Handout Information, Definition, symptoms,treatment, and OT treatment – Flashcards

impairment of language, affecting the production or comprehension of speech and the ability to read or write. It's always due to injury of the brain such as stroke, head trauma, brain tumors, or infections. Varieties of aphasia include Global, Broca's, Mixed non-fluent, Wernicke's, and Anomic.

Difficulty producing language, Problems understanding language, Reading and Writing issues

− Restoring language abilities addressing impaired communication modalities − Strengthen intact modalities and behaviors to support and augment communication − Teach strategies to help compensate for language impairments − Train family and caregivers how to effectively communicate with the client in order to maximize their communication competence. − Educate the client and caregivers about the disorder

• Have client draw or paint as alternate forms of communication • Encourage the client to attend a community class to increase social participation and find other ways to communicate • Educate client or caregiver on the use of sign language

Poor coordination and unsteadiness due to the brain's failure to regulate the body's posture and regulate the strength and direction of limb movements. Can develop over time or suddenly

• POOR COORDINATION • UNSTEADY WALK AND TENDENCY TO STUBLE • DIFFICULTY WITH FINE MOTOR TASK • CHANGE IN SPEECH • NYSTAGMUS (INVOLUNTARY BACK-AND-FORTH MOVEMNTS)

• SPEECH AND LANGUAGE THERAPY (DYSARTHRIA & DYSPHAGIA) • PHYSIOTHERAPY: HELP MAINTAIN THE USE OF YOUR ARMS AND LEGS AND ADDRESS FATIGUE • MEDICATION & SUPPLEMENTS: MUSLCE & BLADDER RELAXANTS, TREATING NEUROPATHIC PAIN, DEPRESSION, ETC. • BOTOX: BLOCKS THE SIGNALS FROM YOUR BRAIN TO THE MUSCLES • BLADDER CONTROL TECHNIQUES: LIMIT FLUID INTAKE, PLANNED TOILETING, CATHETER & AVOID DRINKS THAT STIMULATE URINE PRODUCTION

• FOCUSING ON SKILLS SUCH AS STRENGTH AND ACTIVITY TOLERANCE OR ENDURANCE • ADDRESSING TASK PERFORMANCE • UTILIZING ADAPTIVE EQUIPMENT • MODIFYING THE ENVIRONMENT • SOCIAL SUPPORT

The lack of knowledge regarding objects in relation to each other as well as lack of planning, sequencing and timing of activity steps. Also called dressing apraxia

• Action discontinuity • Inability to plan or use everyday tools • Miss use of a simple object • Hard time matching objects and actions • Unaware of mechanical advantage of the tool • Deficits in executive functioning • Memory limitations

• The best treatment is Occupational therapy • Not an easy diagnosis to plan for. It works more in the mind aspect of the brain rather then the structural and chemical components. It affects multiple areas and can hinder performances in memory, learning, and executive functioning.

Meaningful gesture •Phase 1: Show patient a context picture, then show a gesture picture fitting the context and have patient imitate the gesture. •Phase 2: Only show context picture and have client try to recall what gesture would be used in this context. •Phase 3: Have client imitate gestures that correspond to context picture Direct Training •Have client preform ADLs with minimal errors (NOT trial and error). Support from the OT is to minimize error so they don't occur and correct behavior and problems when they arise, harder trial should be repeated and followed out to until completed every time. Explorative training •Teaching clients to recognize the function of on object by analyzing its form and structure. Also used with new tools the client might not be familiar with so they can formulate new thoughts and hopefully assimilate it to other tools functions.

Spasticity is a neuromuscular condition usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. The damage causes a change in the balance of signals between the nervous system and muscles and characterized by tight or stiff muscles and an inability to control those muscles.

• Increased muscle tone • Overactive reflexes • Involuntary movements, which may include spasms (brisk and/or sustained involuntary muscle contraction) and clonus (series of fast involuntary contractions) • Pain • Decreased functional abilities and delayed motor development • Difficulty with care and hygiene • Abnormal posture • Contractures (permanent contraction of the muscle and tendon due to severe persistent stiffness and spasms) • Bone and joint deformities

• Passive Range of Motion (PROM) • Stretching and Positioning • Splinting to preserve ROM • Constraint Induced Therapy: restrain affected limb to encourage activity in affected limb • Electrical Stimulation (ESTIM) • Medications such as, Intrathecal Baclofen Therapy (ITB) or chemodenervation • Aquatic Therapy, Occupational Therapy, Physical Therapy • Adaptive Equipment • Surgery for overactive nerves • Botox Injections

PROM on the affected side, and creating a splint to wear at night or during the therapy session to stretch the muscles to prevent contractors. Electrical stimulation can also be applied to muscles to help reduce the tone and relax the area. Types of braces can be used to spasticity, such as Saebo braces. They help brain the brain to properly use these spastic muscles and stretch the affected extremity to reduce contractures.

Total or partial paralysis of one side of the body resulting from disease of or injury to the motor centers of the brain

• Difficulty walking • Balance issues or loss of balance • Difficulty swallowing • Vision issues • Difficulty speaking • Numbness, tingling, or loss of sensation on ½ the body • Loss of bladder and bowel control • Unable to perform tasks • Feeling of depression • Increased emotional sensitivity • Poor memory

• Neuromuscular electrical stimulation on the part or side of the body. • Modified constraint induced therapy (mCIT) to promote the use of the affected side of the body. • Mirror therapy, which will activate the part of the brain and muscles, as if the patient was actually doing that activity. • Botulinum Toxin injections to decrease high muscle tone. • Positioning of the body parts to increase comfort and decrease pain.

• Facilitating upper and lower extremity movement. • Shifting weight in order to involve the hemi-side. • Addressing cognitive and perceptual deficits that correspond. • Providing problem-solving opportunities. • Completing activities or tasks that are important to the client and for everyday functional routine. • Giving the client the tools needed to be as independent as possible. • Educating and administering adaptive equipment.

The inability to translate an idea into motion, resulting from some interference with transmission of the appropriate impulses from the brain to the motor centers. There is no loss of the ability to perform an action automatically, but the action cannot be performed on request. The condition is often caused by diffuse cortical disease or left hemisphere damage

• Difficulty performing movements on request • Difficulty copying movements • Difficulty making gestures • Difficulty when planning movements to cross midline • Difficulty orienting upper extremity to conform to objects

Therapy is the only effective method, no real surgical or medical intervention

• Verbal Cues • Demonstrating task • Breaking down the tasks into smaller steps • Sequencing tasks and then putting them together • Gesture Training • Strategy Training • Conductive Education • Direct Training • Error Reduction • Education

Topographagnosia -The inability to orient oneself in one's surroundings as a result of a brain injury -Impairment in the interpretation of maps, house plans, etc. Environmental Agnosia -Inability to recognize familiar places -Loss of topographical familiarity Tactile Agnosia - Inability of someone to recognize an object by sensation such as feeling it in their hand even if they are able to recognize the object visually - Also called Astereognosis Auditory Agnosia - inability to recognize sounds as symbols or words as music; caused by a lesion of the auditory cortex of the temporal lobe - can physically hear the sounds and describe them, but are unable to recognize them - differs from deafness; can hear the sound, but cannot put a name to it

Topographical → - Getting lost in a familiar environment - Unable to draw a plan of their house Environmental → - Getting lost in familiar places, but able to read maps and house plans Tactile → - Inability to detect an object by sensation even when sensation is intact - Lesions in the parietal lobe Auditory → - Inability to repeat and/or understand spoken language - Able to identify sounds [such as a car horn], but cannot understand spoken language - Spoken words come across as a muffled or humming noise, also may sound like a foreign language

-Strengthening unaffected navigational strategies to bypass defective ones [Topographical & Environmental] - Visual detection of an object prior to using hand sensation to understand shape and texture [Tactile] - Sign Language Therapy [Auditory]

There are no specific treatments for agnosias, but OT can aid in → - Organizational Strategies - Alternative Cueing Devices - Compensatory Approaches - Alternate Modalities - Vocational Goals

defined as the clinical diagnosis of difficulty swallowing

• Pain while swallowing • Inability to swallow • Sensation of food getting stuck in throat/ chest/ or behind breastbone • Drooling • Regurgitation • Hoarseness • Weight loss • Coughing or gagging when swallowing

• Possible feeding tube if necessary (G-tube or PEG tube); once oral feeding resumes, the tube can be removed • Dilation - stretching of the narrowed passages of the esophagus • Medications to help relax esophageal muscles • Botox injections in esophagus • Positioning of the body and head to aid in swallowing - ex. tilting head to right or left OR tilting head downward when swallowing • Exercises and new swallowing techniques to help compensate • Exercises to coordinate swallowing muscles - stimulate nerves that trigger swallowing reflex

• Refer to SLP • Facilitate preparatory exercises before meals that help enable the oral and pharyngeal motions necessary for eating. • Educate client + caregiver(s) on feeding and swallowing strategies to increase eating and feeding performance. • Educate on diet modification to increase safety when swallowing (ex. cutting up food into smaller pieces)

A motor speech disorder in which movement of muscles (lips, tongue, vocal folds, and diaphragm) used for speech production is impaired.

• Slurred and/or slow speech • Inability to speak louder than a whisper or speaking too loudly • Rapid speech • Nasal, raspy or strained voice • Uneven or abnormal speech rhythm • Monotone speech • Difficulty moving your tongue or facial muscles • Social communication difficulties

• Modify articulation o Have the client practice being more conscious of lip movement o Slow down the speech • Modify phonation o Have client practice phonating with "ah" for as long as they can, and work up to going longer and longer with quality phonation • Modify resonance o Have client practice speaking with a wider mouth • Modify prosody o Prosody: patterns of stress and intonation o Have client practice stress drills (putting stress on the correct parts of words and sentences) o Tongue: • Isotonic: repetitive movements of the tongue without resistance • Isometric: use tongue blade to strengthen protrusion of tongue o Lips: • Isotonic: puckering and unpuckering, smiling and frowning, lip rounding, lip spreading, lip closing, lip opening, make sure they aren't opening and closing the jaw

• Speech musculature exercises (tongue, lips, jaw muscles, vocal folds) • Improving breathing endurance • Slowing speaking rate • Feeding

Apperceptive Visual Agnosia • Client is unable to put together the pieces of an image in order to perceive the entire picture • Difficulty identifying features of an object or differentiating between objects • Example: An individual could see a set of eyes, lips, and a nose but is unable to recognize a face Associative Visual Agnosia • Individuals cannot match an object to memory or recall names of visual stimuli • Can describe an object but are unable to put a name to it • Example: An individual would be able to draw an object but then cannot name what they drew on their paper

o Vision is intact o Deficits in visual perception rather than motivation, intelligence and attention o Objects are seen but not identified o Objects are detected through the use of other senses o Vision tests are not applicable

• Primarily treated through rehabilitation due to lack of traditional medical intervention. • There are no procedures, surgeries, or medications available for this diagnosis.

o Keep everyday objects needed for occupational performance in consistent locations o Incorporate objects/ tools that are used in everyday life into treatment for familiarization o Educate on ways to rely on intact senses o Rehearse naming and identification objects o Provide treatment sessions in familiar environment