Course Description

The Hemiplegic Arm….Put it in a Sling?!?!?

The hemiplegic arm is not needed to walk, however its residual impairment in chronic hemiplegia accounts for continued rehabilitation intervention. The arm is an extension of the trunk through the shoulder girdle components: the scapula and clavicle. Little attention and effort is expended on the hemiplegic arm because of the push to teach compensatory strategies utilizing the less affected upper extremity due to shorter lengths of stay in order to optimize functional independence prior to discharge.

Neuroimaging research indicates there are different recovery levels as indicated by brain activation patterns in the contralateral lesioned site with movement related activity of the hemiplegic arm. Task practice; skill acquisition and how learning occurs are behaviors that contribute to the brain's ability to create new pathways for neuron function, replacing those injured by stroke. Rehabilitative strategies then should attempt to integrate the hemiplegic arm as a base of support prior to gait (sit, sit<--> stand), and incorporate it during daily living skills to perform as the dominant extremity or as a gross assist.

This course will address arm movement during gait and strategies to enhance performance during functional activities while ambulating. Treatment ideas incorporating pre-gait & gait activities will be demonstrated and practiced. Evidence based practice models for constraint induced movement therapy (CIMT); bi-manual upper extremity tasks; taping and electrical stimulation will be discussed as rehabilitation interventions to reduce impairment. A prior course on normal and abnormal gait analysis is recommended.

Course Level (As defined by the APTA): Intermediate – Assumes that participants have a general familiarity with topic (gait).  The focus is on increased understanding and application of information (integrating the hemiplegic upper extremity during gait activities).

Participants

Occupational and Physical Therapists; Certified Occupational Therapist Assistants; and Physical Therapist Assistants who engage in patient ambulation.

Course Objectives

After completing this course, the participant will be able to:

1. Explain upper extremity kinesiology during the phases of gait.
2. Demonstrate activities to promote normal movement of the hemiplegic arm movement via weightbearing & non-weightbearing techniques during a group presentation.
3. Analyze normal movement of the arm during functional activities.
4. Describe adjunctive therapies utilized in the treatment of the hemiplegic arm.
5. Develop treatment interventions for the hemiplegic arm.

Continuing Education Units

A certificate of attendance will be issued denoting eight (8) contact (clock) hours or .8 CEUs of continuing education awarded. The contact hours or CEUs will vary in each state according to licensure boards, state associations, or sponsoring entities.

For this Course, Please:

1. (Females) wear a halter or bathing suit top to expose the trunk & upper extremity for lab sessions.
2. Review the following or bring a resource:
   • muscles of the trunk & upper extremity
   • joint morphology of the shoulder girdle & upper extremity