Treatment of motor dysfunction

♦ Patients are treated using multisensory cueing, coupled with cognitive cueing or mental rehearsal, and reinforcement of response.

♦ Patients and carers are instructed in auditory, visual, and tactile cues to facilitate movement.

♦ Relaxation techniques can be helpful in the treatment of rigidity.

♦ Stretching is used to decrease spasm, increase proprioceptive feedback, and increase active mobility.

♦ Use of rhythm has been associated with an increase in movement ease and fluidity.

♦ Coordination drills are practised to increase accuracy of fine motor skills and the speed of these movements.

♦ Grading of simultaneous physical activities can assist with integration of performance of more than one task at a time (e.g. walking and talking).

♦ For patients with dystonia, the 'Bly multisensory treatment approach' is used. This focuses on sensory discrimination retraining for 1-2 hr, twice per week in the clinic, supervised by an OT. It also requires an intensive 2 hr/day home exercise programme practising the techniques, plus 30 minutes/day of visualization of movement.

♦ Home exercise programmes are designed to optimize strength and range of motion as well as enable the patient to continue being active in their own care.

♦ Energy conservation and work simplification techniques are taught to help manage the fatigue and decreased endurance which result from movement disorders.

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