Chapter 12 - Neurological Approaches: Eval and Intervention

Question 1

Dysmetria

Answer 1

undershooting or overshooting

Question 2

Dyssynergia

Answer 2

Decomposition of movement

Question 3

Dysdiadochokinesia

Answer 3

Impaired ability to perform rapid alternating movements

Question 4

Hemiballismus

Answer 4

Unilateral chorea characterized by violent forceful movements of the proximal muscles

Question 5

Crossed extension reflex

Answer 5

Flex a leg while opposite leg is flexed, when flexing the leg the opposite leg will extend

Question 6

Positive supporting reaction

Answer 6

Contact to ball of foot in upright position will produce leg extension

Question 7

Associated reactions

Answer 7

Example, if R hand is grasping, L hand will also grasp

Question 8

Static splint

Answer 8

Utilized for external support, prevention of motion, stretching of contracture, aligning joints for healing, resting joints, or reducing pain

Question 9

Dynamic splint

Answer 9

Utilized to increase passive motion, assist weak motions, or substitute for lost motion

Question 10

Cock-up splint

Answer 10

Allows digits to function - wrist in 10-20 degrees of extension to prevent contracture (i.e flaccid wrist)

Question 11

Resting hand splint

Answer 11

Supported wrist, digits, and thumb in a functional position for prolonged periods (i.e. developing a contracture of the long flexors)

Question 12

Opponens splint

Answer 12

May be short or long, designed to support the thumb in a position of abduction and opposition.
Utilized during functional activities to compensate for weakness patterns

Question 13

Bobath finger spreader

Inhibitory/tone normalizing orthoses

Answer 13

Abduction splint, soft, and positions digits and thumbs in abduction to reduce tone

Question 14

Rood cone

Inhibitory/tone normalizing orthoses

Answer 14

Deep pressure - cone shaped and utilized to reduce flexor spasticity in hands

Question 15

Orthokinetic splint

Inhibitory/tone normalizing orthoses

Answer 15

utilizes tactile input to facilitate and/or inhibit appropriate muscle groups

Question 16

Spasticity reduction splint

Inhibitory/tone normalizing orthoses

Answer 16

Places the spastic distal extremity on submaximal stretch to reduce spasticity

Question 17

Overhead suspension

Supported orthoses

Answer 17

Incorporates an arm support that is supported by a sling and suspended by an overhead rod.
Appropriate candidates have proximal weakness with muscle grades in the 1/5 to 3/5 range are appropriate (ALS, MC, Guillian Barre)

Question 18

Balanced forearm orthoses
(mobile arm supports or ball bearing forearm)
Supported orthoses

Answer 18

Consists of arm trough, proximal and distal arms and supported bracket
Allows patient with weak proximal musculature to utilize available control of the trunk and shoulder to engage in functional tasks

Question 19

Shoulder slings

Supported orthoses

Answer 19

Support a flaccid arm after neurologic insult for short and controlled time periods - long term use may be detrimental

Question 20

Key Treatment Strategy:

Sensory stimulation used to evoke a motor response

Answer 20

Rood approach: Yes: uses direct application of sensory stimuli to muscles and joints
Brunnstrom Approach: Yes: movement occurs in response to sensory stimuli
PNF approach: Yes: tactile, auditory, visual sensory stimuli promote motor response
NDT: Yes: abnormal muscle tone occurs, in part, because of abnormal sensory experience

Question 21

Key Treatment Strategy:

Reflexive movement used as a precursor for volitional movement

Answer 21

Rood approach: Yes: reflexive movement achieved initially through the application of sensory stimuli
Brunnstrom Approach: Yes: move patient along a continuum of reflexive to volitional movement patterns
PNF approach: Yes: volitional movements can be assisted by reflexive supported posture
NDT: NO

Question 22

Key Treatment Strategy:

Treatment directed toward influencing muscle tone

Answer 22

Rood approach: Yes: Sensory stimuli used to inhibit or facilitate tone
Brunnstrom Approach: Yes: Postures, sensory stimuli used to inhibit or facilitate tone
PNF approach: Yes: movement patterns used to normalize tone
NDT: Yes: handling techniques and postures can inhibit or facilitate muscle tone

Question 23

Key Treatment Strategy:

Developmental patterns/sequences used for the development of motor skills

Answer 23

Rood approach: Yes: Ontogenic motor patterns used to develop motor skills
Brunnstrom Approach: Yes: Flexion and extension syngergies; proximal to distal return
PNF approach: Yes: patterns used to facilitate proximal to distal motor control
NDT: Yes

Question 24

Key Treatment Strategy:

Conscious attention is directed toward movement

Answer 24

Rood approach: NO
Brunnstrom Approach: Yes
PNF approach: Yes
NDT: Yes

Question 25

Key Treatment Strategy:

Treatment directly emphasizes development of skilled movements for task performance

Answer 25

Rood approach: NO
Brunnstrom Approach: NO
PNF approach: NO
NDT: Yes