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Management of Neuromotor and Musculoskeletal Impairments of the Upper Extremity After a Stroke

Salvador Bondoc, OTD, OTR/L, BCPR, CHT
September 28th, 2010
21 Waterville Road, Avon, CT 06001
860.331.1792

Course Overview:

Among stroke survivors, 55-75% will continue to have impairments in the upper extremity despite intensive rehabilitation (Wolfe, Winstein, Miller, Taub, Uswatte, Morris, et al, 2006). Recent developments in neurorehabilitation has lead to renewed optimism for stroke survivors with chronic upper extremity impairments. What has become known as constraint-induced therapy (CIT) or constraint induced movement therapy (CIMT) has altered the landscape of neurorehabilitation.

This program will provide an overview of the nature and process of implementing a CIMT protocol, examples of how it can be modified to suit standard clinical practices. In addition, this program will present intervention strategies that could address musculoskeletal impairments so that forced use intervention becomes more feasible for clients who would otherwise not qualify in a standard CIMT protocol.

The course is designed to qualify for 7.25 clock hours and 435 instructional minutes.

Course Objectives:

At the end of the presentation, the participants shall be able to:

1. Define and explain the theoretical and scientific underpinnings of the forced use paradigm
2. Describe the components of the “classic” constraint-induced therapy (CIT) program
3. List various ways in which CIT has been adapted and modified to cater to a broader spectrum of neuromotor abilities of clients with stroke.
4. State the evidence to support classic CIT and its modifications
5. Describe various musculoskeletal impairments (e.g., subluxation, disuse contractures) associated with stroke that may pose challenges to participation in a CIT program
6. Describe a variety of preparatory intervention approaches to address and circumvent the effects of musculoskeletal (secondary) impairments on upper extremity function
7. Conceptualize ways to adapt a forced use therapy program in one’s own practice
   

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Course Outline & Schedule

• 8:00 – 8:15........................ Registration and Breakfast
• 8:15 – 10:00...................... Components of Constraint Induced Therapy
  This segment will introduce to the audience the Forced Use Paradigm and the state of currentevidence for Stroke. The first components of CIMT will be covered including Constraint vs. Restraint, Shaping and Behavioral Strategies.
• 10:00 – 10:15.................... Break
• 10:15 – 12:00..................... Components of Contraint Induced Therapy
  This segment continues to provide the audience with the other components of CIMT Including Task Practice,Transfer Package, and Behavioral Contracts. This section will be concluded with caseillustrations and questions and answers.
• 12:00 – 1:00....................... Lunch
• 1:00 – 2:45......................... Biomechanical Solutions For The Neurologically Impaired Hand
  This segment will provide a biomechanical explanation of the problem associated with a neurologically impaired hand due to stroke. Splinting and positioning options will be discussed.
• 2:45 – 3:00......................... Break
• 3:00 – 4:45......................... Shoulder Subluxation – Pathomechanics And Evidence-Based Management
  This segment will provide a biomechanical overview of the shoulder complex as it relates to subluxation. Evidence-based treatment options including electrical stimulation, taping and forced use therapies will be covered.
• 4:45 – 5:00......................... Wrap up and Conclusion

Registration Form (print out and mail in)

Management of Neuromotor and Musculosketal Impairments of the Upper Extremity after a Stroke

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The cost of the seminar is $125, including continental breakfast and lunch.

Please make checks payable to AllStar Therapy, LLC and send payment with this form to:
21 Waterville Rd., Avon, CT 06001

For questions call or email
Christine Ross • 860.331.1792
christine@astherapy.com

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