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Adult Neuro > 6- Stroke Research and Motor Learning > Flashcards

6- Stroke Research and Motor Learning Flashcards

1
Q

What are some predictors of poor functional recovery when it comes to stroke?

A
  • extent and depth of the stroke
  • previous stroke
  • older age
  • incontinence
  • visuo-spatial deficits (esp neglect)
  • poor sensation
  • delay in hospital admission 1st in 6th months
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2
Q

What are some factors that DON’T predict functional recovery?

A
  • hemisphere affected
  • severity of hemiparesis at admission
  • gender
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3
Q

Most motor recovery occurs within the 1st ___ post CVA

A

6 months

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4
Q

What does severe spasticity and flaccidity affect?

A

Poorer ambulation recovery

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5
Q

What is the most important muscle for functional ambulation?

A

Rectus femoris

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6
Q

When is hand motor recovery poor?

A
  • initial complete paralysis at onset

- no measurable grip strength at 1 month

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7
Q

_____% of pts with some function in 1st month have good motor recovery (Esp finger extension)

A

70%

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8
Q

When does rehab work best for stroke?

A

Better the earlier it starts, the more intense it is, the more task specific it is, when delivered by multidiscipinary teams, and with the engagement and motivation of the patient

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9
Q

What is evidence based in the evaluation of stroke?

A

standardized tools and regular reassessment

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10
Q

What is evidence based in the treatment of stroke?

A

Using theoretical concepts that are supported by a body of research to guide treatment
Using treatment strategies that are based on best available evidence and are cost effective

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11
Q

What is compensation?

A

uses remaining circuitry to utilize other muscle groups/synergies and motor plans (like using an intact UE to compensate for hemiplegic one)

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12
Q

What is rehabilitation?

A

recovery of lost function using neuroplastic mechanisms and redundancy built into brain circuitry (CIMT and BWSTT brain scans)

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13
Q

What are the 10 factors neuroplasticity depends on, according to Kleim?

A
  1. Use it or lose it
  2. Use it and improve it
  3. Specificty
  4. Repetition
  5. Intensity
  6. Time
  7. Salience
  8. Age
  9. Transference
  10. Interference
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14
Q

What is a task-oriented concept of motor control?

A

movement is organized around tasks, not reflexes

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15
Q

What is the concept of motor control centered about interaction with the environment?

A

environment dictates how we respond and move

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16
Q

What does the concept of motor learning entail?

A
  • practice makes perfect
  • variety is the spice of life
  • goal driven (meaningful tasks the patient is motivated to complete)
17
Q

What is the concept of the therapist as a collaborator?

A
  • adapt to the environment to allow for motor learning and function
  • teacher vs. handling specialist
18
Q

What is explicit learning?

A

can verbalize the steps, centered in language centers and prefrontal lobes
(example- manual on how to program a remote)

19
Q

What is implicit learning?

A

unconscious learning of an action, various centers all over the brain?
(example-learning to ride a bike)

20
Q

What type of learning is planning movements and strategy correction?

A

Explicit

21
Q

What type of learning is executing movements and in-task adjustments?

A

Implicit

22
Q

Task-specific training takes advantage of 2 types of recovery in stroke rehab:

A

Compensation

Recovery of lost function (neuroplasticity and redundancy)

23
Q

Why must practice be beyond the acquisition of a skill?

A

For long-term potentiation

24
Q

What does distributed practice mean? Why is it important?

A

learning is better when you give rest breaks in between bouts

  • allows patients to think about and consolidate learning
  • allows patients to strategize next attempt
25
Q

What is variable practice?

A

changing it up instead of practicing the same thing over and over (blocked practice)

26
Q

What is contextual interference?

A

random sequencing that forces the patient to think about each attempt as a new challenge, instead of relying on rote memorization of a task

27
Q

What is internal feedback?

A

provided by sensory feedback mechanisms

28
Q

What is external feedback?

A

provided by the therapist visually, audibly, physically

29
Q

Which type of feedback is faster and more accurate?

A

Internal

30
Q

Is delayed or immediate feedback better? why?

A

delayed is better than immediate because it allows us to give a rest after a task before giving feedback and ask patient to predict how they did before offering knowledge of results (leads to better performance and retention)

31
Q

What is even better than delayed or immediate feedback? what is it?

A

Summary feedback is even better. Waiting until after several attempts before giving an overall estimation of performance

32
Q

What is bandwidth feedback?

A

allowing a certain level of error before offering feedback (# of mistakes, distance outside parameters)

33
Q

When it comes to feedback…

A

less is more!

34
Q

More cards

A

More cards

Adult Neuro (10 decks)

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