Application of Strength Training and Motor Learning in Pediatrics Flashcards
Review: What are the principles of neuroplasticity?
Use it (or lose it) and improve it
Specificity
Repetition matters
Intensity matters
Time matters
Salience matters
Age matters
Interference
What can we improve repetitions in for stroke rehabilitaiton?
Upper extremity!
What is a way to explain the required repetitions/intensity for recovery?
The body wants to take the path of least resistance. So if you have a lesion, you might have some spontaneous recovery. But in order to really unmask and awaken these dormant pathways, you have to push it. You have to really do intense repetition, intense practice in order to make that happen.
What is massed practice?
it’s thought to be a high-dose or high-intense level of practice in the upper extremity
What is a form of unilateral intense practice?
A cast or a splint on your uninvolved side, and you’re getting lots of intense practice with your involved side
What is forced use?
When somebody is in a cast or a splint on their uninvolved upper extremity to try to force the use of their more involved upper extremity
What is a form or bilateral intense practice?
Hand Arm Bilateral Intensive Therapy (HABIT)
Takes from the concepts of constraint-induced therapy and applies it to bilateral
What does the research say about unilateral intense practice?
All models of CIT have shown improvement in UE function
Models have not been directly compared
Many variables demand research direction
What does the research say about bilateral intense practice?
Based on the concept that it is the PRACTICE that matters
Bilateral training may be more appropriate and task specific in young children
Utilize concepts of task practice, shaping, and home program
Pros and cons compared to CIT
What does the research say about intense practice?
Combination approach?!
Unilateral and bilateral intensive had more improvement than conventional
Unilateral demonstrated improved grasp; bilateral demonstrated improved bilateral spontaneous use
and ADLs in younger children
Consistent with HABIT findings
Approach may be individualized based on goals and motivation
What is your role as a PT to implement intense UE therapy?
Direct provider/collaborator in formal protocol
Direct provider of informal protocol
Refer to providers of protocol
Incorporate strategies into overall intervention plan
What may program development of an UE intense look like?
Facility resources
- Policy/procedure
- Formal program vs informal
- Feasibility
- Reimbursement
Type of practice
- Uni or bi
- Individual or group
Pt selection
- Age
- Dx
- Chronicity
- Considerations
Type of constraint
- Ensure safety
- Method of delivery
- Providers of service
- Frequency/duration
Activities
- Protocol vs individualized
Education plan for child and
caregivers
Outcomes
PT role in developing/shaping
program
What is the PT management of a UE intense program?
Examination and evaluation
Task analysis (Target Movement Profile)
Child and Family Goals
Role in care
Design a comprehensive intervention plan
Outcome measures
What is a target movement profile?
Breakdown of movements/motions for each section of the UE
What are some key components of and UE intense program?
Repetition
Shaping
Functional Practice
Behavior change
