11/13 HD, rare conditions, neuroplasticity Flashcards
what is neuroplasticity? is it good or bad? what drives neuroplasticity?
Ability of neurons to change function, chemical profile, or structure. Can be adaptive or maladaptive. Driven by the genetic code, experience, injury.
What are the features of neuroplasticity in Adults?
Injury induced reorganization and recovery of function can occur in adults. Ongoing in normal activity and learning.
What is Diaschisis ?
A localized injury creating disruption of a pattern of brain activity.
What can be used to help reduce or eliminate a diaschisis caused by injury?
behavioral therapy (forced use)
review: what are basic components of the nervous system?
10% neurons, 90% glia. Astrocytes.
Oligodendrocytes & Schwann cells. Microglia.
Review: what are basic parts of a neuron and how do they work with neuroplasticity?
Soma. Dendrites: Spines as a site for plasticity to occur. Axons: Presynaptic terminal as a site for plasticity to occur.
What is Synaptogenesis?
Formation of new synapses, not new blood supply: Axonal sprouting and regeneration. Dendritic sprouting. Dendritic spine alterations. A normal process w/ synaptic pruining.
what happens in neurogenisis?
Neural stem cells develop
What is angiogenesis?
Blood vessel proliferation. Correlates with amount of neurogenesis. Serves as supporting pathway for new neuron migration.
important concepts in neuro-rehabilitation
use behavioral training techniques, activate the excitatory system, limit inhibitory system (learned non-use). introduce the right functional activity at the right time to enhance cortical reorganization.
what are the guidelines for rehabilitation of a paretic hand post CVA?
Training of the hand should begin early, include sensory stimulation, move toward complexity of motor task. Early intervention may prevent painful shoulder, spasticity and reduce neglect.
What does FITT stand for in neuro rehab?
Frequencty, Intensity, Time, Type.
What are the FITT guidelines for LE rehab?
Frequency: 2-5 times per week for 4 weeks. Intensity: highest tolerable speed (80-85% predicted HR max, RPE 17). Time: 45 minutes. Type: Treadmill
(Rule of thumb: gait speed <.2 m/s, 40% BWS may be helpful)
What are FITT guidelines for UE rehab?
Frequency: 3 times per week for 6 weeks
Intensity: >/= 300 repetitions per session
Time: 60 minutes
Type: supervised, massed practice of functional daily tasks.
Graded and progressed for each participant
Included reaching, grasping, moving/ manipulating, releasing objects.
What are the benefits of using robotics in neuro rehab?
Robotics allow benefits from repetitive motion.
Provide sensorimotor stimulation.
Consistent and reproducible practice.
Objective quantification
What are 8 intervention principles in neuo rehab?
Use it or lose it. Use it and improve it. Specificity, Repetition, Intensity, Timing, Salience, and Age all matter.
give an example of a patient for whom neuro rehab principles may not apply?
Someone with MS and a blunted response to exercise would not work for this person.
name 4 rare infectious disorders of the nervous system.
Meningitis, Encephalitis, Brain Abscess, Prion Disease.
What are 3 categories of neoplasms that, in rare cases, affect the nervous system?
Primary tumors
Secondary tumors
Paraneoplastic syndromes
what is meningitis?
The meninges of the brain and spinal cord become inflamed. Across the BBB (blood brain barrier so immune system not effective).
what are the cardinal signs of meningitis?
Headache, fever, stiff and painful neck. (from Fuller text –>) Often pain in lumbar area and posterior thigh. If infection affects brainstem centers than can see seizures, coma, vomiting, papilledema, cranial nerve palsies, and deafness.
What are some clinical tests for meningitis? (from Fuller text, not on slides)
Kernig’s sign: pain with combined hip flexion and knee extension in supine (like a hamstring length test). Brudzinski’s sign: flexion of the neck in supine causes flexion of hips and knees b/c of pain.