trick movements in wrist drop ?

[marieangie]

hi friends ,what trick movements can v give the patient with saturday night palsy......n what type of PNF PATTERNS ?

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[emad]

Hello Marie:

Seems you have a case of Radial Nerve injury . It is better to give us more markers /data regarding the patient such as time of incidence , investigations performed ....As well, I do NOT know what do you mean by trick movements ?
Do you think there is research /evidence supports efficacy of PNF in a case of nerve injury ?

Cheers
Emad

[marieangie]

this is case of injection injury 5 months back patient's age is 75yr,n EMG shows fibrillation potentials of +3 grade n +1 for extensors , n some abnormal voluntary potentials ,mean pt is in good condition ,but patient is not changing in his grades of MMT which is G1 at present ,he is my long relative .
trick movements r used 4 replacing original movts ,but i want to know properly what they r?

n PNF...........dear there are several evidences .........

[emad]

Well , Let me say at the moment I am not up-to-date , because I do NOT know something called trick movments as therapy for nerve injury . All what I found regarding trick movments are articles or researches from 1970s regarding invoulntary motions in nerve injuries as flicker contractions .Attached with this post a PDF article regarding ticks/tricks motions .Trick movments.pdf


Just , I like to know what have you applied for that patient ? Then I will suggest ..........

Cheers
Emad

[marieangie]

i provided patient with the galvanic stimulator after sd curvation,MHP for contractures,passive stretching ,passive mobilisation,glidings,PNF flexion patterns,b little bit of massage.
splints ,roll ball,active move n many more cares 4 HET,what do u say?

[marieangie]

one more thing thanx 4 article .

[emad]

You are welcomed .

Emad

[emad]

Well , I do believe what are using to address that case is NOT up-to-date ..Are there still physiotherapists on the Earth usaing Galvanic stimulation ?
I believe strenghtening active ex are good.
Emad

[marieangie]

so i m ,using galvanic or direct interuppted current is not a sin .when person does'nt show response to faradic current ,what's negotiation using stimulation ...............

[sdkashif]

EMG shows fibrillation potentials

Fibrillation indicates denervation of the muscle. It indicates the state of paralysis. What about the results of his nerve conduction studies both motor and sensory for radial nerve paralysis. Moreover, perform the sensory, motor neurological examination for his upper limb. Note the strength of muscles around wrist and elbows and see whether it is distal or proximal nerve paralysis.

Why do you want to prefer traditional physiotherapy measures over the other methods. Is there efficacy of other methods over the traditional physiotherapy measures? Movements are good whether they are trick or passive; but the basic idea is to preserve the joint range and muscle elastibility due to prolonged disuse. Regarding the use of electrical stimulation in the cases of nerve paralysis, there is still recommendation in the electrotherapy books. I don't think what an individual opinion of therapist irrespect of any reference have any importance but see what the books or references say regarding that. Some times there is lack of evidence based studies over a particular nerve paralysis and the physiotherapy methods; so that could be reason that you may not get enough support from the evidence based studies data.

So ROM exercises, IDC, massage and splinting is good to continue.

Kindly provide more detail of your clinical examination of your patient.

[emad]

Muscle and joint are not key within this case managment .Just we have a nerve problem ...The nerve has priority and its blood supply has equal priority .
Avoidance of what causing more nerve comperssion /tensioning is inportant whatever electrotherapy applied ....mantinaing good neural mobility is the basic factor ..not joint or muscle mobility or elasticity ...So that I can say it in a confident manner splints have no role .

Time is enough for regeneration process ...but the point is our role should NOT cause mis-wiring !!!

sorry If my views seems odd, it is just my last post within this thread ... I will read only .....

cheers
Emad

[marieangie]

NCV shows 2.5 amplitude for 16 cm of motor studies......with 5 of latency for extensor indicis ,

n sensations r normal for first and second web space same for 16cm with no latency.

n provided all of my efforts ,but patient din recovered in his grades of MMT .only his contractures were overcome ,that know is not enough for patient.

[marieangie]

n thanx mr EMAD for ur precioussssssss................views