Traumatic Brain Injury &
bbbbbbAssistive Technology
 
 

What is AT? Team SLP OT/PT  DEFICITS  ASSESS  AT  PRODUCTS Case Studies Links Glossary References Abstracts home                                                                                                                                                                                                                                                                                                                                   University of Nebraska-Lincoln   TBI Homepage

Occupational Therapists /  .....Physical Therapist Physical Impairments Caused by Traumatic Brain Injury Neuromotor.Impairments .... Functional Limitations aRigidity aSpasticity aHypotonicity aAtaxia aTremors aApraxia ..aPrevents active movements ..aPrevents good positioning ..aInterference with purposeful ..movements ..aInitiation of balanced muscle ..contraction for stability ..aLoss of trunk and extremity control ..aLimit gross motor ability ..aLimit accuracy in fine motor tasks ..aLimit spontaneous gross and fine ..motor movement of tasks Jaffe, Mastrilli, Molitro, & Valko, (1985), pp.170-1   Assessing Physical Deficits to Determine Appropriate Assistive Technology The OT or PT is responsible for identifying strengths and challenges of mobility, activities of daily living (ADL), and instrumental activities of daily living (IADL).  Many standardized and informal measures have been developed to measure these skills.  These tools can be used to gather information of functional mobility and daily living abilities.   Levels of Assessment Performance-Based  Functional Assessment Strategy Assessment Impairment Assessment Tests and Measures Gait Tests Three Minute Walk Test Dynamic Gait Index Tinetti Mobility Test Gait Strategies Movement Sensory Adaptive Strength tests Range of Motion tests Coordination tests Muscle tone tests Reflex tests Sensory tests Cognitive tests Balance Tests Functional Reach Test Tinetti Balance Test Ataxia Test Battery Balance Strategies Movement Sensory Adaptive ADL Tests Katz Index Functional Independence Measure Barthel Index Sit-to-Stand Strategies Movement Sensory Adaptive IADL Tests OARS Lawton Scale for Instrumental Activities of Daily Living (SIADL) Blanton, Porter, Smith, & Wolf (1999).  p. 223 Performance-Based functional measures are used to determine the patient's level of independence in daily life activities and are the foundation to develop functional goals during rehabilitation.  These include bathing, dressing, feeding, mobility, traveling capability, phone usage, housework, etc.  Strategy assessment includes how the person organizes sensory and perceptual information necessary to perform a task and how this changes under various conditions.  Impairment assessment identifies impairments that might affect functional movement skills.  These include strength, range of motion, coordination, muscle tone, reflexes, sensation, and cognition (Blanton, Porter, Smith, & Wolf, 1999,  p. 222).   Assistive Technology Intervention for Physical Impairments Following Traumatic Brain Injury Severe Physical Impairment Normalize tone Weight bearing Vestibular stimuli: rapid and intermediate or slow and rhythmical Position and neutral alignment Functional range of motion Rolling Sitting Splinting Serial casting Positioning devices Tilt table Functional mobility Sitting Rhythmic initiation Orientation to midline Elicit balance reactions Stability Weight bearing Tilt table Endurance Frequent sitting Prefeeding Upright sitting Anterior pelvic tilt Neck cocontraction Oral Stimulation Moderate Physical Impairment Normalize tone Weight bearing Inhibitory positioning Functional range of motion Splinting Serial casting Passive and active range of motion Heat application Stretching and strengthening exercises Functional mobility Segmental trunk activities Transfer and gait training Self-propulsion in wheelchair Stability Weight bearing  Shifting activities Facilitate posture control against gravity Endurance Increased time out of bed Use of arm and leg ergometers Prefeeding Elongation of neck extensors Positioning to normalize tone Touch or ice to lips Mobilization of jaw as needed Mild Physical Impairment Normalize tone Frenkel's exercises Neuromuscular facilitation with functional integration Functional range of motion Teach functional self-stretching activities Functional mobility Advanced wheelchair and gait mobility Perceptual motor training Community barrier training Higher-level balance training Stability Rhythmic stabilization Strengthening exercises Endurance Arm ergometer Bicycle and treadmill Aerobic activities Work specific activities Community outings Blanton, Porter, Smith, & Wolf, (1999),  p. 226-228 Survivors of TBI can be helped in many ways through assistive technology, such as electrical feeding devices, voice-activated environmental control units, vehicles with adaptive driving controls and lifts, and power wheelchairs propelled by slight head movements.  Examples of AT utilized to improve mobility are proper positioning in bed and wheelchair with the use of casts or splints, head rests to accommodate different levels of head control and upper extremity support, and the use of seating equipment to optimize stabilization and distal function for manual or power wheelchairs.  ADL assistive technology includes cooking, cleaning/storage, personal care, and safety/security aids.   AT System and Device Products and Manufacturers   To access websites, click on the blue diamond on the left. Theraproducts Positioning/seating Handwriting Scissors Fine motor Gross motor Daily living aids Evaluations Publications ABLEDATA Controls Home management Orthotics Personal care Prosthetics Seating Sensory disabilities Transportation Therapeutic aids Vocational management Walking Wheeled mobility CNS Familyworks Homemanagement equipment