EL-2-16-01
THE ROLE OF DYNAMIC EMG, NERVE BLOCKS AND SURGERY IN THE MANAGEMENT OF UPPER EXTREMITY MOTOR IMPAIRMENT AFTER BRAIN INJURY
N. H. Mayer, M. A. Keenan, A. Esquenazi (MossRehab Hospital & Temple University, Philadelphia, PA, USA)
Abstract: Common central motor impairments seen after traumatic brain injury (TBI) include spastic hemi - tri - and tetraparesis, cerebellar-pathway incoordination (limb ataxia, truncal ataxia, hemiataxia) and combined upper motoneuron syndrome with contra- lateral ataxia ("brainstem syndrome"). In this session, we discuss the functional classification of such motor impairments as limbs with restricted motion versus limbs with excessive motion. When upper limb motion is restricted, patients lose active access to targets in the environment and/or caregivers lose passive access to body parts that need care. When upper limb motion is excessive, inaccuracy of movement, instability of posture and misapplied force affects the patient's active function. For cases of restricted motion, dynamic EMG may be used to identify whether weakness and/or dyssynergy of a given muscle contributes to restricted movement. EMG findings in common patterns of upper motoneuron dysfunction will be presented. Based on dynamic EMG information, the use of diagnostic nerve blocks and surgical interventions will also be presented to illustrate the concept of movement enhancement or unmasking. When upper limb motion is excessive, dynamic EMG is used to study proximal and distal muscle involvement. Therapeutic utility of this information will also be illustrated with case material.
S-2-12-01
COMMUNITY-BASED REHABILITATION PROGRAM IN VIETNAM
T.T. Nguyen, N.X. Nguyen (Rehabilitation Dept., Bach Mai Hospital, Hanoi, Vietnam)
The Community-based Rehabilitation Program (CBRP) was launched hi Vietnam in order to solve the disability issue effectively.
The CBRP has been integrated with the Primary Health Care Program and promoted and expanded by seminars and training courses through out the country.
The CBRP has reached 80% of disabled people who have demand for rehabilitation.
The CBRP has proved to be appropriate to Vietnam's economic and social condition.
