Nerve Damage Symptoms and Common OT Interventions

As salam.. just want to share some of my assignments as an OT students for degree.. :) I am still learning to be an OT, it is such a long journey to be face..insyaAllah.. :D

The nervous system has three primary functions. The Sensory System gathers information about the environment around the body and transmits it to the brain.  This would include touch, taste, or any of the five senses.  The Motor Nerves (Somatic) control the voluntary movements of the body such as walking or talking. The Autonomic Nerves control the involuntary actions of the body such as heartbeat, digestion, or adrenal release. Symptoms of nerve damage depend on this type of nerves. Damage to the nerves is also called neuropathy. Because of the complexity of this body system there are many possible problems that may occur with a myriad of symptoms.  These can range from the nuisance of having numbness in the end of a finger to a disabling injury to the spine.  Nerve damage may be the result of, or a symptom of, a number of diseases.  Listed below are some explanation about how nerve damage occurring in an individual.

            Autonomic nerve damage symptoms may include inability to sense chest pain, too much or too little sweating, dry eyes and mouth, bladder dysfunction and also sexual dysfunction. Motor nerve damage symptoms may include weakness, muscle atrophy, paralysis and twitching. Sensory nerve damage symptoms may include problems with positional awareness, hypersensitivity, tingling, numbness, and burning pain. Some may find walking difficult or have a hard time holding onto things.

            Firstly, nerve damage may occur because of compression or trauma. Anything that results in trauma or compression of nerves can result in nerve damage. This includes pinched nerves in the neck, crush injuries, and carpal tunnel syndrome. Secondly, diabetes. About 50% of people with diabetes suffer from nerve damage, which becomes more likely as the disease progresses. Diabetic neuropathy is a serious complication and may affect all three types of neurons. Sensory nerves are most often affected, causing burning or numbness. If someone have diabetes and are experiencing symptoms of nerve pain or nerve damage, they should consult a medical professional as soon as possible. Thirdly, nerve damage occurs because of motor neuron diseases. The motor neurons are nerves in the brain and spinal column that communicate with the muscles throughout your body. Diseases that affect these nerves, including paralysis, amyotrophic lateral sclerosis, also called ALS or Lou Gehrig's disease, can result in progressively worsening nerve damage. Nerve damage may also occur in alcoholic person.

            Common occupational therapy intervention procedures to relieve its symptoms are, Tendon-Gliding Exercises, Transcutaneous Electrical Nerve Stimulation (TENS) and Robot-Assisted Therapy. Tendon-Gliding exercises use to for patient who have Carpal tunnel syndrome (CTS). CTS is defined as the symptoms manifested when the median nerve, the major sensory and motor nerve of the hand, becomes compressed as it travels from the forearm to the hand through the carpal tunnel. Isolated tendon gliding exercises of the flexor digitorum superficialis and flexor digitorum profundus to each digit passing through the carpal tunnel has also shown to be effective in recent studies. The results of the study indicated a significant improvement in patients’ carpal tunnel symptoms when tendon-gliding exercises were performed in conjunction with traditional treatment. Each exercise series starts with the wrist and digits in full extension, then the digits are held in a hook grip, followed by a straight fist, followed by a full fist. These exercises are to be preformed five times each, five times daily.

            Sensory integration disorder or dysfunction (SID) is a neurological disorder that results from the brain's inability to integrate certain information received from the body's five basic sensory systems. The neurological disorganization resulting in SID occurs in three different ways: the brain does not receive messages due to a disconnection in the neuron cells; sensory messages are received inconsistently; or sensory messages are received consistently, but do not connect properly with other sensory messages. When the brain poorly processes sensory messages, inefficient motor, language, or emotional output is the result.

            Sensory integration disorder (SID) is treatable with occupational therapy, but some alternative methods are emerging to complement the conventional methods used for SID. Therapeutic body brushing is often used on children (not infants) who overreact to tactile stimulation. A specific non-scratching surgical brush is used to make firm, brisk movements over most of the body, especially the arms, legs, hands, back and soles of the feet. A technique of deep joint compression follows the brushing. Usually begun by an occupational therapist, the technique is taught to parents who need to complete the process for three to five minutes, six to eight times a day. The time needed for brushing is reduced as the child begins to respond more normally to touch. In order for this therapy to be effective, the correct brush and technique must be used.

            A report in 1998 indicated the use of cerebral electrical stimulation (CES) as being helpful to children with conditions such as moderate to severe autistic spectrum disorders, learning disabilities, and sensory integration dysfunction. CES is a modification of Transcutaneous Electrical Nerve Stimulation (TENS) technology that has been used to treat adults with various pain problems, including arthritis and carpal tunnel syndrome. TENS therapy uses a low voltage signal applied to the body through the skin with the goal of replacing painful impressions with a massage-like sensation. A much lower signal is used for CES than that used for traditional TENS, and the electrodes are placed on the scalp or ears. Occupational therapists who have studied the use of CES suggest that CES for children with SID can result in improved brain activity. The device is worn by children at home for 10 minutes at a time, twice per day.

Love Your Nerve

            Persons with stroke or paralysis are commonly provided rehabilitation by occupational therapists. Occupational therapy endeavors to restore the person’s independence in activities of daily living, skills in functional performance, infuse evidence based practice to assure that interventions are efficacious and cost effective. One of the treatments for these types of nerve damage is robotics. In robot-assisted therapy, movement of the entire extremity can be assisted simultaneously, as opposed to facilitation of one movement component at a time.  The patient initiates the movement; the movement is detected by Electromyography (EMG) electrodes which then trigger the robotic device to complete the movement, thereby providing sensory motor feedback to the patient. Robotics allow for simultaneous kinematic data collection, which substantially increases their value.  While robotic assisted movement therapy has shown “confirmed benefits” in the return of motor control in patients with both acute and chronic stroke, the cost is prohibitive in most research settings at this time.

P/s: I got this contents from various sources from internet, I didn't keep the link of the sources so readers should also think again before taking any from this entry.

Kuala Lumpur

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