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Action Plan for IELTS is a short, self-study guide for students about to take the IELTS test. Bli forst att betygsatta och recensera boken Action Plan for IELTS Self-study Student's Book General Training Module. Virtually all parts of the brain participate directly and indirectly in the control of purposeful movement. Inability to generate muscle contractions with high intensities necessary to produce fast movement. Normal motor function will not be possible in the presence of muscle contracture as the adaptations that take place have an adverse effect on both the passive and active properties of the muscle. Picture 1(a) (above) Development of severe contractures of both feet may cause pressure areas and skin breakdown, pain and joint dislocations.
Picture 1(b) (above): Loss of range makes maintaining the hygiene of the hand very difficult and can lead to breakdown of the skin in the palm of the hand. Tone refers to the resistance of a muscle when it is being passively stretched or lengthened. Reduced co-ordination may be seen as the inability to selectively isolate the action of muscles within the overall synergy of movement.
Video 3 (Above)  Ataxic movements can be seen with the difficulties in reaching and manipulation of small objects.
Apraxia is defined as an inability to perform a goal directed movement which cannot be explained by weakness, incoordination, sensory loss or an inability to understand commands.
Ideational apraxia – where there is a conceptual problem and they do not know what to do.
Tremors are involuntary movements characterised by rhythmic oscillations of a joint or limb. Training to improve a task needs to involve practicing components of that specific task as well as the whole task. Some individuals have difficulty moving around in bed, as well as getting in and out of bed. Once in sidelying, provide prompts or assistance in getting the individual to push through their arms into a sitting position.
Ensure the individual is safe sitting on the edge of the bed, by providing supervision or hands on assistance to ensure their safety. Being aware of safe manual handling techniques and good back posture when providing manual assistance.
Video 4: (above) Demonstration from moving from lying down to sitting on the edge of the bed.
Weakness down one side of the body (hemiparesis) may result in reduced weight bearing through the affected leg, reduced knee extension and leaning to the weaker side. Establishing the number of repetitions of the exercises that will be performed during each session. A client who presents with a hemiparesis may require ongoing walking retraining to improve the quality of their movements. Establishing the distance in which you are going to walk and ensuring there is somewhere to sit down if need be. Similarly, a client who presents with an ataxic gait may benefit from walking practice to increase distance and endurance as well as the quality of their movement.

Anger management problems can stem from the brain injury itself, as well as from problems with reduced self-control, impulsivity and lowered frustration tolerance. The following changes are often used as guideposts to alert a person that they are becoming angry.
In thinking about how people with TBI can change from being calm to being angry or aggressive it is useful to think about triggers and responses (both pre-injury and post-injury).
Anger can be a secondary feeling and so it is important to ask the question: was there a primary feeling? In any difficult situation it is important to maintain focus on the problem not the behaviour.
Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Closed head injuries can also be caused by a blow to the head but the skull remains intact. This can be caused by a blow to the head where the skull is fractured (broken) and the dura (brain coverings) are torn, exposing the brain.
Penetrating injuries - when an object penetrates the skull, causing injury to the brain. For both of these types of mechanisms there are two types of injury that can result - primary injuries and secondary injuries. For example, if a car hits a tree, the car suddenly stops. A blow to the head can cause injury on opposite side of the brain to where the impact was as the brain bounces backwards (a contra-coup injury), commonly this damages the frontal and occipital lobes.
The brain exits the skull through a hole at the base of the skull and becomes the spinal cord. During a penetrating head injury the primary injury is to the area of brain damaged by the penetrating object. The brain can swell, either from a blood clot or swelling of the blood tissue (oedema). Rapid retrieval and skilled early management can minimise secondary damage.
People who sustain a brain injury may present with one of the types of problems listed below, but more commonly they have a mixture of these presentations. This may be dependent on whether the limb has to be moved against gravity, for example, but can also depend on other factors such as motivation, behaviour and cognition.
Severe contractures also cause significant pain when attempting to move the fingers for cleaning. The primary feature of ataxia is that movements are poorly controlled and inaccurate with abnormalities in rate, range and force of movement. This is essential to training as postural adjustments required to maintain balance while performing a task are specific to that task. Specific exercises can be given by a qualified physiotherapist to assist the individual in becoming more independent in this task.
Exercises may be prescribed by the physiotherapist to increase the loading of the weaker leg so that there is more even weight bearing when standing.
Improved quality of walking can result in reduced energy exenditure for the client, improved strength and thus an ability to walk for longer periods.

The above strategies would be useful in ensuring walking practice can occur in a safe environment for both the client and the carer. The brain within the skull still has forward momentum and can hit the inner surface of the skull (which has bony edges) with some force, thereby causing bruising, lacerations and bleeding. During a TBI incident the brain can begin to swell from injuries, which causes it to be pressed down into this hole in the skull. The remainder of the brain is usually not damaged unless it is from from secondary injury complications. This is especially important in preventing death and limiting disability. It gives students a last-minute action plan, providing examples, mini practice tasks and strategies to maximise their band score in the test. At the root of this disorder seems to be fundamental problems in predictive timing and modulation of motor output. When given a hammer, they do not know what to do with it, but may be able to identify it verbally. Each individual will have a specific programme designed to meet their needs and prescription of exercises will be based around the missing or altered essential components of the task. It should be noted however, that an ataxic gait is less predictable and as such requires extra vigilance when supervising walking practice. For example, the physiotherapist may prescribe some lower limb strengthening exercises for a person with a hemiparesis who is unable to sufficiently take weight through their affected leg. Prescription of such items is a clinical decision based upon ensuring the safety of the client as well as enabling independence. Secondary injuries are complications that can arise from primary injuries after the accident and lead to further brain damage. In addition, the twisting motions that typically accompany such accidents mean that the bundles of nerve fibres can be stretched or shear (this is called diffuse axonal injury).
This can damage the brain stem and is extremely life threatening, because the brain stem controls the basic vital functions (e.g. These exercises may be presented in an exercise book which the carer can use with the client to facilitate practice and monitor progress.
If a carer has concerns regarding the use of any aids, it is important that these are raised with the treating physiotherapist.
The term closed head injury is also used to describe this type of TBI, because the damage to the brain occurs as the result of these internal mechanisms, but with the skull remaining intact. This type of injury can't be seen on early CT scans, but often shows up later as areas of brain that are missing (atrophy). The carer may also be required to ensure that the device is maintained in good condition and that no secondary complications arise from its use. This may involve monitoring of the skin integrity to ensure there is no breakdown as a result of wearing an orthoses.

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