP. Good. Uswatte et al. had 60 participants in age range from 2-8 years with upper extremity paresis due to...
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...associated with CP. They found that children had at least on of the following symptoms: birth weight was less than 2,000 grams and prolonged crying for more than one day (Nelson & Ellenberg, 1979). Further they found that diminished activity, apgar score of 3 or less, thermal instability, gavage feeding or hypo/hypertonia were (Nelson & Ellenberg, 1979). A popular surgical treatment was selective posterior rhizotomy (SPR) which is where a lumbar laminectomy is done with the stimulation of rootlets in the spine from L2 to S2 (Peacock, Arens, and Berman 1987). Another study identified 25 children with spastic CP before and after the surgical treatment to assess the effects of SPR. The results showed a reduction in muscle tone, range of movement and motor function (Peacock & Staudt, 1991). It also showed improvements in gross motor skills (Peacock & Staudt,...
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...PETA Kassie White-Simmons U.S. Government – POL 110 Instructor, Dr. McCue December 3, 2012 Strayer University PETA Define an interest group, with examples. The interest group that I will discuss in this paper is the one of the most well-known animal rights groups in the world; People for the ethical treatment of animals, commonly known as, PETA. Founded in March 1980 by Newkirk and fellow animal rights activist Alex Pacheco, the organization first caught the public's attention in the summer of 1981 during what became known as the Silver Spring monkeys case, a widely publicized dispute about experiments conducted on 17 macaque monkeys inside the Institute of Behavioral Research in Silver Spring, Maryland. The group first came to public attention in 1981 during the Silver Spring monkey’s case, a dispute about experiments conducted by researcher Edward Taub on 17 macaque monkeys inside the Institute of Behavioral Research in Silver Spring, Maryland. (Eldercare Home Health, 2012) The case led to the first police raid in the United States on an animal laboratory, triggered an amendment in 1985 to the United States Animal Welfare Act, and became the first animal-testing case to be appealed to the United States Supreme Court, which upheld a Louisiana State Court ruling that denied PETA's request for custody of the monkeys. Pacheco had taken a job in May 1981 inside a primate research laboratory at the Institute, intending to gain firsthand experience of working inside an...
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...Running head: CANCER PAIN MANAGEMENT 1 Cancer Pain Management Lavon R. Williams University of South Alabama Running head: CANCER PAIN MANAGEMENT Cancer Pain Management Cancer is rapidly becoming a chronic illness, and an estimated that 10 million individuals in the United States are survivors of cancer (Sun, Borneman, Piper, Koczywas, & Ferrell, 2008). According to 2008, cancer statistics from the American Cancer Society, about 2 565,650 people die in the United States from cancer every year. Approximately 1.6 million new cases of cancer are expected to be diagnosed in the United States this year (American Cancer Society, 2012). This is why the health care needs of cancer patients are unique, and many are at risk for developing late or long-term side effects and pain from their primary treatments. These long-term effects may also hinder optimal physical, psychological, and cognitive functioning for patients (Sun et al., 2008). Pain is experienced by 30% to 50% of cancer patients receiving treatment and by 70% to 90% of patients with metastatic or advanced disease. In almost every cancer-related case pain is inadequately managed due to a lack of patient and professional knowledge of optimum management (Sun et al., 2008). This paper will discuss how nurses can help provide adequate pain management in advanced cancer patients. Patient and family needs Support for the patient and family may include education and information, coping skills, counseling and psychotherapy...
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...States Induced by Music and Autobiographical Memories Jonna K. Vuoskoski and Tuomas Eerola University of Jyvaskyla ¨ ¨ The present study addressed music’s disputed ability to induce genuine sadness in listeners by investigating whether listening to sad music can induce sadness-related effects on memory and judgment. Related aims were to explore how the different mechanisms of music-induced emotions are involved in sadness induced by familiar, self-selected music and unfamiliar, experimenter-selected music, and whether the susceptibility to music-induced sadness is associated with trait empathy. One hundred twenty participants were randomly assigned into four conditions with different tasks: listening to unfamiliar sad or neutral music, or to self-selected sad music, or recalling a sad autobiographical event and writing about it. The induced affective states were measured indirectly using a word recall task and a judgment task where participants rated the emotions expressed by pictures depicting facial expressions. The results indicate that listening to sad music can indeed induce changes in emotion-related memory and judgment. However, this effect depends, to some extent, on the music’s relevance to the listener, as well as on the personality attributes of the listener. Trait empathy contributed to the susceptibility to sadness induced by unfamiliar music, while autobiographical memories contributed to sadness induced by self-selected music. Keywords: music-induced emotion...
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...Blood Pressure Chapter 9 - The Pulmonary Artery Catheter Chapter 10 - Central Venous Pressure and Wedge Pressure Chapter 11 - Tissue Oxygenation Section V - Disorders of Circulatory Flow Disorders of Circulatory Flow Chapter 12 - Hemorrhage and Hypovolemia Chapter 13 - Colloid and Crystalloid Resuscitation Chapter 14 - Acute Heart Failure Syndromes Chapter 15 - Cardiac Arrest Chapter 16 - Hemodynamic Drug Infusions Section VI - Critical Care Cardiology Critical Care Cardiology Chapter 17 - Early Management of Acute Coronary Syndromes Chapter 18 - Tachyarrhythmias Section VII - Acute Respiratory Failure Acute Respiratory Failure Chapter 19 - Hypoxemia and Hypercapnia Chapter 20 - Oximetry and Capnography Chapter 21 - Oxygen Inhalation Therapy Chapter 22 - Acute Respiratory Distress Syndrome Chapter 23 - Severe Airflow Obstruction Section VIII - Mechanical Ventilation Mechanical Ventilation Chapter 24 - Principles of Mechanical Ventilation Chapter 25 - Modes of Assisted Ventilation Chapter 26 - The Ventilator-Dependent Patient Chapter 27 -...
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...Videogames: A Consideration of Their History and Their Roles Videogames: A Consideration of Their History and Their Roles 3.A: Narrative Videogames have been and continue to be a great part of my life. Ever since the tender age of three I have been fascinated by the interactivity and the captivating graphics displayed by videogames. Furthermore, I have developed and retained an appreciation for the capacity that many well developed videogames have to blend competitiveness, the need for intellectual dexterity, and pure entertainment. I have long understood the task of producing a game with such comprehensive quality as both an art and a science. In any case, my videogame passion has slowly but surely charmed me into learning much about the philosophy of videogames, their design and development, and especially the history of videogames. Despite my life-long passion with videogames, I began a true self-propelled academic investigation into the world of videogames only a few years ago. I remember quite vividly that this intellectual journey into the world of videogames was prompted by a friend of mine who was intrigued by the fact that I was often engulfed in the world of videogames. During those days I was much younger and consequentially much more immature than now. Not only did I enjoy videogames, I spent a great deal of the few funds which I had on purchasing new games, much of my free time playing games, and a lot of time also discussing videogames in general...
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