VIDEO ANALYSIS PRESENTATION

OCCT 502: ANALYSIS OF MOVEMENT IN OCCUPATION

Stephanie Perry-Brideau

Anna Suchy

JP Kriel

http://www.icelearningcenter.com/university-video-library/upper-extremity-dressing

MEET “DILBERT”

STROKE STATS

Stroke is the third leading cause of death in the United States

Stroke is the leading cause of serious, long-term disability in the United States

Strokes can—and do—occur at ANY age. Nearly one quarter of strokes occur in people under the age of 65

On average, every 40 seconds someone in the United States has a stroke

US Stroke deaths: 35+ (1991-1998)

Stroke Statistics, 2011

“Last year I had a stroke. It left me in bad shape. I had to teach myself how to walk and talk again. It’s been a long, hard fight. My speech is not perfect but I’m getting there.“ – Dick Clark

People, 2006

CLIENT DESCRIPTION

Young stroke survivor

Difficulties with ADLs and upper extremity

techniques

Exhibits expressive aphasia, cognitive/perceptual

deficits and right hemiplegia.

Self-Care, 2008

OCCUPATIONS AFFECTED BY IMPAIRMENTS ADLs IADLs Rest & Sleep Education Work Play Leisure Social Participation

Occupational Therapy Practice, 2008

HOW IS THE WRIST JOINT AFFECTED BY THE CLIENT’S IMPAIRMENT?

Skeletal Considerations

Articular Considerations

Arthrokinematics

Muscular

Considerations

Innervating Nerves

Servicing Arteries

Lippert, L.S., 2006

BIOMECHANICS NEEDED FOR CLIENT’S MOVEMENTS

Static

o COG

o BOS

o Stability/Balance

o Posture

o Thoracic support

Dynamic

o Trunk flexion/extension

o Lifting impaired arm

o Torsional/Rotary

movement

o Using functional hand

Lippert, L.S., 2006

BIOMECHANICAL FRAME OF REFERENCE

Reduce impairment/teach new skills

Improve ROM and flexibility in impaired arm, also preventing contractures

Improve strength of both impaired arm and compensating arm

Improve endurance of impaired arm to perform task for long duration

Improve structural stability with COG and BOS

Improve coordination

REHABILITATION FRAME OF REFERENCE

Improving independence with adaptive equipment

Choosing methods by collaborating with client

Dysfunction due to stroke Teaching how to use

adaptive equipment Modifying client’s home

environment Adapting tasks and activities

INFLUENCE OF MOTOR CONTROL/MOTOR LEARNING

Impaired fine motor skills (ie: issues buttoning) Paralysis of right arm and hand Spasticity could lead to possible contracture;

splinting may be necessary Poor reflexes Lack of balance and coordination; trunk stability

devices may be necessary Spatial and perceptual impairment affecting

ability to judge distances (ie: placing impaired arm into sleeve, looking down to button shirt)

INFLUENCE OF ENVIRONMENTAL DEMANDS

Person:o Impaired sensory and

cognitive abilitieso Expressive aphasiao Right hemiplegia

Tasks:o ADL and IADL assistanceo Son/father/boyfriend roleso Ability to perform tasks will

lead to future role performance

Context:o Temporal: late 20s, dependent on

caregiver, tasks performed in hospital before returning home

o Environmental/Social: assistive devices, home modification, relationships at home, religious practice

Personal-Context-Task Transaction:o Use of assistive devices and

routine modification before becoming independent

o Independence will allow client to better perform tasks in any setting

CLIENT RECAP!

REFERENCESLippert, L.S. (2006). Clinical kinesiology and anatomy. Philadelphia: F.A. Davis Company.

Occupational therapy practice framework: domain and process 2nd edition. (2008). Bethesda,

MD: American Occupational Therapy Association, Inc.

Self-care: dressing in acute care part two. (2008). [Web]. Retrieved from http://www.icelearning.com

Silverman, S. M. (2006, January 2). Dick Clark Makes New Year's Return - Dick Clark : People.com. People.com : The #1 Celebrity Site for breaking news, celebrity pictures and star style. Retrieved October 4, 2011, from http://www.people.com/people/article/0.com

Stroke Statistics. (2011, September 02). Retrieved from

http://www.strokecenter.org/patients/stats.htm#Charts

Ways of living: intervention strategies to enable participation (4th ed.). (2011). Bethesda: American Occupational Therapy Association.