Cerebellar Lesions and functional mobility

Question 1

What is ataxia

Answer 1

failure of muscle coordination; irregularity of muscle action

key feature of cerebellar lesions

Question 2

Cerebellar lesion Ax for

1. coordination
2. balance
3. Functional ability

Answer 2

coordination

1) UE: finger to nose (elbow straight), dysdiadochokinesia, (elbows not supported on lap), finger opposition
2) LE: toe tapping, heel on shin * do at same time, then separate; start slow then fast* record how many reps and quality

balance
- Romberg (differentiate from somatosensory deficit),

Functional
- TUG, 10 m walk

Question 3

Cerebellar lesions Rx

Answer 3

• postural control
• prevent and treat biomechanical limitations
• promote muscle strength, endurance, and coordination
• start with specific strategies: small range near midline, work out, progress: decrease guidance, cueing, number of fixed points, increase active ROM, speed, change direction

Question 4

Orofacial nerve injury Ax

Answer 4

• facial expression: wrinkle forehead, tightly close eyes, smile widely, purse lips together, smile wide and protrude chin
• look for asymmetry and differences in upper and lower face

Question 5

Orofacial nerve injury Rx

Answer 5

exercises promoting symmetry, mouth care, face tapping, stretching active area

Question 6

What training functional mobility always roll to which side first (affected or unaffected?)

Answer 6

Unaffected - therapist can guide effected limb

Question 7

Walking velocity for a…

• Household walker
• Limited community ambulator
• Community ambulator
• Average velocity for a community ambulator

Answer 7

• 0.4m/s
• 0.4-0.8 m/s
• > 0.8 m/s
• 1.3 m/s

Question 8

When training reach and grasp you need to consider which 3 systems

Answer 8

Postural control
Transport
Manipulation (grasp)

Question 9

Do ballistic movements require sensory feedback?

Does grasp require sensory feedback?

Answer 9

No

Yes - grip size and force

Question 10

What movements are required to perform reach

Answer 10

trunk control, elbow extension, pronation, stable scapula and shoulder, wrist extension, finger opening

Question 11

What movements are required to perform grasp

Answer 11

Radial deviation
wrist extension
Thumb opposition

Question 12

What measurements do you take when doing seating fro SCI

Answer 12

measure from surface to:

• PSIS, inferior angle of scapula, spine of scapula, elbow, top of head
• trunk depth, thigh length, shank length, outer knee width, chest width, hip width

Find out what they will be using chair for