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Neuromotor > Contrived techniques > Flashcards

Contrived techniques Flashcards

1
Q

“Artificial” or “deliberately created” rather than arising naturally or spontaneously; Purpose is to use a sensory system to get a motor response; Use early on as an adjunct to treatment

A

Contrived treatment technique

  • intervention is temporary; PT needs to fade back use of techniques
  • uses input system to get motor response
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2
Q

What are the types of input systems?

A
  1. proprioceptive
  2. vestibular
  3. exteroceptive (hearing, smell, vision, sound etc)
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3
Q

When would you stop using contrived techniques?

A

Since it’s use is temporary..

  1. Pt is gaining more conscious control/volitional control
  2. If it’s not working
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4
Q

What are the proprioceptive deep sensory receptors?

A
  1. Muscle Spindle - found in belly of muscle; use for facilitation
  2. GTO - Found at ends of muscle (PROX/DIST); Used for inhibition
  3. Joint Receptors - joint capsule, ligaments; Used for facilitation; ex. approximation to help postural muscles kick in and they stand
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5
Q

What sensory receptors are type Ia, Ib, II, III, and IV affarents?

A 
Ia = m spindle, annulospiral ending
Ib = GTO
II = m spindle, flower spray
III = pain and temp
IV = Pain and other receptors
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6
Q

Toward the middle of the spindle; Annulospiral nerve endings; Respond to change in velocity (quick stretch)

A

Type Ia, m spindle

- dampen spasticity in shortened position

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7
Q

Toward the end of the spindle; Flowerspray nerve endings; Respond to increase in muscle length

A

Type II, m spindle

- dampen spasticity in shortened position

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8
Q

Sensory receptor that responds to tension; Located in the muscle tendon – at proximal and distal tendons; Used for inhibition

A

Type Ib, GTO

- contract/relax technique

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9
Q

How do use the GTO to get more ROM in a person who has spasticity?

A
  • Stretch the muscle - SLOW/ PROLONGED stretch, so spastic m. has a chance to respond might feel m. “let go” at some point, and get more range
  • have to evaluate if it’s worth it in terms of PT progress (incr ROM may only last 10 mins), BUT if pt feels better after/for the rest of the day after, it might be useful to add to ther ex
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10
Q

What does clonus interplay between?

A

M spindle and GOT

- indicates UMN lesion

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11
Q

What are the types of joint receptors?

A
  1. Golgi type endings - largest, respond to rate of joint movement and gravity
  2. Paciniform endings - respond to rapid joint movements, deep pressure, and vibration
  3. Rufinni’s endings - respond to rate and direction of joint movement
  4. Free nerve endings - signal joint pain
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12
Q

Joint receptors are used for facilitation; Exert strong influences on the motor system
What are they sensitive to?

A
  1. Movement
  2. Position
  3. Traction
  4. Compression
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13
Q

What are the proprioceptive facilitation techniques?

A
  1. Tapping
  2. Quick stretch
  3. Resistance
  4. joint approximation
  5. joint traction
  6. high frequency vibration
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14
Q

what type of m. contractions usually come back first when weakness is present?

A

Eccentric, then isometric, then concentrec

- less m units for eccentric

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15
Q

What does joint approximation facilitate?

A

postural extensor and stabilizing responses (co-contraction

  • enhances joint awarenec
  • contraindication = inflamed joints
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16
Q

What does joint approximation facilitate?

A
  • Activates joint receptors
  • Facilitates joint motion
  • Enhances joint awareness
  • Improve mobility, relieve muscle spasm, reduce pain
  • Contraindication: hypermobile or unstable joints
17
Q

What are the proprioceptive inhibitory techniques?

A
  1. inhibitory stretch
  2. Hold-relax method/ contract relax
  3. full body rotation - helps with widespread rigidity/ spasticity; disassociate the body
  4. oscillations - inhibits spasticity
  5. Low frequency vibration (<75 Hz)
18
Q

Deep, maintained stretch along the longitudinal axis of tendons with positioning; Prolonged positioning in lengthened range; Activates GTO; Prolonged weight bearing to dampen tone; Weight bearing on a spastic arm; Inhibitory (serial) casting

A

inhibitory stretch

19
Q

What ROM position should you use for inhibition? facilitation?

A 
inhibition = midrange to shortened position
facilitation = lengthened position
20
Q

What spinal column contains exteroceptive input?

A

Dorcal column

  • large, well myelinated
  • apply to gate theory to inhibit stimuli from spinothalamic tracts
21
Q

What are exteroceptive facilitation techniques?

A
  1. Intermittent Contact - Facilitate contraction, sensory awareness, directional cues, security/support; NDT approach comes from this
  2. Light Touch - Brief, light contact with the skin can facilitate; brief swipe of ice cube, light pinch; used in more involved pts
22
Q

What are exteroceptive inhibitory techniques?

A
  1. maintained firm pressure
  2. slow repetitive stroking - paravertebral stroking 3-5 mins
  3. neutral warmth
  4. prolonged cooling - dr. m firing, inhibits tone or spasm (but can incr spasticity)
23
Q

What are visual facilitation techniques?

A
  1. bright lights

2. bright colors

24
Q

What are visual inhibitory techniques?

A
  1. dim lights

2. calm colors

25
Q

What are auditory facilitation techniques?

A
  1. loud and excited voice

2. upbeat music

26
Q

What are auditory inhibitory techniques?

A
  1. soft and calm voice

2. relaxing, soft music

27
Q

In the middle ear ______ detects horizontal movement, while ______ detects vertical movement. _______ detects rotation.

A

utricle; saccule (otoliths)

semicircular canals

28
Q

What type of vestibular stimulation inhibits tone, relaxes, and decreases arousal?

A

Slow vestibular movements

  • slow rhythmic movements
  • rolling or rocking
29
Q

What type of vestibular stimulation increases tone, and arousal, while improving motor coordination and posture?

A

rapid vestibular stimulation

  • useful in pts with hypotonia and bradykinesia (DS, PD pop)
  • can activate sympathetic response
30
Q

Reflex maintiaing the stability of an image during rapid head movements (keeps it in focus, etc)

A

Vestibuloocular reflex

31
Q

Reflex of head, neck, trunk m. activation movements to keep head upright during movement of the body

A

vestibulospinal reflex

32
Q

What causes stimulation of parasympathetic system?

A

relaxation/ inhibitory

  1. Maintained firm pressure
  2. Slow repetitive stroking
  3. Prolonged icing
  4. Neutral warmth
  5. Deep breathing
  6. Relaxation exercises
33
Q

What are the possible PNF techniques that can be used?

A
  1. Rhythmic Initiation
  2. Alternating Isometrics or Rhythmic Stabilization
  3. Slow Reversals
  4. Agonist Reversals
34
Q

Passive movements; Progressing to active assistive and active movements; Move the patient through the desired movement; “1, 2, 3, and up”; Indicated for spasticity, rigidity, difficulty initiating movements, motor planning and learning deficits, aphasia

A

Rhythmic initiation

35
Q

Apply resistance with hands and change placement; Patient maintains a position using isometric contraction; Build up resistance gradually; PT moves hands quickly; Use command – “don’t let me move you”; Avoid holding breath; Indicated for impaired strength, coordination, and control, if ROM limitations

A

Alternating isometrics or rhythmic stabilization

- improves stability

36
Q

Concentric contraction of agonist then antagonist against resistance; Move through full ROM; Indicated for impaired strength and coordination between muscle groups or if patient fatigues quickly; PT moves hands

A

Slow reversal

37
Q

Concentric contraction through available ROM followed by a hold then eccentric contraction moving slowly back to starting position; Used in antigravity activities; Indicated for weak postural muscles, difficulty with eccentric control of body weight, poor dynamic postural control; Hands stay in same place

A

Agonist reversal

Neuromotor (17 decks)

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