Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Semester 5 PMNM Exam 3 > Coordination and Balance > Flashcards

Coordination and Balance Flashcards

1
Q

Coordination - definition

A

ability to perform smooth accurate movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypermetria deficit

A

Inability to grade forces appropriately for the distance and speed of a task

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypermetria deficit is usually associated with what

A

cerebellar dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Coordination deficit

A

inability to coordinate an intersegmental task due to deficit in timing and sequencing of one segment to another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Requirements for coordination

A

Intact motor cortex, BG, Cbm and proprioception

REquires biomechanical and neuromuscular systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cerebellar coordination deficit - can lead to what

A 
Ataxia
Dysmetria
Dysdiadochokinesia
Intention tremor
Dysarthria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dorsal column medial lamniscus coordination deficit can lead to what

A

decreased proprioception

dysmetria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Basal ganglia coordination deficit can lead to what

A 
Athetosis
Chorea
Dystonia
Hemiballismus
Resting tremor
Rigidity
Akinesia/bradykinesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Athetosis -

A

slow, involuntary, worm-like movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chorea -

A

involuntary, rapid, irregular, jerky mvmnt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dystonia -

A

sustained voluntary contractions (spasmodic torticollis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dysarthria -

A

speech articulation, melodic element lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Components of coordination

A

Sequencing
Timing
Scaling/Grading Forces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is involved in sequencing (components of coordination)

A

Synergies

Co-activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is involved in timing (components of coordination)

A

Initiation - force generation, ROM, motivation, postural control
Execution - prox stability with distal mob
Termination - difficulty with stopping or changing direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is involved in scaling/grading forces (components of coordination)

A

Hypermetria - overshooting

Dysmetria - judging force and distance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Documentation of coordination exam

A

Can do a scale - they were accurate 0 out of 5 times, or can be a percent
Narrative needs to be included

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Goals of interventions with coordination dysfuncition

A

Improve prox stability
Improve eye-hand coord for funct tasks
Improve coord of reciprocal mvmnts
Control mvmnts against gracity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What to be cautious of with adding weights

A

Rebound effect - can lead to ataxia being worse when take weights off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Frenkels exercises

A

progression of exercises for coordination

no evidence to support it - but can give good exercises for HEP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Interventions for those with mvmnt deficit associated with accuracy (timing and direction) or speed problem
1 Timing/speed
2 Sensory

A

If timing.speed - add music or metronome

If sensory deficit - add vibration, approximation, visual cues/targets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Interventions for those with mvmnt deficit associated with adaptability problem (sensing change, obstacles)

A

Empty cup vs full cup - can incorporate strength too
Set up obstacle to improve problem solving - can offer endurance component too
Maybe take away visual so they dont know if it is heavy or light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Interventions for those with mvmnt deficit associated with strength problem

A

Stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Postural control -

A

interaction of neural and musculoskeletal systems

Control of body positiions in space for purpose of stability, orientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Postural stability

A

balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

System changes - vestibular

A

1 Can be peripheral or central
2 Info from peripheral system transmitted to vesibular nucleus and cbm
- dec hair cells
- degeneration of vest system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

System changes - sensory

A

Tactile - dec prop and cutaneous receptors, inc thresholf for firing
Visual - dec pupil reactivty and lends elasticity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Pathologies that can lead to vestibular changes

A

BPPV
Menieres
Bilateral vestibular dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pathologies that can lead to sensory changes

A

Cataracts (cloudy)
Glaucoma (loss of peripheral vision)
Macular degeneration (loss of central vision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

System changes - musculoskeletal

A 
Dec in bone density
Dec in ROM/flexibility
Mm dec in size type 1, dec in type 2
mm atrophy
inc in mm fat and CT
31
Q

System changes - neuromuscular

A

Dec in nerve cells
Dec in cog processing
Dec in speed of impulses
Dec sensitivity of baroreceptors - ortho hypo

32
Q

Central sesnory processing of input - sensory reweighting

A

postural control based on vision, vestib, somatosens
They all come in together - but when one is not function we need to adjust the contributions to make up for the difference

33
Q

Recurrent fallers -

A

2 or more falls in either a 6 or 12 months time span

34
Q

Types of falls

A

Accidental or non
Syncopal or non
Intrinsic vs. extrinsic
with or without injury

35
Q

False assumpations with falls

A

due to carelessness
normal with aging
they just hapen
cant be predicted or anticipated

36
Q

MS - what percent fall risk

A

more then 50%

37
Q

PD - what percent fall risk

A

60% one fall a year

39% recurrent falls

38
Q

CVA - what percent falls

A

double fall risk

most happen with ambulation

39
Q

Alzheimers - what percent fall risk

A

double the fall risk

40
Q

Intellectual/Developmental disability - fall risk screening

A

limited fall risk screenings for this populaion

41
Q

Mvmnt system diagnosis - Sensory detection deficit

A

inability to execute intersegmental mvmnt due to lack of joint position sense of multisensory failure (joint position sense, vision, vestibular)

42
Q

Mvmnt system diagnosis - sesnsory selection and weighting deficit

A

inability to screen for and attent to appropriate sensory inputs
pts likely complain of dizziness or visual motion sensitivity

43
Q

Measurement tools for screening fall risk

A

STEADI
Stay independent questionnaire
TUG
FRAST

44
Q

PT exam - history

A 
function in diff environments
fall hx and fear of falling
adaptive equipment
meds
medical testing
family, social, work hx
45
Q

PT exam - vestibular

A 
Dizzy - have them define it
Details of their sx
Exam - 
1 smooth pursuit
2 VOR cancellation
3 VOR
4 Saccades
5 Hallpike
6 Determine if periph or centr vertigo
46
Q

PT exam - static balance tests

A 
Romberg
Single leg stance
Postural stress test
Perturbations
Functional reach
LOS on force plate
47
Q

PT exam - dynamic balance tests

A

Fukuda
FSST
Mini BEST
Fregly Gabriel Quantitative Ataxia Test Battery

48
Q

Mini BESTest addresses what 4 systems

A

Anticipatory postural adjustments
Postural responses
Sensory orientation
Gait stability

49
Q

What other 2 does the long BESTest add

A

Biomechanical

Stability limits/verticality

50
Q

Berg - what is inc fall risk

A

less than 45 out of 56

51
Q

TUG - what is abnormal

A

more than 30 seconds

52
Q

Tinetti POMA - what is increased fall risk

A

Less than 23 out of 28

53
Q

Five times sit to stand - what is abnormal

A

scores greater than 15 sec

measures strength

54
Q

LImitations of Funtional balance measures

A

might not predict balance in complex environemtns
most dont measure all 3 aspects of postural control (steady state, reactive, anticipatory)
No measure of the quality of mvmnt

55
Q

Sensory manupualtion tests

A

clinical test for sensory integration and balance (foam)
equi-test = surround on movable force plate
vestibular tests

56
Q

Participation exam tools

A

(all questionnaires)
Fall efficacy scale
Activities specific balance confidence scale
UIC fear of falling scale

57
Q

Comprehensive fall risk assessment - if in community

A

multidisciplinary with medical review, medications, physical exam, gait/balance exam, home assessment

58
Q

Comprehensive fall risk assessment - if in hospital

A

mental status, medications, toileting, other dx, footwear

59
Q

Goals for interventions

A 
pt ed
improve balance
reduce motion provoked sx
improve coordination
dec disability, improve function
dec falls - be careful with this one
60
Q

Interventions - need to consider if

A

restorative or compensatory

61
Q

Interventions - CVA

A

aerobic is beneficial

62
Q

Interventions - PD

A

need to use block practice and lots of repititions

63
Q

Intervetnions - Guillain Barre, polio, ALS, MS

A

Risk of fatigue or overworking the motor units

64
Q

six dimensions of mvmvnt

A 
flexibility
strength
accuracy
speed
adaptability
endurance
65
Q

What mode of balance exercise is effective

A

should be done in stance

progressive program that has strength and abalnce is best

66
Q

Not effective in balance exercise

A

strength, stretching, walking as single interventions are not effective
inconclusive on perturbation and compensatory stepping training

67
Q

Factors to manipulate for Rx

A 
Surface
Speed of mvmnt
Cognitive demands
Sensory input 
Task - objects to manipulate
Time to complete tasks
68
Q

Dosage (this is all balance)

A

1 to 3 times a week

Min of 50 hours over 3 to 6 months (best if over 10 week time frame)

69
Q

PT supervision vs. Can they stay at home

A

Monitor safety, vitals, fatigue
Progressions - do they need assistance or can they do them
Cognition
Upside to home - a lot more to practice that we can’t simulate in clinic

70
Q

Evidence based exercise programs for balance

A

Otago
Stepping On
Tai Chi

71
Q

Otago

A

Home based
17 exercises to be done for a year with levels of progression
Highly effective for those over 80
35% fall and injury reduction

72
Q

Stepping on

A

7 sessions for 2 hours over 2 months
Focuses on adoption of safety strategies
31% fall reduction in community adults

73
Q

Tai Chi

A

reduce fall risk by 47.5%

74
Q

Intervention for older adults

A 
hip protector pads
Vit D
vibrating insoles
grab bars, assistive devices
exercise program for balance, gait, strength

Semester 5 PMNM Exam 3 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions