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yankeept -> Re: help needed w/stroke patient (May 11, 2000 4:51:00 AM)
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Thanks so much for the replies. I've been on jury duty so I haven't been working with the patient & haven't had time to respond sooner.
To make a few points more clear. When I have the patient in standing without her shoes/socks on, I observed her using an ankle strategy to try to maintain her balance. When this is not enough, I feel the patient doesn't use a hip strategy then to maintain her balance. She knows she is losing her balance, but cannot do anything about it. The scary part is that she has no protective UE responses, meaning she would fall flat on her face if I let her. She tends to fall like a tree at times. She does not exhibit any changes in tone during tehse activities. She does reasonably well with a walker, although needing help secondary to the left neglect.
I need a little more time to digest what Bobcat said. However, the patient's balance varies quite a bit. When it's "good", she can maintain static standing on a level surfaces by herself. She can maintain this position against anticipated resistance. However, against unexpected resistance she will often lose her balance. Standing on any sort of foam will almost always result in a loss of balance.
Any comments regarding "treating" absence of hip strategy & loss of protective responses & possible decreased balance reactions.
I've had her sitting on a rocker board, which she does well with. When I progressed to a physioball, she can maintain a static position, but usually loses her balance with any dynamic activities.
Thanks again,
Brian
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