Pat, What is trigeminal nerve stimulation and how do you do it? Rob --- pat leegan <[EMAIL PROTECTED]> wrote:
> HI, > I am a home health OTR/L working with a bilateral > CVA patient (46 yrs) with hign extensor tone upper > and lower extremities. I have been using a distal to > proximal approach, as the reverse has not produced > results, and have been doing tigeminal nerve > stimulation to decrease tone (which has been > moderatly sucessful).and PNF patterns D1 and D2. > I would appreciate any additional approaches from > the list, that might break this tone. He is not able > to get into quadrqped, and is most often seen in > bed.He does have 1/4 finger flexion right hand and > 1/4 thumb flexion right. > He has a very supportive family that are currently > participating in his home exercise progtam, which > includes gentle biltateral joint mobilization and > prolonged stretching. > any suggestions would be greatly appreciated. > Peace, Pat Leegan, MS,OTR/L > > Ron Carson <[EMAIL PROTECTED]> wrote: > Hello All: > > Nice to finally see a little "traffic" on the > OTlist. > > Interestingly, I was JUST on Cochrane.org and one of > their Evidence > Summaries is about preventing falls in the elderly. > Given that their > information is in the public domain, I'll post it > here. Of course, you > can also read it on their website. > > Ron > > ################################################################# > > Abstract > > BACKGROUND: > > Approximately 30 per cent of people over 65 years of > age and living in > the community fall each year; the number is higher > in institutions. > Although less than one fall in 10 results in a > fracture, a fifth of fall > incidents require medical attention. Objectives > > To assess the effects of interventions designed to > reduce the incidence > of falls in elderly people (living in the community, > or in institutional > or hospital care). > > SEARCH STRATEGY: > > We searched the Cochrane Bone, Joint and Muscle > Trauma Group Specialised > Register (January 2003), Cochrane Central Register > of Controlled Trials > (The Cochrane Library, Issue 1, 2003), MEDLINE (1966 > to February 2003), > EMBASE (1988 to 2003 Week 19), CINAHL (1982 to April > 2003), The National > Research Register, Issue 2, 2003, Current Controlled > Trials > (www.controlled-trials.com accessed 11 July 2003) > and reference lists of > articles. No language restrictions were applied. > Further trials were > identified by contact with researchers in the field. > > SELECTION CRITERIA: > > Randomised trials of interventions designed to > minimise the effect of, > or exposure to, risk factors for falling in elderly > people. Main > outcomes of interest were the number of fallers, or > falls. Trials > reporting only intermediate outcomes were excluded. > > DATA COLLECTION AND ANALYSIS: > > Two reviewers independently assessed trial quality > and extracted data. > Data were pooled using the fixed effect model where > appropriate. > > MAIN RESULTS: > > Sixty two trials involving 21,668 people were > included. > > Interventions likely to be beneficial: > > * Multidisciplinary, multifactorial, > health/environmental risk > factor screening/intervention programmes in the > community both > for an unselected population of older people (4 > trials, 1651 > participants, pooled RR 0.73, 95%CI 0.63 to 0.85), > and for older > people with a history of falling or selected because > of known > risk factors (5 trials, 1176 participants, pooled RR > 0.86, 95%CI > 0.76 to 0.98), and in residential care facilities (1 > trial, 439 > participants, cluster-adjusted incidence rate ratio > 0.60, 95%CI > 0.50 to 0.73) > > * A programme of muscle strengthening and balance > retraining, > individually prescribed at home by a trained health > professional > (3 trials, 566 participants, pooled relative risk > (RR) 0.80, 95% > confidence interval (95%CI) 0.66 to 0.98) > > * Home hazard assessment and modification that is > professionally > prescribed for older people with a history of > falling (3 trials, > 374 participants, RR 0.66, 95% CI 0.54 to 0.81) > > * Withdrawal of psychotropic medication (1 trial, 93 > participants, relative hazard 0.34, 95%CI 0.16 to > 0.74) > > * Cardiac pacing for fallers with cardioinhibitory > carotid sinus > hypersensitivity (1 trial, 175 participants, WMD > -5.20, 95%CI > -9.40 to -1.00) > > * A 15 week Tai Chi group exercise intervention (1 > trial, 200 > participants, risk ratio 0.51, 95%CI 0.36 to 0.73). > > > Interventions of unknown effectiveness: > > * Group-delivered exercise interventions (9 trials, > 1387 > participants) > > * Individual lower limb strength training (1 trial, > 222 > participants) > > * Nutritional supplementation (1 trial, 46 > participants) > > * Vitamin D supplementation, with or without calcium > (3 trials, > 461 participants) > > * Home hazard modification in association with > advice on > optimising medication (1 trial, 658 participants), > or in > association with an education package on exercise > and reducing > fall risk (1 trial, 3182 participants) > > * Pharmacological therapy > (raubasine-dihydroergocristine, 1 > trial, 95 participants) > > * Interventions using a cognitive/behavioural > approach alone (2 > trials, 145 participants) > > * Home hazard modification for older people without > a history of > falling (1 trial, 530 participants) > > * Hormone replacement therapy (1 trial, 116 > participants) > > * Correction of visual deficiency (1 trial, 276 > participants). > > Interventions unlikely to be beneficial: > > * Brisk walking in women with an upper limb fracture > in the > previous two years (1 trial, 165 participants). > > Authors' conclusions: > > Interventions to prevent falls that are likely to be > effective > are now available; less is known about their > effectiveness in > preventing fall-related injuries. Costs per fall > prevented === message truncated === Need Functional Therapy Activities? http://hometown.aol.com/MrFunction ____________________________________________________________________________________ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
