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Self-feed techniques

ALISON

Posted: Thursday, April 10, 2008 4:40 PM

Joined: 3/31/2008
Posts: 50

Does anyone know a good intervention for a client with Parkinson's, has intention tremors, and is having difficulty with grasp, as well as, hand to mouth coordination?

JennaB08

Posted: Sunday, April 13, 2008 8:07 PM

Joined: 4/10/2008
Posts: 5

you may have thought of these...but just in case....have you tried weights on his wrists, or weighted silver ware? sometimes the weight helps decrease the intention tremors. Just a thought.

wvuot2009

Posted: Thursday, April 17, 2008 3:51 PM

Joined: 4/10/2008
Posts: 3

I was going to suggest weighted silverware or wrist weights as well. If he is having trouble with grasp I'd slap some built up foam on the silverware or use adapted silverware so that he is able to hold it. There are some built up foams that are already weighted. I don't know how bad his grasp is, but you could try that.

Zena

Posted: Thursday, April 17, 2008 9:45 PM

Joined: 4/11/2008
Posts: 1

I would try wrist weights vs weights utensils so he doesnt drop them. I would also try a u-cuff to eliminate difficulties with grasp. Also double check positioning during feeding. Make sure his shoulder girdle is stable and he has proper elbow support to allow him to isolate elbow flex/ext. Alot of my patients have a tendency to lean forward to bring the mouth closer to the plate and I notice an increase in tremors when the shoulder girdle isn't stabilized. Let us know what happens

Kimberly09

Posted: Thursday, May 08, 2008 11:42 AM

Joined: 5/8/2008
Posts: 2

I am a 2nd year OT student, and last semester I actually did a case study presentation on PD. One of our treatment activities we demonstrated was feeding, and we initially suggested weighted utensils. Here's what I learned from my professor....There is actually no evidence showing weighted utinsils are effective for this population. The key is proximal stability for distal mobility! Zena's comment about positioning is key. My professor suggested elevating the eating surface or setting the plate on a foam block or something several inches above the table. This would enable the client to be able to weight bear on their elbow increasing proprioceptive feedback and proximal stability. She also suggested a weighted plate and angled utinsils to minimize distal movements needed for successful self-feeding. I hope this helps a little!!!

mhornmandiola

Posted: Wednesday, May 21, 2008 1:38 PM

Joined: 5/8/2008
Posts: 1

Hi! Besides the weights and grasp devices, you might want to try elevating elbow or providing an arm support for stability. It can help with scooping and taking spoon to mouth actions.

marcelle

KMKEP

Posted: Thursday, May 22, 2008 8:30 AM

Joined: 5/22/2008
Posts: 4

maybe you should do a study on weighted utensils... they are helpful when you cannot get the positioning you desire... we could always use more research to support what interventions we are using.

NeuroOT

Posted: Sunday, August 03, 2008 1:16 PM

Joined: 8/3/2008
Posts: 7

I agree with proximal stability. Take away the degrees of freedom as much as possible. Another key element is graded task practice: finger foods-->Easy to manage with a fork foods-->Easy to eat with a spoon foods-->Cutting meat-->Eating soup. Etc Etc. Good old task practice is an essential part of the rehab. Easy enough but effective!

lindseyann

Posted: Monday, January 12, 2009 12:38 PM

Joined: 11/12/2008
Posts: 1

Kimberly09

Hi Kimberly, I was wondering if you had the research articles on the effectiveness of weighted utensils; I would be interested in looking at them. Was your professor saying they hadn't been proven for use with only clients with Parkinson's or for all types of clients. I am in a pediatrics setting and am wondering if you or your professor were aware of research on weighted utensils for children. Thanks!

cfota

Posted: Saturday, June 20, 2009 10:25 AM

Joined: 10/15/2008
Posts: 7

i know that this is an older topic, but what has worked with my son who has CP and a few of my patients is to find cheap silverware with plastic (white, green, black) built up handles. usually found in a bundle at walmart, dollar stores. they can be bent to an angle specificaly for each pt. whether left or right handed. if needed you can use straps or red tubing to decrease grip difficulties. From my experience, the built up handled utinsels from catalogs are too bulky and big for most people to use.

jwyoung

Posted: Monday, October 05, 2009 6:42 PM

Joined: 10/5/2009
Posts: 1

Try using a builted up grip/weighted spoon and fork. Also use the hand over hand tech for feeding repetition and verbal cueing in key. Good luck!!!

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