Michelle Green – Stroke Rehab for Patients who “Push”: Management Strategies for a Unique Patient Population

Description

Handouts

Outline

ICF MODEL AND ROLE IN ASSESSMENT AND TREATMENT

• ICF Models guide to clinical reasoning
• Levels of ICF definitions and examples
• Correlation with assessment, prognosis and treatment planning

PATHOPHYSIOLOGY OF “PUSHING”

• Role of vestibular system
• Localization of lesions correlating with “pushing”
• Thalamic lesions and “pushing”
• Role of graviceptive systems
• Best support for occurrence of “pushing”

COMMON CHARACTERISTICS OF “PUSHERS”

• Alignment faults (trunk, head, pelvis, femur)
• Movement dysfunction
• Midline deficits
• Other (sensory loss, visual, neglect, cognition)

ASSESSMENT TOOLS

• Tests to confirm presence of “Pushing”
• Outcome measures
• Role of upper and lower trunk assessment

TASK-ANALYSIS, HYPOTHESIS DRIVE APPROACH

• Why use this framework for clinical reasoning
• What is the framework
• How it guides tasks assessment and guides treatment choices
• How to execute a task analysis
• Neuroplasticity and directing treatment choices
• Motor control and motor learning theories on set-up and progression

TREATMENT SET-UP FOR SUCCESS (REDUCE RISK, IMPROVE SAFETY, IMPROVE OUTCOMES)

• Choosing a position for treatment
• Align patient for best results
• Activate muscles in coordinated sequenced fashion to mimic functional demands
• Rehabilitation of function
• Compensation or Recovery?

TREATMENT FOR THE LOW, MID AND HIGH-LEVEL “PUSHER”

• Primary characteristic for each level
• Starting point and progression
• Functional re-education considerations
• Use of objects, adjunct, and equipment in treatment

Faculty

Michelle Green, PT, DPT, C-NDT, NCS Related seminars and products: 7

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Michelle Green, PT, DPT, C-NDT, NCS, is an expert in stroke rehabilitation, with over 20 years of experience helping countless patients recover from neurological conditions. Her background in NDT, Pilates, and yoga has influenced her assessment and treatment approach, providing her with enhanced insight into movement assessment and guided movement re-education.

Dr. Green travels nationally to present seminars on stroke rehabilitation, and she is known for her dynamic, hands-on teaching style. She earned her Doctorate in Physical Therapy from University of North Carolina Chapel Hill, and she teaches as an assistant professor in the DPT program at Campbell University. Her additional interests include education and learning, impairment-based treatment across the lifespan, and application of mind-body practices for improving mental and physical health.

Speaker Disclosures:

Financial: Michelle Green is an assistant professor at Campbell University. She receives a speaking honorarium from PESI, Inc.

Non-financial: Michelle Green is a member of the American Physical Therapy Association; and the North Carolina Physical Therapy Association.