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Occupational Therapy Innovations for the Neuro Patient

Occupational Therapy Innovations for the Neuro Patient. Saebo Stretch, Flex and Reach Presented by Sarah Sanderman , MOTR and Karen Hookstadt , OTR. UE Concerns Post Stroke. Only 50% of survivors are likely to regain some functional use of an UE

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Occupational Therapy Innovations for the Neuro Patient

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  1. Occupational Therapy Innovations for the Neuro Patient Saebo Stretch, Flex and Reach Presented by Sarah Sanderman, MOTR and Karen Hookstadt, OTR

  2. UE Concerns Post Stroke • Only 50% of survivors are likely to regain some functional use of an UE • Spasticity, primarily higher distally in an UE • Luxation, instability of joints • Atrophy • Muscle imbalance • Contracture

  3. Saebo StretchSaebo Flex / Reach • Saebo Stretch is a dynamic resting hand splint; a flexible splint with progressive inserts to increase force application based upon the presence of tone (Saebo) • Saebo Flex and Reach allow for integration of the arm and hand during functional activities • Promotes activities that require new learning; challenging and novel activities that promote brain rewiring • Addresess spasticity; defined as a velocity-dependent hyper-excitability of the muscle stretch reflex resulting in increased muscle tone (Saebo) • Trains a client in compensatory movement which speeds recovery • Allows a client to “turn off” their tone (flexors)

  4. Saebo Stretch • Dynamic hand piece • Strapping system that accommodates finger alignment and joints • Hand is not functional while in this splint. • Allows for movement with reactions and exertion.

  5. Saebo Stretch • A flexible splint with progressive inserts based on the client’s tone • Soft tissue shortening can start within 7 daysof incident • Saebo Stretch offers “low load, long duration” of impact – 6 to 8 hours per day • Typical result is a 5 – 7% increase in ROM

  6. Appropriate ClientsSaebo Stretch • Client must show: • 35° active wrist extension with MCPs, PIPs and DIPs in neutral • Should be able to tolerate splint for 6-8 hours • Pediatric sizes available

  7. Appropriate Clients Saebo Flex / Reach • Client must show a minimum of: • 15° active shoulder elevation • 15° active elbow flexion • ¼ range of active finger flexion • Full passive finger IP/MCP extension with the wrist passively extended to 15° (at minimum) and 35° optimally *If the client is an inpatient, there are no active shoulder or elbow movement requirements.

  8. Customized FittingSaebo Flex / Reach • Components include customized forearm shell, dorsal plate, digicaps and standard springs, mounts, bead lines and lead lines. • With the Saebo Flex, the client has free use of the elbow, the Saebo Reach assists with elbow extension.

  9. Prescribed ActivitiesRepetition is the key! • Clients should wear the device for two sessions totaling 45 minutes each per day • Prescribed activities with equipment include: • Crates and balls • Use of a height adjustable target (HAT) • Use of cylinders, PVC trees and pegs Functional activities include loading a dishwasher, placing items in a fridge, sweeping with a whisk broom, answering a phone, folding laundry.

  10. Video • Saebo Flex in use with a client.

  11. Availability • Insurance varies and may cover some of the cost of a device. • Currently Medicare covers the Saebo Reach only • To pay out of pocket for a device, the Saebo Reach is approximately $2000, Saebo Flex $1500, Saebo Stretch $300.

  12. Take Away Gems • These devices, although potentially expensive, have been proven to increase the function in a hand exhibiting a neurologically based deficit. • The Saebo Stretch is worn for long periods of time, during times of rest; the Saebo Flex and Reach are worn only during functional training with the device. • Devices may be trialed before purchase, contact an OT to recommend clients who may benefit from aggressive UE training after a neurological incident.

  13. Questions?References • Improving Upper Extremity Motor Recovery Following Neurological Injury, Saebo Course Manual 2012 • Photos courtesy of Google Images, 2012 • Video courtesy of Spalding Rehabilitation Hospital, 2012.

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