Evidence-Based Upper Limb Retraining after Stroke (ONLINE x 6)

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A workshop for physiotherapists and occupational therapists run over 6 mornings (Danish time) during Jan/Feb 2022. Taught in English.

This 6-morning zoom workshop is an alternative to the 3-day face-to-face workshop. It is being taught in English, for Danish physiotherapists and occupational therapists by Dansk Selskab for Neurologisk Fysioterapi (Danish Association of Neurological Physiotherapy). The workshop is now open to other therapists.

Mornings in Europe, evenings in Australia (6.00-10.30pm AEDT).

Contact person for enquiries in Denmark: Sine Secher Mortensen – sinesecherm@hotmail.com

Cost: $694.09 (AUD) incl tax and Eventbrite admin fee

Presenters: Karl Schurr – physiotherapist, Dr Annie McCluskey – occupational therapist, Dr Lauren Christie – occupational therapist, Dr Emma Schneider – occupational therapist

Learning objectives: By the end of the 6 sessions, participants will be able to:

  • Name the essential components of normal reach and manipulation
  • Recognise common compensations when observing stroke survivors attempting to grasp objects, and explain how to minimise compensatory strategies
  • Name and discuss factors thought to contribute to the development of muscle overactivity, spasticity and stiffness, and intervention strategies to help minimise these secondary problems
  • Explain the relationship and differences between overactivity, spasticity, muscle length changes and stiffness, missing essential components and compensations
  • Plan and conduct an assessment and training session with a stroke survivor using motor learning principles and task-specific practice
  • Discuss factors which affect motor learning, and can be modified to enhance learning and increase client practice
  • Use an electrical stimulation machine to stimulate upper limb muscles.
  • Discuss current evidence for constraint-induced movement therapy, mental practice, mirror box therapy and electrical stimulation for improving upper limb motor recovery

NB Presentations on 27 Jan, 8 Feb & 23 Feb are the same as the 3-part online UL workshop being presented online 21 & 28 Feb-14 Mar 2022.

Timetable:

(1) Thu 27 January 2022 (08.00am-12.30pm, Denmark time)

Movement analysis (4.5 hrs). Examples will be provided of features to look for when observing a person reach to grasp and manipulate a cup, knife and fork. Slow motion video analysis will be used and practiced online (using zoom breakout rooms) Common compensations or kinematic deviations will be highlighted due to weakness and/or loss of coordination. Discussion of homework to be completed before Session 4.

(2 ) Mon 31 January 2022 (08.00am-12.30pm, Denmark time)

Clinical demonstration 1 (4.5 hrs): Presenters assess and establish overnight practice for 2 stroke survivors (1 x very weak upper limb and 1 x advanced hand coordination training). Pre-recorded videos may be used if local stroke survivors cannot be recruited.

(3) Tues1 February 2022 (08.00am-12.30pm)

Clinical demonstration 2 (4.5 hrs): Presenters review and progress overnight practice for 2 stroke survivors – also assess and establish practice for a 3rd stroke survivor. Discussion of stroke survivor and therapist homework. Pre-recorded videos may be used if local stroke survivors cannot be recruited.

(4 ) Tues 8 February 2022 (08.00am-12.30pm)

Retraining people who are very weak (4.5 hrs). Review of homework in breakout rooms. The session will provide examples of strength and task-specific training that target weak muscles of the shoulder, arm and hand. Exercises will be presented that stroke survivors can practice independently including targeted practice for shoulder protraction, forward flexion, external rotation, wrist and finger extension, supination and thumb abduction. Interventions to elicit movement include mirror therapy, mental practice and electrical stimulation. Research evidence included. Discussion of homework to be completed before Session 6.

(5) Thurs 10 February 2022 (08.00am-12.30pm)

Clinical demonstration 3 (4.5 hrs): Presenter review and progress practice for 3 stroke survivors . Pre-recorded videos may be used if local stroke survivors cannot be recruited.

(6) Wed 23 February 2022 (08.00am-12.30pm)

Retraining advanced hand coordination (4.5 hrs): Review of homework (via Zoom breakout rooms). The session will provide examples of task-specific training to improve cutlery use, writing and hair care. Part and whole practice examples will be presented, including strategies for reducing force and pressure on utensils, a common problem for stroke survivors with impaired sensation and decreased motor control. Other interventions that can improve strength and in-hand coordination include mirror therapy, electrical stimulation, mental practice and constraint-induced movement therapy. Practical demonstration of electrical stimulation and mental practice. Therapists will be encouraged to practice with their own equipment.Emphasis will be placed on teaching stroke survivors how to practice without 1:1 supervision or manual guidance, in preparation for ward / home-based practice. Research evidence included. Evaluation and reflection where therapists discuss implementation and plans for practice change.

Pre-requisites: None. Suitable for students and recent graduates through to experienced therapists.

Number of registrants: Limited to 30 therapists

Pre-reading & homework: Available from the StrokeEd website (password protected). Therapists should start preparing up to 4 weeks before the event. Allow several hours for the homework if English is not your primary language. Pre-reading includes a book chapter (in English) and some analysis tasks.

Workshop manual – Will be provided as a PDF workbook via the StrokeEd website (password protected) for therapists to print or use electronically .

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