CA Flashcards

2
Q

Define Cerebellar Ataxia (CA)

A

Abnormal coordination due to damaged neurons in the cerebellum. Affects:

  • speed
  • amplitude
  • accuracy
  • force of movement
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3
Q

Causes of CA (and 4 examples)?

A

Focal lesions (e.g. stroke, TBI, tumour and MS)

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4
Q

Name the 3 functional divisions of the cerebellum and describe their functions

A

1) Vestibular cerebellum ? (balance) balance, eye movement
2) Cerebrocerebellum ? (planning) preparation, initiation, precision, timing, sequencing, coordination of movement
3) Spinocerebellum ? (execution) execution of limb movements, smoothness of muscle movements

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5
Q

What roles does the cerebellum have?

A
  1. Motor control regulation
  2. Synergies
  3. Intensity of movement
  4. Movement to movement error correction
  5. Timing and sequencing
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6
Q

General function of the cerebellum

A

Dexterity and postural control

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7
Q

Define ataxia

A

Lack of voluntary coordination of muscle movements

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8
Q

Define

  • Dysmetria
  • Rebound phenomenon
A

Dysmetria ? lack of coordination typified by under/overshooting (not measuring distance correctly)

Rebound phenomenon ? slow antagonist action

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9
Q

Define

  • Dysdiadochokinesia
  • Dysarthria
  • Nystagmus
A

Dysdiadochokinesia ? inability to perform rapid alternating movements

Dysarthria ? poor coordination of speech production muscles

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10
Q

Define

  • Dyssynergia
  • Nystagmus
A

Dyssynergia - poor coordination of timing onset and offset of ag/antagonists (loss of smoothness)

Nystagmus ? oscillating eye movement

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11
Q

What are the main impairments in CA? (2)

A

Loss of dexterity/coordination etc

Loss of balance

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12
Q

What are the main motor performance characteristics in CA?

A
Dysmetria
Rebound phenomenon
Dysdiadochokinesia 
Dyssinergia
Tremors
Dysarthria
Nystagmus
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13
Q

How is CA assessed?

A

Dexterity tests
- Pronation/supination, postural sway, heel/shin, heel over foot, finger to nose/finger, rebound

  • Functional assessment ? sitting, standing etc.
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14
Q

Is a strength assessment usually necessary in CA?

A

NO

- Strength is usually unaffected in CA

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15
Q

CA measures (6)

A

Measures (record accuracy)

  • 10 m walk test (variable step lengths)
  • TUG
  • Step test
  • Functional Reach
  • 6 min walk
  • 9 hole peg test
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16
Q

Typical motor behaviours in CA

- restrictions (2), increases (2) and excessive (2)

A

Restricted

  • amplitude of movement
  • ROM (i.e. stiffness)

Excessive

  • pre shaping and use of support surfaces during reaching (use of adaptive strategies)
  • BOS, stepping and use of arms in walking

Increased

  • speed and difficulty slowing when walking
  • variability of performance
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17
Q

Intervention considerations for CA

A

Considerations:

  • Task specific, high reps
  • May modify and add adaptive behaviours to make task easier with degenerative CA (e.g. multijoint training for recoverable, stabilize joints for degenerative)
  • Train accuracy and speed
  • Remember balance is a main impairment in CA (safety)
18
Q

CA research say about reaching?

A

Reaching

  • Abnormally curved wrist path
  • Better with joints fixed
19
Q

CA research say about gait?

A

Gait

  • Less PF and knee yield
  • More variable

Stepping over an obstacle
- more dysmetria than normal walking

20
Q

CA research on timing?

A

Heel raise

  • same sequence but poor timing
  • poor build up of EMG
21
Q

CA research on dual tasks?

A

Poor with addition of dual task

22
Q

CA research on training accuracy and balance/coordination?

A

Improved accuracy

Improved function and independent walking ability

23
Q

Degenerative CA training?

A

2hrs daily for 4ks PT/OT
= better (walking speed, less falls, ADLs)
= maintained at 12/24wks