(2) Historical Treatments Flashcards

1
Q

What is NDT?

A

hands-on, client-centered approach that seeks to improve gross motor function by facilitating muscle activity through key points of control assisted by the therapist

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2
Q

what is also known as the BOBATH concept

A

NDT

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3
Q

Techniques of NDT

A

Internal proprioceptive cues
External sensory feedback
Target the involved segment
Examples: hands on assistance, visual cues, verbal guidance

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4
Q

Rationale of NDT

A

Initial rationale (top-down approach)
Repeated experiences in “correct” movement ensures that the pattern is readily accessible for motor performance

NO sufficient evidence that it is superior to other treatments

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5
Q

therapy that Recognized we don’t move in cardinal planes, developed patterns that moved in diagonal and spiral paths

A

PNF

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6
Q

goal of PNF

A

improve developmental sequences, gait, transfers and self-care

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7
Q

rationale for PNF

A

Use it or Lose it
Encourages movement of paretic limb/extremity
Use it & Improve it
Movement aids in reconnecting synapses and reinforcing weakened connections
Repetitions
More repetitions leads to improved coordination
Transference
Movement in functional patterns can transfer to daily activities

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8
Q

PNF evidence?

A

PNF is found to be a useful and effective treatment for stroke patients, with emphasis placed on early intervention leading to greater improvements in the long-term
Improvements seen in ADLs, gait, functional activities & QOL

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9
Q

Constraint Induced movement therapy GOAL

A

Goal: to prevent and reverse learned non-use by increasing the amount that the affected limb is used for functional tasks and everyday life
Three Principles:
Restrain the unaffected arm (with a sling, mitt or hand splint)
Forced use of the affected limb
Massed practice (several hours of exercise) of the affected limb

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10
Q

CIMT evidence

A

UE CMIT superior to other treatment for motor recovery but not disability

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11
Q

Mirror therapy

A

mental practice, external feedback (helps brain know how to use affected limb better) helps trick the brain activating m neurons and motor learning

thought to activate superior temporal gyrus leading to increased self-awareness and spatial attention, attention, sensory feedback and use of limb

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12
Q

Mirror therapy helps with

A

motor control sensation, hemineglect,
needs investigations: ADLs and QOL

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13
Q

Robotics

A

Wearable device to improve physical performance
Transfers the weight of limbs to core to help patient coordinate movement
Reduces the stress on joints and muscles
introduced in neuro to help train muscle movements and assist in correcting gait patterns for more functional movement

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14
Q

robotics evidence

A

Robotics used in treatment early on can be helpful for patients who are experiencing subacute stroke.
All techniques were helpful. Self selected velocity and maximal velocity increased in all forms of training. The Lokomat required less staff comparatively.
Research positively improves balance methods in people with stroke

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15
Q

mental practice

A

rehearsal of a task in which the movement is imagined but not executed
2 types:
Imagining the feeling that is associated with the movement
Visualizing actually performing the movement

to help motor performance

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16
Q

mental practice

A

Repetition is just as important
Mental practice does not equal physical practice

incorporate audio/video, encourage pts to practice relaxation
Ideal after neurological injury

17
Q

mental practice evidence

A

Combining therapy with mental practice improved corticospinal excitability, upper limb function, and performance in daily activities

mental imagery may be beneficial, especially because it is safe and cost-effective

does not improve motor function and functional mobility after stroke; evidence was insufficient/inconclusive (this was compared to other therapies)

18
Q

VR evidence

A

Locomotor CPG on VR
Clinicians should perform VR walking training
Clinicians may consider balance training with VR
VR interventions on stroke patients also effectively improve:
upper- and lower-limb motor function
ADL’s daily function
VR interventions on stroke patients do not improve:
cognition

19
Q

what phases should you use NMES, FES, TENS

A

NMES: (acute phase)
Muscle re-education/improve motor control & prevent muscle atrophy
FES: (sub-acute/chronic phase)
Functional activities such as grasping and walking
TENS: (acute phase)
Reduces post-stroke/TBI pain

20
Q

NMES and FES are helpful for

A

NMES can help with maintaining muscle tone, improving voluntary movement, and strengthening brain-muscle connection
-FES can compensate for voluntary motion

21
Q

E stim evidence for CVA

A

ESTIM w/o muscle contraction can improve LE muscle function & functional mobility
TENS can significantly reduce spasticity, improve static balance & walking speed, but not associated w/ improvements in dynamic balance