11 NEURO IN PRACTICE

Question 1

COORDINATION

Answer 1

Ability to execute smooth, accurate, controlled movements.
Dependent on an intact and functioning nervous system.

Must be able to be reversed easily.
Must be able to be stopped easily.
Learned with repetition.
Required for all activities of daily living.

Question 2

COORDINATION TESTS (5)

Answer 2

Finger to Nose Test.
Alternating Pronation/Supination. (RAM: Rapid Alternating Movements)
Foot Tapping. (RAM)
Heel to Shin. (More advanced test)
Catching or Throwing.

Question 3

MUSCLE TONE

Answer 3

Hypertonia or hypotonia.
Spasticity.
Rigidity.
Normal.
Flaccidity.
Clonus.

Question 4

HOW TO TEST TONE (3)

Answer 4

Observation.

ROM Tests:
Move joint both slowly & quickly:
Degree of resistance.
Length of resistance.

Clonus Tests:
Quick stretch to muscle.

Question 5

MODIFIED ASHWORTH SCALE FOR SPACISTICITY

Answer 5

0: No increase in muscle tone.
1: Slight increase in muscle tone, minimal catch.
1+: Slight increase in muscle tone, minimal catch, followed by resistance throughout the movement.
2: More increased muscle tone through most of ROM.
3: Increased muscle tone, passive movement is difficult.
4: Affected parts rigid in flexion or extension. (in any opposite movements)

Question 6

OBLIGATORY SYNERGY PATTERNS

Answer 6

Flexion Synergy.
Extension Synergy.

Question 7

HEMIPLEGIA

Answer 7

One side of the body.

Question 8

MONOPLEGIA

Answer 8

One limb.

Question 9

PARAPLEGIA/DIPLEGIA

Answer 9

Both legs.

Question 10

QUADRIPLEGIA

Answer 10

All 4 limbs.

Question 11

SCI ACUTE CONSIDERATIONS (3)

Answer 11

Spinal Shock: do not mistake spinal shock resolution with increased potential of recovery.

Heterotopic Ossification: formation of bone outside the skeletal system.

Pressure Ulcers: calcaneus, occipital, and sacral regions.

Question 12

SCI SUB-ACUTE CONSIDERATIONS (6)

Answer 12

Functional Training: sitting tolerance/balance, Bed mobility, Transfers, W/C skills, Ambulation.
ROM & Strength.

Respiratory Management: assisted coughing, Incentive spirometers, positioning.

Pressure-Relief Techniques: push up, Leaning side-to-side, Leaning forward.

Muscle Substitution: distal fixation.

Angular Momentum: rolling over, transfers.

Head-Hips Relationship: head goes one way, hips go the opposite way.

Question 13

SCI LONG-TERM CONSIDERATIONS (3)

Answer 13

Osteoporosis: affects majority of individuals with SCI. Fall prevention and education.

Cardiovascular Disease: the leading cause of mortality after 1st year.

Wheelchair propulsion strategies: long smooth strokes, ergonomic rim.

Question 14

STROKE CONSIDERATIONS (5)

Answer 14

Assessment: may not be able to isolate muscle groups.

Shoulder: should not be passively moved beyond 90 degrees.

Neglect Syndromes: awareness of patient and clinician positioning.

Management of Tone: weight-bearing helps with controlled contraction.

RIPE: Repetitions, Intensity, Promise (level of success), Error (grading).

Question 15

STROKE TREATMENT APPROACHES

Answer 15

Mental Imagery.
Electrical Stimulation (EMS)
Sensory Stimulation (TENS)
Mirror Therapy.
Graded Repetitive Arm Supplementary Program (GRASP).
Constraint Induced Movement Therapy (CIMT).

Question 16

CEREBRAL PALSY

Answer 16

Abnormal muscle tone.
Poor selective motor control.
Poor postural control.
Poor coordination.
Muscle contractures.
Muscle weakness.

Question 17

GMFCS

Answer 17

Gross Motor Function Classification System.

Level 1: walks without limitations.
Level 2: walks with limitations.
Level 3: walks with a handheld mobility device.
Level 4: some self-initiated mobility.
Level 5: transported in a manual wheelchair.

Question 18

PEDIATRIC CONSIDERATIONS

Answer 18

Hip displacement/dysplasia.
Spasticity management.
Contracture management.
Carrying and handling techniques.
Focus on age-related functional milestones.
Parent involvement for home activities.
Positioning.

Question 19

RESTING HR IN CHILDREN

Answer 19

Less than 1 year: 110-160 beats/min.
1-2 years: 100-150 beats/min.
2-5 years: 95-120 beats/min.
5-12 years: 80-100 beats/min.
More than 12 years: 60-100 beats/min.

Question 20

PLAY-BASED LEARNING

Answer 20

Balance.
Turn-taking.
Core Strength.
Lower Extremity Strength.
Fine Motor Skills.

Question 21

NEUROREHABILITATION TREATMENT APPROACHES

Answer 21

Aimed at improving function.
Utilizes all aspects of therapeutic exercise.
All approaches dependent on stimulating an ‘impaired’ system .