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physiotherapy 2 > Bobath treatment > Flashcards

Bobath treatment Flashcards

1
Q

what is the definition of bobath?

A

A problem solving approach which is used in patients with functional deficiencies, movement and postural control problems

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2
Q

when the inhibition control disappears we see?

A

Contralateral spastic hemiplegia

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3
Q

Passive movements and participation are the main concerns of bobath goals
true or false?

A

false, active movements and participation

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4
Q

list the treatments goals of bobath application.

A

Regulation of the tonus
Inhibition of the spasticity patterns
Automatic control of the movement
Gaining the normal tonus and movement sensation
Causing changes in the motor answers
Achieving the normal and controlled motor outputs via controlling the abnormal movement (reflex activity)

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5
Q

Being able to control the motor outputs and abnormal reflex movement is related to the ?

A

normal sensory input

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6
Q

what are the Bobath Approach Shunt Inhibition?

A

Reflex inhibition patterns
Distal and proximal key points
Placing maneuvers

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7
Q

Peripheral nervous system (muscles, joints and skin)
are?

A

source of sensation

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8
Q

Central nervous system (Thalamus, Lymbic system, Cerebellum, Brainstem, Spinal Cord)
are?

A

organization

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9
Q

how to gain normal movement?

A

normal sensory input

rhythmic contractions of the Agonist (primary movers) and Synergist (supportive) muscle motor units are activated!

The gradual inhibition of the antagonist muscles is maintained.

The reflex activity of (GTO) is organized.

Preparatory postural adjustments are performed.

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10
Q

what is the response of Cerebellum Purkinje cells to the repetitive, similar movements ?

A

new dendrite formations.

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11
Q

Continues sensory and vestibular information (reflex activity)

Learned automatic movement and the preperation of the acquired tonus (presynaptic inhibition, inhibition of the excitation and excitation of the muscle tissue)

Reciprocal innervation/inhibition (mobility and stability)

Reflex inhibition and excitation etc.

Memory and executive planning
Lasts 10-20 sec.

are for normal motor behavior
true or false?

A

true

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12
Q

An unvoluntary motor response to sensory stimulation at the spinal segmental level is?

A

primitive reflex

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13
Q

Mixed stereotype answers with the participation of the movement primitive patterns is?

A

Stereotype Reflexes

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14
Q

Muscle’s state determines the inhibitor and excitatory state in the peripheral nervous system.

true or false?

A

false, in CNS

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15
Q

Dynamic postural reactions, provide?

A

the ability to preserve the movement against gravity besides the movement performance

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16
Q

adjusting the posture by the postural reactions before the planned movement is?

A

Postural Readiness

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17
Q

what are the features of postural reactions?

A

Active movements.
Subcortically controlled.
Automatic
By controlling the head and trunk, the normal allignment of the head-trunk and trunk-extremities are protected and controlled.
Coordinated as complex and voluntary movement patterns.

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18
Q

we can divide the automatic reactions into 3 which are?

A

Correction reactions
Balance reactions
Automatic adaptations of the muscles against posture changes

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19
Q

Normalizes the head-neck relation with the trunk and extremity’s normal alignment is related to?

A

correction reaction

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20
Q

Balance reactions come out with ?

A

falling risks

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21
Q

When the balance reactions are insufficient what will come out?

A

’protective reactions

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22
Q

The changes in the gravity center during movement > requires ?

A

postural adjusments

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23
Q

Postural adaptation to gravity is?

A

Automatic adaptations of the muscles against posture changes

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24
Q

what are the 3 Prior Conditions are needed for postural normal control?

A

Normal postural tonus
Reciprocal communication of the muscles
Transition of balance and protective reactions to automatic movement patterns

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25
Q

normal reciprocal needs?

A

Synergic fixation
Automatic adaptation of muscles for postural changes
Synergistic muscles

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26
Q

Synergistic muscles provide?

A

the timing and the direction of the movement with the gradual control on the aganist and antagonist muscles

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27
Q

Synergic fixation; proximal control for the distal movement
true or false?

A

true

28
Q

what are 3 main problems in upper motor neuron lesion?

A

Abnormal coordination patterns in posture
Abnormal postural tonus and postural reflex activity
Disturbance in reciprocal innervation

29
Q

A disturbance in the inhibitory mechanisms result in ?

A

abnormal postural tonus and stereotype total motor patterns.

30
Q

A CONTROL MECHANISM
CONTROLS OR STOPS THE MOVEMENT AGAINST EXCITATION.
are for?

A

inhibition mechanism

31
Q

spasticity s related to strength loss of agonist muscles
true or false?

A

false, Secondary strength loss of the antagonist muscles

32
Q

Increased spontaneous discharge of the gama motor neurons

Increased excitability of the alpha motor neuron

Decreased or total loss of the Renshaw inhibition

Decreased autogenic inhibition

will lead to?

A

spasticity

33
Q

Spasticity After Stroke caused by?

A

activation of the stiffened tonic reflexes

34
Q

Mild-moderate spasticity > leads to tone changes in vibration style at the extremities in associative reactions after stroke
true or false?

A

true

35
Q

Excessive, voluntary movement of the healthy side leads to increase in spasticity at the affected side. (due to missing inhibition)
is?

A

associative reactions

36
Q

severe spasticity will lead to?

A

co contraction of the opposite muscles

37
Q

Rehabilitation with compensation causes ?

A

inactivity at the hemiplegic side and increases the spasticity.

38
Q

in stroke rehabilitation we have 3 strokes what are they?

A
  • flaccid period
  • spastic period
  • recovery
39
Q

Sudden/immediate occurrence after CVA
Complicated
Disorientation
May last for days, weeks or more
No movement at the affected side
Not aware of the affected side (neglect)
Even the healthy side can not perform compensation.
are seen in which period?

A

flaccid

40
Q

Joint limitation is present in flaccidity period
true or false?

A

false, it is not present

41
Q

how the upper extremity is seen with flaccidity?

A

head= slightly flexed to the affected side
shoulder= retracted
elbow= extended
forearm= pronated

42
Q

which one is wrong for lower extremity flaccid period?

hip and leg in Extension+ ER
Foot in dorsi flexion
Slight inversion

A

foot in DF,
correct is foot in PF

43
Q

during flaccid period Shoulder and pelvis in slight backward position
true or false?

A

true

44
Q

Hip in flexion, abduction and foot in eversion lying position in elderly people during flaccid period.

true or false?

A

false, foot in inversion

45
Q

fill the blank

Fingers and wrist in ____1___, passive extension with full range, slight resistance at____2____/angle of movement

A

1-slight flexion
2- end of range

46
Q

in flaccid period:

Resistance can be seen with forearm pronation while the elbow is in extension.
true or false?

A

false, with forearm supination

47
Q

First signs of spasticity is felt when ?

A

the ankle is in dorsiflexion while the hip and knee is in extension

48
Q

which test we can perform in spastic period for the upper extremity?

A

PROTECTIVE EXTENSION AND ARM SUPPORT TEST

49
Q

what are the sensory tests that should be done?

A

Assessment of position and movement sense
Localization of pressure and light touch
Stereognosis test

50
Q

Pressure localization and light touch test Should be start from proximal toward distal.
true or false?

A

false, its the opposite

51
Q

Better sensory discrimination on feet and legs compared to hands and arms.
true or false?

A

true

52
Q

arm movement sense is better than the leg
true or false?

A

false, leg sense movement is better

53
Q

according to patient activates test
we first test what patient can’t do
true or false?

A

false we start testing what patient can do.

54
Q

Assessment of Function and the Formation of the Treatment Plan is?

A

What is the most important, primary aim of the treatment?
For which function the patient should be educated?
What can be the limitations at the end of the treatment process?
What you can make your patient to do with a little help?
What is your treatment plan?

55
Q

Unwanted increase in spasticity
Retraction of the shoulder and pelvis
Neglect of the affected side
are the aims of?

A

FLACCID (ACUTE) TERM

56
Q

what should we do for bed position?

A

Prevention of the decubitus ulcer
Prevention of the neglect of affected side
Support to the midline orientation

57
Q

bed position should be changed every?

A

2 hours

58
Q

The arm is positioned to slightly higher point than trunk,
Forearm in supination,
Head is in lateral flexion to the unaffected side (prevention of the neglect)
Shoulder retraction should be avoided.

are all done in which position?

A

supine

59
Q

what is the main aim of sidelying hemiplegic patient?

A

prevention of the shoulder and pelvic retraction and hip adduction.

60
Q

Turning to the affected/disease side is?

A

Easier than healthy side. No assistance is needed.

61
Q

When the patient is turned to affected side, the shoulder should be in?

A

protraction

62
Q

what mobilization and exercises we can do?

A

rotations by first with the Upper half of the body
scapular mobilization
upper extremity mobilization
pelvic elevation or bridge
dorsiflexion
hip and knee flexion
sitting at the edge of the bed then weight bearing
sitting to standing

63
Q

for dorsiflexion education, the foot is hold from which side?

A

the dorsal side, because if it is hold from the plantar side spasticity might be stimulated

64
Q

where the shoulder gridle is placed for sitting activities?

A

under the axilla

65
Q

After some time, when the sitting balance and arm stability is improved what exercise we can do next?

A

crossing movements can be performed to weight bear on the affected upper and lower extremity at the same time

physiotherapy 2 (9 decks)

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