This Week In Therapy: How to walk again after stroke: Why this gait rehabilitation robot is different

This Week In Therapy: How To Walk Again After Stroke (Plus More)

At Occupational Therapy Brisbane, we’re sharing neurological therapy and age care advances: How to walk again after stroke:  Why this gait rehabilitation robot is different, Age care training program associated with reduction in anti-psychotic medication, Drawing and Sculpture: How clinical art is tackling early-onset dementia symptoms, Who is at risk of weight gain after deep brain stimulation(DBS), and Michael. J. Fox on Mindset.

1. How to walk again after stroke:  Why this gait rehabilitation robot is different

Key points about this gait rehabilitation robot prototype

  • The interesting development in this robotics application in mobility is not to walk the person inside a robot instead it’s to follow movement not influence it.
  • That’s a significant distinction when you consider that most robotic gait support market devices aim to influence movement, control movement, substitute function and active participation.
  • Conversely, there appears to be a sensitivity in this prototype to sense a user’s performance and provide the minimum viable assistance.

How it works

  • The device is attached at the pelvis and enables mobility without over restricting the client’s performance. A visual target with rewards enables the client to focus on improving mobility performance.
  • The goal, rehabilitation outcomes which are independent of the robot. The role of the robot is to enable and to transition from it.

Source: The robotics helping stroke patients regain balance

2. Age care training program associated with reduction in anti-psychotic medication

Training aged care facility staff to identify and anticipate an age care resident’s needs led to a decrease in the use of antipsychotic medication to treat dementia symptoms. The study also indicates staff skill development as a result of the training needs to be ongoing rather than short term or one off.

Summing Up The Paper

  • Antipsychotic medications are often used to address behavioral and psych symptoms of dementia in the age care setting.
  • Jennifer Tjia, MD, MSCE,  and associates from the University of Massachusetts Medical School evaluated the  impact of the OASIS program as “Prior large-scale, controlled trials in the [nursing home] setting failed to show meaningful reductions in antipsychotic use,”
  • The study applied the OASIS program in 93 age care facilities and compared this against 831 non intervention facilities.
  • The program was implemented as a train-the-trainer model,. The OASIS program targets direct care and indirect care workers with the goals
    • to re-frame the behaviors of residents with cognitive impairment as the communication of unmet needs,
    • to anticipate resident needs and work with their strengths. Pulling this into the care plans
  • The research team compared baseline medication use established at 18-month before intervention with a 3-month training period, a 6-month implementation period and a 3-month maintenance period.

The Findings

  • The program had the most observable impact at the 3 and 6month periods
  • The program influence declined after 6months and this was attributed to reduced active participation, cross contamination from other dementia programs and leadership changes

Source: Nursing home training program associated with reduction of antipsychotic use Tjia J, et al. JAMA Intern Med. 2017;doi:10.1001/jamainternmed.2017.0746.

3. Drawing and Sculpture: How clinical art is tackling early-onset dementia symptoms

Even if they forget that they made the piece, how they felt while making it definitely still remains

Kanako Obata (clinical artist)

In Japan, approximately 38,000 people are identified as having early onset dementia, This is in comparison to the 4.6million people living with dementia.

The importance of this program and why it’s worth sharing

  • In the Australian context, early onset dementia and people living with short term memory decline rarely have access to service and supports which meets there needs.

About The Program

  • Not just sculpture but the group also explore a broad sensory and medium experiences such as listening to the sound of rain while painting on panes of glass or imagining what it’s like inside dirt while painting on a flower pot.
  • The effectiveness of the treatment on dementia is still being researched, but according to Obata,

Art is just a tool. Having fun and smiling is what’s most important.

Source: https://mainichi.jp/english/articles/20170430/p2a/00m/0na/005000c


4. Do you know who is at risk of weight gain after deep brain stimulation(DBS)?

It’s previously been acknowledged people who experience Parkinson’s Disease and undergo deep brain stimulation are likely to gain weight, however, it’s unclear as to why this is the case.

A new study published in the journal Cortex reveals the multifaceted nature of weight gain in people who under go DBS to address their symptoms of Parkinson’s Disease.

Summing Up The Study

  • The significant predictors of weight gain include the behaviors of wanting food ( an increased desire for food) and impulsiveness.

The Benefits Of This Study

  • Provides more insight into the post DBS intervention needs of people living with Parkinson Disease
  • Provides potential clinical markers for OTs to consider the lifespan of their prescription of modifications, equipment and technology.
  • Highlights weight gain is a multi-factorial issue and requires a multidisciplinary approach which may need to be promoted and discussed with the client, carers and others care partners such as primary healthcare professionals.

Source: Weight gain after STN-DBS: The role of reward sensitivity and impulsivity

 

5. Michael J Fox on Mindset

Talks At Google: A grand round discussion by Dr. Bill Marks, the head of clinical neurology at Verily Life Sciences, with the Michael J. Fox . A conversation about

  • the role of mindset in living with Parkinson’s Disease
  • Michael’s  journey with Parkinson’s disease
  • Michael’s Foundation’s work and the importance of accountability when it comes to awarding grants.
  • the lessons which have emerged from living with the condition

Source: An article in Parkinson’s News Today. https://parkinsonsnewstoday.com/2017/05/11/michael-j-fox-talks-about-his-positive-attitude-to-parkinsons-disease/

Relevant Resources

  1. Parkinson’s Disease Path-Finder: Your PD Plan Helping You Move Forward In Your Life With Purpose, Direction and Control . This might be a good starting point.
  2. Tai Chi For Parkinson’s Disease


DISCLAIMER:

The Occupational Therapy Blog is a news and health promotion initiative. It by no means aims to be a source of medical or therapeutic advice. We enjoy sharing information and will attempt to curate it as best we can. You’d appreciate we like to lighten our blog articles which often tackles very serious and personal issues. It’s our way of sharing. The information contained on this blog is not intended to be a substitute for professional advice, or intervention. Always seek the advice of your GP or qualified therapist with any questions you may have regarding your personal situation. Never substitute or delay seeking professional advice because of information you’ve read on this website.

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