Deficits in upper extremity function are among the most common and devastating impairments, spanning virtually every neurologic diagnosis. As clinicians, we have more evidence than ever at our disposal describing the optimal treatment strategies for addressing neurologic upper extremity impairment. However, there are still therapies used routinely in the clinic that are outdated or not supported by current research, which may prevent our patients from maximizing their recovery. As such, it is of critical importance to share evidence-based treatment strategies, based on the scientific principles of neuroplasticity and motor learning, with clinicians across the country in order to maximize UE outcomes and quality of life for our patients. This course is designed to provide a rationale for and description of evidence-based treatment approaches as well as assessments that can be incorporated into clinical practice in a variety of neurologic diagnoses. This course will also provide recommendations for approaches based on impairment level so that our therapy sessions can be tailored to the skillset of each individual patient in order to maximize outcomes.
Heather is an occupational therapist and PhD candidate in the School of Health and Rehabilitation Sciences at Ohio State University. Currently working in the B.R.A.I.N. lab as a graduate research associate, she is primarily interested in developing and testing interventions that improve motor function and quality of life in stroke survivors. Specifically, her primary research area of emphasis is examining the effect of noninvasive brain stimulation combined with occupational therapy (Functional Brain Stimulation™) on improving arm and hand function in survivors of stroke. Heather has also engaged in research and/or published in the topics of mental practice, outcome measurement validity, and portable upper extremity robotics.
This chapter describes neuroplasticity, including basic physiologic mechanisms of cortical reorganization post-stroke. It will cover use-dependent plasticity, learned non-use, and their impact on UE function post-stroke.
This chapter describes P.R.A.C.T.I.C.E. Principles and generally how they can be integrated into clinical therapies.
This chapter covers transcranial direct current stimulation. Rationale for tDCS use in UE motor function will be briefly described, as well as tDCS mechanisms for anodal versus cathodal approach.