(1) Mvmt System Dx Flashcards
what are the 7 benefits to using the mvmt system dx?
- facilitate recognition of PT as a doctoring profession with mvmt expertise
- clarify treatment
- reduce variability/increase efficiency in practice
- aid in defining effective treatment strategies
- consistent terminology
- reduce documentation burden
- more cost effective
what are the 6 core tasks
- sitting
- standing
- STS
- step up/down
- walking
- reaching/grabbing/manipulating
what are the 8 Neuromuscular Mvmt System Dx?
- mvmt pattern coordination deficit
- force production deficit
- fractionated mvmt deficit
- postural vertical deficit
- sensory selection and weighting deficit
- sensory detection deficit
- dysmetria
- hypokinesia
what is the key impairment in MPCD
mild coordination deficit - deficits in timing and sequencing
which NM mvmt system dx has and inability to coordinate and inter-segmental task because of a deficit in timing and sequencing of one segment in relationship to another
MPCD
what is the typical medical dx for pts with MPCD
varied but tends to be higher level of function
the following key tests and signs are used for what mvmt system dx?
- postural responses poor or slow
- timing of mvmt is issue
MPCD
what is the intervention strategy for MPCD
- increased limb use and mvmt speed/amplitude
- refine mvmt strategies
you have a pt that is climbing stairs, and they are unable to lift their foot up onto the step. However, after some practice and some cueing about lifting the leg higher, they are successfully completing the task. What mvmt system dx is this?
MPCD
what mvmt system dx: performance improves with practice / instruction
MPCD
what is the typical outcome for a pt with MPCD
good/favorable
What mvmt system dx is being described:
- little/no m weakness
- generally fractionated mvmt
- no to mild spasticity
- no to mild sensory loss
- no to mild non-equilibrium coordination deficits
- inappropriate amplitude of mvmt affecting balance
MPCD
what score will a pt with MPCD have on the modified ashworth scale?
0-2
what is the key impairment for force production deficit
weakness
what medical dx are common with FPD
CNS or PNS lesion
what are the key tests and signs in a pt with FPD
- strength testing < 3+ OR
- can’t move thru full ROM OR
- deterioration with m fatigue
what are the focus interventions for pts with FPD
- resistance training
- limb protection
- short term or long term compensation
what is the outcome for pts with FPD
good or poor
what mvmt system dx is being described:
- fractionated mvmt may be difficult
- normal to mildly altered tone
- normal to mildly impaired sensation
- coordination bay be unable to test OR slow but accurate
- possible need for supportive structures
FPD
what is the key impairment for sensory detection deficit?
lack of joint position sense or multi-sensory failure
what medical dx are often associated with sensory detection deficit
- those that affect JPS, vision, bilateral, vestibular loss
THe following are some key tests and signs for what mvmt system dx?
- decreased light touch/proprioception
- trouble with timing STS
- wide based gait
- difficulty in low light/eyes closed/uneven situations
sensory detection deficit
what is the intervention focus for sensory detection deficit
compensatory and adaptive strategies
what is the outcome for pts with sensory detection deficit
variable but often poor
the following associated signs are common with what mvmt system dx?
- poor timing and coordination mvmt
- slow and clumsy
- some improvement with visual guidance
sensory detection deficit
what is the key impairment in sensory selection and weighting deficit
decreased ability to screen and attend to appropriate sensory input
the following are associated with what mvmt system dx?
- difficulty maintaining postural orientation
- positional instability
- complain of dizziness and/or visual motion sensitivity
sensory selection and weighting deificit
what medical dx are common with sensory selection and weighting deficit
vestibular deficits
dizziness, visual sensitivity, spinning, vertigo, sensory avoidance, unsteadiness, stroke, MS, TBI, Etc.
the following are key tests and signs of what mvmt system dx?
- increased sway
- greater instability with head mvmts
- rely heavily on hip strategies
- symptoms with smooth pursuits and saccades
sensory selection and weighting
what is the intervention focus for pts with sensory selection and weighting deficit?
- stability tasks in simple /complex environments
- head turns
- desensitization to visual flow info
what is the outcome for sensory selection and weighting deficit
good - usually ambulate well with no or mild deficits
the following are signs associated with what mvmt system dx?
- mvmt is fractionated and non-equilibrium coordination is intact
- may have + vestibular tests
- gaze aversion
- self stim behaviors
sensory selection and weighting
what is the key impairment of postural vertical deficit
inaccurate perception of vertical orientation w/ resistance of correction of COM alignment
what is the common medical dx associated with postural vertical deficit
stroke
what are the common key tests and signs for postural vertical deficits
- resistance to correction
- may have neglect
what is the intervention focus for postural vertical deficit
- teach awareness of true vertical
- increase awareness of involved side
- COM over BOS
what is the outcome for postural vertical deficit
variable - based on severity of cognitive/behavioral deficits
the following are signs associated with what mvmt system dx?
- volitional mvmt is variable
- may have motor planning difficulty
- sensation may be lacking (LT and JPS)
- behavior may be impulsive or fear avoidant
- judgement = possibly poor or fear avoidance
postural vertical
what is the key impairment for pts with Fractionated mvmt deficit
- inability to fractionate mvmt
- moderate or greater hyperexcitability
what medical dx is associated with FMD
ALWAYS CNS (stroke, TBI, etc.)
what are some key tests and signs associated with FMD
- non-fractionated mvmt during functional tasks
- dominated by synergy mvmt patterns
- unable to make rapid reversals in mvmt
- stiff gait
what score on the Modified Ashworth scale will a pt with FMD demonstrate?
3-4
what is the intervention focus for pts with FMD
- maximize speed and endurance, and timing and amplitude of postural responses
- pain free ROM
what is the outcome for pts with FMD
Poor - depends on amt of antigravity strength
the following signs are associated with what condition?
- associated reaction seen with effort
- lacks dissociation of m groups during activities
- compensatory gait signs
* stiffness of gait
FMD
the following are signs associated with what mvmt system dx?
- scissoring
- assistive devices and AFO commonly needed
- reach is limited, minimal hand mvmt in grasp
- asymmetrical postural control is frequent
FMD
what is the key impairment in DYsmetria
inability to grade forces appropriately for distance and speed of task
what medical dx are commonly associated with dysmetria
most commonly associated with cerebellar dysfunction
the following are key signs and tests associated with what mvmt system dx?
- overshoot with walk and reach
- poor termination phase of mvmt
- impaired non-equilibrium coordination
dysmetria
what is the intervention focus for pts with dysmetria
- simplify mvmts / reduce degrees of freedom
- assistive devices
- weighted vest
what is the outcome like for pts with dysmetria
variable with compensation
the following signs are associated with pts of what mvmt system dx?
- often need UE support to sit safely
- wide BOS / high guard
- variable foot placement and overshooting
- generally require assistance
dysmetria
what is the key impairment in hypokinesia
- slowness in initiating and executing mvmt
what medical dx is often associated with hypokinesia
Parkinson’s Disease
- can also be stoke involving BG
the following signs and tests are seen in pts with what mvmt system dx?
- trouble initiating OR slow mvmt
- lose balance backwards/retropulsion
- rigid with passive mvmts
hypokinesi
what is the intervention focus for pts with hypokinesia
- improve mvmt speed and amplitude
- improve coordination and postural responses
what is the outcome like for pts with hypokinesia
variable with compensation but generally poor
the following signs are associated with what mvmt system dx?
- rigidity
- non-equilibrium coordination –> undershoots target, slow reciprocal mvmts
- peds –> delayed integration of early primitive reflexes
hypokinesia
