Stroke is a leading cause of disablement in the Unites states. Each year 200,000 Americans fall victim to stroke. Even with medical treatments that are provided to decrease spasticity and inflammation, patients still fail to fully recover post stroke. However, with rehabilitation provided by Physical therapists and their assistants we’re able to decrease the functional deficits that accompany a CVA. My patient is a 41 year old male who had been brought to our acute care hospital due to a diagnosis of a right CVA and right hemiparesis. The patient is 10 days post stroke, and was completely functional before incident. He now presents with a flexor synergy in his right UE with no voluntary motion of the hand and neglect to right side limb. In
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Activation of the hemiplegic muscles in stroke patients is difficult due to a decrease in the number of motor units, recruitment, and the balance between the agonist and antagonist muscles. Studies have shown an increase in the force of the upper and lower hemiparietic extremities, and improved posture stability through the use of vibration. Low frequency vibration (5-50Hz) also has an inhibitory effect on muscle tone through the activation of spindle secondary endings and the Golgi tendon organs. By relaxing spindle activity through prolonged vibration and activating the Golgi tendon the muscle is able to relax allowing it to be elongated and easier to move. In order to demonstrate the positive effects of vibration a randomized study brought together 16 patients; 8 who would receive 20Hz of vibration while standing on a platform for 1 minute six times in one session, and 8 patients who did not receive vibration while standing on the platform. Patients with disability tend to have trouble performing high intensity training, which is why examiners should provide other methods of strength and balance exercises in order to improve muscle force and control. The final results gathered on the third week of treatment suggested that one session of whole body vibration can highly increase voluntary movement and muscle activation of the lower extremity muscles post …show more content…
My patient has poor dynamic balance during standing activities and only fair balance with dynamic sitting. In order to directly focus on sitting dynamic balance I decided to have my patient perform lateral pelvic tilts, reaching within and out of arms reach, and shuffling forward and backward on a hard surface. Once my patient scores “good” on the balance scale during dynamic seating, I will progress him to dynamic standing balance activities which in the long run will influence his gait. One of the PT’s goals is to have the patient become independent with rolling on the right side and supine to sit in order to increase his bed mobility; due to this, I will also include rolling activities on the affected and unaffected side using the shoulder girdle or pelvis. Looking at the studies outcome and my patients impairments, I believe these exercises will strongly benefit my patient, and progress him further to his and the PT’s
Activation of the hemiplegic muscles in stroke patients is difficult due to a decrease in the number of motor units, recruitment, and the balance between the agonist and antagonist muscles. Studies have shown an increase in the force of the upper and lower hemiparietic extremities, and improved posture stability through the use of vibration. Low frequency vibration (5-50Hz) also has an inhibitory effect on muscle tone through the activation of spindle secondary endings and the Golgi tendon organs. By relaxing spindle activity through prolonged vibration and activating the Golgi tendon the muscle is able to relax allowing it to be elongated and easier to move. In order to demonstrate the positive effects of vibration a randomized study brought together 16 patients; 8 who would receive 20Hz of vibration while standing on a platform for 1 minute six times in one session, and 8 patients who did not receive vibration while standing on the platform. Patients with disability tend to have trouble performing high intensity training, which is why examiners should provide other methods of strength and balance exercises in order to improve muscle force and control. The final results gathered on the third week of treatment suggested that one session of whole body vibration can highly increase voluntary movement and muscle activation of the lower extremity muscles post …show more content…
My patient has poor dynamic balance during standing activities and only fair balance with dynamic sitting. In order to directly focus on sitting dynamic balance I decided to have my patient perform lateral pelvic tilts, reaching within and out of arms reach, and shuffling forward and backward on a hard surface. Once my patient scores “good” on the balance scale during dynamic seating, I will progress him to dynamic standing balance activities which in the long run will influence his gait. One of the PT’s goals is to have the patient become independent with rolling on the right side and supine to sit in order to increase his bed mobility; due to this, I will also include rolling activities on the affected and unaffected side using the shoulder girdle or pelvis. Looking at the studies outcome and my patients impairments, I believe these exercises will strongly benefit my patient, and progress him further to his and the PT’s