Update 'README.md'
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README.md
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README.md
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_ _ _ _
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#### >>> move to FnO !! ####
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#### > > > move to FnO !! ####
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| score | Brooke armfunctie |
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|-------|--------------------------------------------------------------------------|
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_ _ _ _
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### HC FSHD ###
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- Er zijn veel spierziektes; omdat je zoveel spier hebt, met veel verschillende functies:
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+ mobiliteit/bewegen
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+ digestie (SMCs)
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@ -2193,9 +2190,9 @@ In de werkgroep bespreken we jullie plannen
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_ _ _ _
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### WG Degeneratie ###
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### WG Degeneratie
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#### Casus 1 ####
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#### Casus 1
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- (1) Wat zie je op deze scan?
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+ normaal beeld
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@ -2238,7 +2235,7 @@ ad. ergotherapeuten geven specialized neglect-training
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_ _ _ _
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Neuromodulat
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### Neuromodulatie ###
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#### Casus 2 ####
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+ kortetermijn geheugen
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+ verm aandacht voor R
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### HC neurale adaptatie (2020-03-03)
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#### Intro
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- model: CVA
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- problem: many theoretic approaches in stroke rehab (e.g.: Affolter, Vojta, P.N.F., Johnstone, M.R.P., Brunnstromm)
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- NDT: neuro-developmental treatment
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- speerpunt was symmetrie:
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- bewegen werd afgeraden, indien beweging niet symmetrisch kon worden uitgevoerd
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- `CAVE`: hersteelvermogen is niet altijd hoog genoeg voor herstel tot volledig symmetrisch functioneren => dan: wachten met bewegen tot volledige symmetrie is behaald (**vertraagd dus het herstel**)
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- little clinical evidence
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- little fundamental insight in functional recovery
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- **There is no evidence of a surplus value of one neurologically oriented training method over the other in stroke rehab.**
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- Neural repair => restitution of function
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- Neural compensation => substitution of function
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- res + sub of func => skill acquisition
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- **FAC-score** (functional ambulation score):
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- scoort zelfstandig lopen
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- 5 (volledig zelfstandig lopen ==//==> 0 (niet lopen)
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- _"To what extent **can** and **should** postural symmetry be promoted after stroke?"_
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#### Postural instability
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- in SMK onderzocht
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- voor het eerst (2004) werd het mogelijk om postural instability _voor elk been onafhankelijk_ te meten.
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#### Balance study
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**TEKENINGEN TOEVOEGEN???**
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- statische assymetrie: staande assymetrie
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- dynamische assymetrie: corrigerende bewegingen assymetrie
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- Summary of balance study:
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- after supratentorial stroke:
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- clinical balance considerably improves (e.g. FAC, BBS)
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- frontal plane standing balance most strongly affected
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- frontal > saggital plane standing balance improves in time
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- **but... static and dynamic asymmetry persist to a substantial degree**
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- Conclusion balance study:
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- **An important part of standing balance recovery from stroke takes place _independent_ of:**
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- improved static weight bearing on the paretic leg
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- improved dynamic contribution by the paretic leg
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- _Especially true in pts. with severe leg paresis_
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- **Even in well-recovered communicty-dwelling chronic stroke pts, large differences are found between the dynamic contribution of each leg to balance control)
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- Balance study was redone, results:
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- static assymm. 60% / 40%
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- dynam assymm. 90% / 10%
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- (perc are noted as: correction by non-paretic leg / correction by paretic leg)
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- Re-study: EMG-activity vs. functional recovery
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- Results:
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- EMG-patterns remain unchanged, even if functionality increases
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- Even if one-legged function remains unchanged; two-legged function increaes and total/eventual balance outcome is better.
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- **Men denkt dat de resultaten niet-afwijkend zijn, omdat de rompsieren zowel cerebraal als spinaal bilateraal geinnerveerd zijn.**
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#### Bottom line:
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- **compensatory mechanisms play a major role** in the recovery of balance and gait after stroke => this notino questions the prolonged emphasis of some approaches on **restitution of function** (BobachTx = NDT)
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#### Post-stroke balance and gait framework
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