(A) Neuromotor Impairment (Ax & Tx) Flashcards
What assessments can be done to assess body functions and structures or what could be assessed
- posture, balance
- AROM, PROM (ROM)
- strength (grip, pinch strength, MMT)
- m tone, sensation, edema, pain
- coordination
What is paresis?
partial paralysis or weakness (loss of strength) of body part
what is plegia
complete paralysis of body part
what is hemiparesis
partial paralysis or weakness on half side of body => can be mild, moderate, or severe & can be Upper or LE
what is hemiplegia
complete paralysis of half of body (could be UE or LE)
Describe a scapular assessment (3)
- positioning: winging (shoulder blade sticking out), has it moved
- movement/strength (palate spine and follow its movement into shoulder flex/ext)
- tone surrounding scapular (palpate)
* compare w unaffected side*
what is a shoulder subluxation
change in glenohumeral joint w palpable gap between acormion and humeral head
what can cause a shoulder subluxation?
w stroke, can occue in hemiplegic arm due to flaccid supporting musculature
How do you assess a shoulder subluxation?
- may or may not have pain associated with it (if dont have pain, its most probable a neurological proble not subluxation which tend to be very painful)
- palpate gap between acromion and humeral head: feels very stiff
wrist and elbow should be included in splint for shoulder subluxation
What construct the box and block test assess?
unilateral gross manual dexterity
what construct does the 9 hole peg test assess
finger dexterity
what construct does the fugl (FMA) assess?
motor functioning, balance, sensation, joint functioning
what construct does the chedoke mcmaster assess
physical impairement
level of disability
Upper and lower limb
what are the treatment (prevention, pain modalities, exercises) used for shoulder subluxation/apin?
- prevention:
- early ROM exercises
- positioning w pillows, splint, slings - exercise
- tx contracture
- arom shoulder
- frequent prom shoulder - prom modalities
- thermal, hand desensitization, electric n stimulation - medication
- injections
what positioning should be done for shoulder subluxation in a seated position (4)
- back supported chair
- feet flat on floor
- equal weights thru buttocks
- affected arm suppoted on adjustable base
what positioning techniques should be used for shoulder subluxation when lying on unaffected side? (3)
- head and trunk straight using pillows behind back
- shoulder and pelvic forward using pillow
- arm and leg raised forward onto pillow
what positioning techniques should be used for shoulder subluxation when lying on affected side? (3)
- ease affected shoulder forward
- affected arm resting on bed, pal upwards
- affected leg flexed forward
what positioning techniques should be used for shoulder subluxation when lying on in bed (on back)?
affected arm supported by pillow
what are the 10 principles of experience dependent plasticity
- use it or lose it (activate brain areas)
- use it and improve it
- specificity (specific training leads to increased function)
- repetition matters
- intensity matters (frequency)
- time matters (different forms of plasticity occur at different times => acute vs chronic)
- salience matters (training relevant to client)
- age matters (> younger brain plasticity)
- transference (plasticity in one function can enhance aquisition of similar functions)
- interference
what is muscle tone
tension of muscle at rest
what is hypotonia? (3)
- muscle slower react to stretch
- unable to sustain prolong m contraction
- feels soft, floppy
what is hypertonia?
- overreactive muscle to stretch
- may maintain prolonged contraction (risk of contracture)
what is a clonus?
repetitive contraction in antagonist m in response to rapid stretch
what is the clinical presentation of hyperspasticity in UE?
- flexed elbow
- bent wrist
- pronated foreaem
- clenched fist
- thumb in palm
