(2) Historical Treatments Flashcards
What is NDT?
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
what is also known as the BOBATH concept
NDT
Techniques of NDT
Internal proprioceptive cues
External sensory feedback
Target the involved segment
Examples: hands on assistance, visual cues, verbal guidance
Rationale of NDT
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
therapy that Recognized we don’t move in cardinal planes, developed patterns that moved in diagonal and spiral paths
PNF
goal of PNF
improve developmental sequences, gait, transfers and self-care
rationale for PNF
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
PNF evidence?
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
Constraint Induced movement therapy GOAL
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
CIMT evidence
UE CMIT superior to other treatment for motor recovery but not disability
Mirror therapy
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
Mirror therapy helps with
motor control sensation, hemineglect,
needs investigations: ADLs and QOL
Robotics
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
robotics evidence
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
mental practice
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
