- 1. Intentional tremor in the ataxic hand Exposition of a real
case. Handfun Meeting 2013. scar Dez Meleiro.
2. What is ataxia? Disturbance in voluntary movement Muscles
contrain irregularity and weakly. Intentional tremor, Coordination
Impairment, disdiacocinesia, dismetria, occular tremor.
Discontinued movement (1)(2) Handfun Meeting 2013. scar Dez
Meleiro. 3. How does the cerebellum work? Handfun Meeting 2013.
scar Dez Meleiro. Cerebellum Cortex Muscles, tendons, joints
Vestibular nerve Vision Motor Plan Periphery State Normal movement
4. What is intentional tremor? Rhythmical and oscillanting
movement. Appears with actions. Two components: Nervous and
mechanical. (3)(4)(5) Handfun Meeting 2013. scar Dez Meleiro. 5.
PRESENTATION AND TREATMENT OF A REAL CASE Handfun Meeting 2013.
scar Dez Meleiro. 6. Handfun Meeting 2013. scar Dez Meleiro. 7.
Objective Measurements Handfun Meeting 2013. scar Dez Meleiro. 8.
Objective Measurements Spiral test Fugl-Meyer Scale (Upper
Extremity Motor) :46/66 Handfun Meeting 2013. scar Dez Meleiro. 9.
Handfun Meeting 2013. scar Dez Meleiro. Main functional goal Fill a
glass of water and drink it. Spilling as little as possible. Why
cant the patient achieve this goal? Intentional tremor -Which are
the worst enemies of intentional tremor? Proximal stability and
upper limb propioception. 10. Handfun Meeting 2013. scar Dez
Meleiro. Intentional tremor Not using of Right Upper Limb Atrophy.
Proximal hypotonia Perceptive deficiency 11. PHYSICAL TREATMENT
Handfun Meeting 2013. scar Dez Meleiro. 12. Eliminate cervical and
thoracic movement dysfunctions Subjective vertical visual line.
Eyes-Head-Trunk coordination. Decrease in nervous tension
(7)(8)(9)(10) Handfun Meeting 2013. scar Dez Meleiro. 13. VISUAL
TREATMENT Handfun Meeting 2013. scar Dez Meleiro. 14. Activation of
the right scapular muscles with function Handfun Meeting 2013. scar
Dez Meleiro. Increase Proximal Stability. Decrease Mechanic
Component. Safety. Bimanual Coordination (synchronization) 15.
Handfun Meeting 2013. scar Dez Meleiro. 16. Handfun Meeting 2013.
scar Dez Meleiro. Bimanual coordination Point a finger at 17.
Handfun Meeting 2013. scar Dez Meleiro. Grip and proximal stability
18. Handfun Meeting 2013. scar Dez Meleiro. (11)(12)(13)(14)(15)
19. CHOR Contactual Hand- Orientating Response The CHOR
facilitates: Midline orientation. Light touch contact as balance
aid. Limp support and limb loading. Postural stabilisation for
selective movement. Distal input improves proximal stability (16)
Handfun Meeting 2013. scar Dez Meleiro. 20. CHOR Handfun Meeting
2013. scar Dez Meleiro. 21. CHOR (16)(17)(18)(19) Handfun Meeting
2013. scar Dez Meleiro. 22. Motor Re-learning Repeat without
repetition Imagining Active participation Postural Control Memory
(20)(21)(22)(23)(24) Handfun Meeting 2013. scar Dez Meleiro. 23.
Results Handfun Meeting 2013. scar Dez Meleiro. 24. Results
Fugl-Meyer Scale (Upper Extremity Motor) : 55/66 Handfun Meeting
2013. scar Dez Meleiro. 25. Bibliography Handfun Meeting 2013. scar
Dez Meleiro. 1. El cerebelo y sus conexiones, en Neuronatoma
Clnica. Snell. Lippincot y Williams. 2010. Barcelona (Espaa). P
230-250. 2. Purves, Augustine, Fitzpatrick, Hall, LaMantia,
McNamara, Williams. Neurociencia. 3 ed, Madrid: Editorial Mdica
Panamericana,2008. 3. Deuschl G, Bain P, Brin M. (1998). Consensus
statement of the Movement Disorder Society on Tremor. Ad Hoc
Scientific Committee. Mov Disord;13 Suppl 3:2-23. 4.Marsden CD,
Origins of normal and pathologic tremor. En: Findley LJ, Capildeo R
(Eds). (1984). Movement Disorders: Tremor. New York: Oxford
University Press, pp 37-84. En: Fahn S, Jankovic J (Eds). (2007).
Principles and practice of Movement Disorders. Churchill Livingston
Elsevier. 26. Handfun Meeting 2013. scar Dez Meleiro. 5. Deuschland
G. Bergman H. Pathophysiology of Nonparkinsonian Tremors. Movement
Disorders.2002.17, Suppl. 3. p S41S48 6. Shumway Cook, A.
Woollacoott, Mh. Normal reach, grasp and manipulation (Cap. 16).
Motor Control. Translating research into clinical practice. Theory
and practical applications. Lippincott. Williams-Wilkins;
Philadelphia, 2001-2007: 443-467 7. P.M. Davies. Pasos a seguir. 2
ed. Madrid: Editorial Mdica Panamericana. 2006. 8. Bettina Paeth
Rohlfs. Experiencias con el Concepto Bobath. 2 ed. Madrid:
Editorial Mdica Panamericana; 2006. 9.Blegiomini C, Wall M, Smith
A, Castiello U. Differential cortical activity for precision and
whole-hand visually guided grasping in humans. European Journal of
neuroscience (2007).Vol. 25: 1245-1252. 10.Cohen N, Cross E, Tunick
E, Grafton S, Culham J. Ventral and dorsal stream contributions to
the online control of inmediate and delayed grasping: A TMS
aproach. Neuropsicology (2009); 47: 1553-1562. 27. Handfun Meeting
2013. scar Dez Meleiro. 11. Daneaul JF, Carignan B, Duval C. Finger
tremor can be voluntarily reduced during a tracking task. Brain
Research 1370. (2011) 164-174 12. Richard L. Senesac L. et al.
Response to Intensive Upper Extremity Therapy by Individuals with
Ataxia from Stroke. Top Stroke Rehabil 2008;15(3):262271 13. Park
J; Lewis M.M; Huang X.; Latash M.L. Effects of
olivo-ponto-cerebellar atrophy (OPCA) on finger interaction and
coordination. Clinical Neurophysiology. 2013. 124. 991998 14.
Winter J.M. et al. Effects of Mobilization and Tactile Stimulation
on Chronic Upper-Limb Sensorimotor Dysfunction After Stroke.
Archives of Physical Medicine and Rehabilitation 2013;94:693-702
15. Sleimen-Malkoun et al. Bimanual training in stroke: How do
coupling and symmetry-breaking matter? BMC Neurology. 2011. 11.11
16.Recovery of upper limb function, en Bobath Concept. Theory and
Clinical Practice in Neurological Rehabilitation. Raine, Meadows,
Lynch-Ellerington. Wiley-Blackwell. 2010. Oxford (United Kingdom) P
154-158. 28. Handfun Meeting 2013. scar Dez Meleiro. 17. Werring D.
Improving hand motor control after stroke. J Neurol Neurosurg
Psychiatry. 2009. 80: 586 18. Hird JS, Landers DM, Thomas JR, Horan
JJ. Physical practice is superior to mental practice in enhancing
cognitive and motor task performance. Journal of Sport and Exercise
Psychology 1991; 13:281-293. 19. Mackrous, Isabelle Proteau, Luc.
Specificity of practice results from differences in movement
planning strategies. Source: Experimental Brain Research; Nov2007,
Vol. 183 Issue 2, p181-193, 13p. 20. Proteau, Luc; Carnahan,
Heather. What Causes Specificity of Practice in a Manual Aiming
Movement: Vision Dominance or Transformation Errors?, Journal of
Motor Behavior, Sep2001, Vol. 33 Issue 3, p226. 21. Motor learning
following unilateral stroke. Archives of Physical Medicine &
Rehabilitation. 1996. 77(8):811-5. 22. Abreu BC. The effect of
environmental regulations on postural control after stroke.
American Journal of Occupational Therapy.199. 49(6):517-25. 23.
Isawa J, Criscimagna Hemminger S; Shadmer R. Cerebellar
Contributions to Reach Adaptation and Learning Sensory
Consequences. The Journal of Neuroscience, 2012 32(12):42304239.
24. Martin CL et al. Effectiveness of physiotherapy for adults with
cerebellar dysfunction: a systematic review. Clinical
Rehabilitation 2009; 23: 1526. 29. Thanks! Handfun Meeting 2013.
scar Dez Meleiro. http://neurorehabilitacion.wordpress.com
[email protected]
