Brainscape's Knowledge GenomeTM

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


See full index

Neuro Final > CP intervention class > Flashcards

CP intervention class Flashcards

1
Q

neurological interventions:

A
  • oral baclofen
  • intrathecal baclofen pump
  • botox injections
  • selective dorsal rhizotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

orthopedic intervention:

A

single event multi-level surgery (SEMLS)

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

SEMLS: soft tissue procedures

A

tendon release/lengthening

distal rectus femoris transfer

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

SEMLS: bone procedures

A

femoral extension osteotomy

varus derotation osteotomy (VDRO) and acetabular osteotomy

hemi-epiphysiodesis

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

Novak 2020 – Evidence Alert Traffic Light System

A

framework for grading the strength of evidence for different interventions, particularly in the field of cerebral palsy (CP)

system uses a traffic light analogy to communicate the quality and effectiveness of interventions, with colors indicating the level of recommendation based on available evidence

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

Red light:

A

Don’t do it interventions- not recommended beyond traditional care, may not have enough evidence

Strong evidence suggests that the intervention is ineffective or even harmful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Yellow light:

A

Probably do it and probably don’t do it interventions (distinguished by the ‘worth it line’- fewer and lower quality articles

There is mixed or emerging evidence for the intervention, indicating it may be promising but requires further research to confirm its efficacy

Practitioners should proceed with caution and monitor outcomes closely

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

Green light:

A

Effective interventions- more high-quality articles

Strong evidence supports the intervention as beneficial

These are recommended interventions because high-quality studies, such as systematic reviews or randomized controlled trials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Green light motor interventions:

A

bimanual = hand function

CIMT = hand function, activity & participation

Hippo therapy = balance symmetry

Partial Body Weight Support Treadmill Training = walking speed

Goal directed training = hand function, gross motor

strength training = muscle strength

mobility training = walking speed

task specific training = gross motor

treadmill training = walking speed, walking endurance, gross motor

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

Bimanual Training (Hand Function):

A

Focuses on improving the coordination and use of both hands together

Significant improvements in dexterity, grip strength, and goal achievement

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

Constraint-Induced Movement Therapy (CIMT) (Hand Function, Activity, & Participation):

A

Involves restraining the less-affected hand to encourage use of the more-affected hand, promoting hand function and real-life task performance

Increased use of the affected limb, better outcomes in fine motor tasks, and greater engagement in bimanual activities

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

Hippotherapy (Balance and Symmetry):

A

using the movement of a horse to improve postural control, balance, and symmetry in patients with motor impairments

Positive changes in trunk control, pelvic stability, and overall symmetry in walking and sitting

It can also have a positive emotional and motivational effect

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

Partial Body Weight Support Treadmill Training (Walking Speed):

A

Involves using a treadmill with partial body weight support to enhance walking ability

Improvements in gait speed, step length, and walking endurance

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

Goal-Directed Training (Hand Function, Gross Motor Skills):

A

Tailored interventions focusing on specific goals important to the individual’s daily activities, involving practice in meaningful contexts

Improved outcomes in goal-specific tasks, including fine motor tasks (e.g., grasping) and gross motor tasks (e.g., sitting or walking)

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

Strength Training (Muscle Strength):

A

Focuses on increasing muscle strength through repetitive, resisted exercises

Gains in muscle power, endurance, and functional skills such as standing, walking, and transferring

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

Mobility Training (Walking Speed):

A

Involves focused practice on walking skills, often using walking aids or support to improve speed and quality of gait

Improved speed, cadence, and walking efficiency

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

Task-Specific Training (Gross Motor Skills):

A

Repetitive practice of functional tasks to improve gross motor skills, focusing on specific movements relevant to daily activities

Gains in posture, balance, and gait mechanics

Task-specific training increases muscle coordination and task execution by reinforcing neural pathways responsible for the movement

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

Treadmill Training (Walking Speed, Walking Endurance, Gross Motor Skills):

A

Using a treadmill to promote gait re-training and improve overall walking capacity

Enhances cardiovascular fitness, muscle strength, and walking distance

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

Green light contracture & alignment interventions:

A

lower limb casting = passive range

BoNT + casting = passive range

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

Lower Limb Casting (Passive Range of Motion):

A

Serial casting or static positioning of the lower limbs to improve or maintain passive range of motion (PROM) by lengthening shortened muscles and soft tissues

Significant improvement in passive dorsiflexion of the ankle

Often used to manage spasticity-related contractures, casting has been shown to temporarily improve alignment and gait patterns

ollow-up interventions like bracing, stretching exercises, or functional activity training

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

Botulinum Toxin (BoNT) + Casting (Passive Range of Motion):

A

Combines the effects of Botulinum Toxin (BoNT) injections, which reduce muscle spasticity, with serial casting to improve passive range of motion by further relaxing overactive muscles and lengthening them through casting

Enhanced PROM in targeted muscles (e.g., gastrocnemius for ankle dorsiflexion)

benefits in both joint alignment and muscle flexibilit

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

Green light self care/ function interventions:

A

goal directed training = self care

home program = self care

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

Goal-Directed Training (Self-Care):

A

Focuses on practicing and improving skills related to specific personal goals, particularly those essential for daily living and self-care, such as dressing, grooming, or feeding

Improved self-care abilities, such as dressing, bathing, and personal hygiene, through repeated practice of specific tasks

better task performance and independence

improving overall quality of life

facilitates motor learning by focusing on real-life, functional tasks

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

Home Programs (Self-Care):

A

Structured home-based exercise or activity programs designed to help individuals practice self-care tasks in their natural environment, promoting continuous progress outside of clinical settings

improvements in self-care task performance due to regular practice at home, where children and adults with CP can work on skills like feeding, dressing, or toileting with guidance

Helps maintain progress made in clinical settings and provides opportunities for more frequent repetitions of self-care tasks

better functional outcomes, greater independence, and more participation in daily routine

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

Green Light PT Interventions

A

Real-life tasks and activities (routine-based)

Self-generated active movements at high intensity

Motivation is essential – Goal is set by child

Successful, task-specific practice that is rewarding and enjoyable

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

Real-Life Tasks and Activities (Routine-Based Interventions):

A

focus is on using activities that are part of the individual’s daily routine or are meaningful to their everyday life

walking, dressing, or playing, are integrated into therapy sessions to promote functional skill development

Improvements in functional mobility and self-care skills

Increased independence in daily tasks and greater participation in social activities

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

Self-Generated Active Movements at High Intensity:

A

Encourages individuals to generate their own movements actively, focusing on high-intensity, repetitive practice to improve motor control and strength

based on neuroplasticity principles, where high-intensity, task-specific movements lead to better motor outcomes

Enhanced motor control, muscle strength, and endurance

Better outcomes in gross motor skills such as walking, running, or grasping objects

improve motor planning and problem-solving

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

Motivation is Essential – Goal is Set by the Child:

A

Therapy is more effective when the child is motivated by goals that they set themselves

Greater adherence to therapy and more enthusiastic participation

Higher levels of goal achievement and better functional outcomes

Children are more likely to practice independently and remain committed to therapy when the goal is personally meaningful

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

Successful, Task-Specific Practice that is Rewarding and Enjoyable:

A

meaningful tasks that the child finds enjoyable and rewarding

increases motivation, facilitates motor learning, and promotes mastery of specific skills

Significant improvements in motor function, such as balance, strength, and coordination

faster skill acquisition and better retention

boosts self-confidence and encourages continued effort and practice

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

CONTRACTURE MANAGEMENT

A

Serial casting or dynamic bracing

Strong evidence for changes in dorsiflexion

Typical Protocol: Serial casting for 4-6 weeks with weekly re-fittings or changes, followed by orthotics.

31
Q

Serial Casting and Dynamic Bracing =

A

widely used for managing contractures, particularly in individuals with conditions like cerebral palsy, stroke, or brain injury

focus on improving joint range of motion by progressively stretching tight muscles and soft tissues, typically the lower limbs

32
Q

Strong Evidence for Dorsiflexion Improvement =

A

especially in cases of equinus deformity (where the foot points downward) due to tight calf muscles

improving passive range of motion (PROM), particularly in the ankle joint, which contributes to better gait patterns and overall mobility

33
Q

Typical Protocol Casting:

A

typically performed over a period of 4-6 weeks

casts are usually re-fitted or changed every 7 days to gradually increase the stretch on the tight muscles

e-fitting allows for small increases in range of motion as the muscle and soft tissue adapt to the stretch

Once the serial casting phase is complete, the patient is often transitioned to orthotic devices (e.g., ankle-foot orthoses, or AFOs) to maintain the gains in range of motion and prevent recurrence of the contracture

34
Q

Task-Specific and 
Goal-Directed Therapy

A

Multiple terms in the literature:
Activity-focused
Task-oriented training

May need to address body structures/function before task practice

Motor control and learning principles come into play

Postural control components

35
Q

Activity-Focused Therapy:

A

Emphasizes practicing functional activities that are part of daily life

36
Q

Task-Oriented Training:

A

Refers to repetitive practice of specific tasks that are aimed at improving motor skills and functionality in real-life contexts

37
Q

Motor Control:

A

The ability of the central nervous system to regulate and direct the mechanisms essential for movement

Task-specific therapy is grounded in principles of motor control, which focuses on how the brain controls movement patterns

38
Q

Motor Learning:

A

Involves acquiring new skills through practice and experience

Principles such as repetition, intensity, and feedback are crucial to refining movement patterns and making them more efficient

39
Q

10x10x10
Inclusion Criteria

A

10 degrees of wrist extension

10 degrees of thumb abduction

10 degrees of extension for at least two other fingers

Other considerations:
cognitive function, spasticity, balance

40
Q

Components of Constraint-Induced Movement Therapy (CIMT)

A

emphasizes repetitive, task-oriented practice of the affected arm while constraining the unaffected arm

41
Q

CIMT COMPONENTS

A

Typically provided daily over a period of 2 weeks and led by an OT, PT, or both

Constraining the unaffected arm

Repetitive task-oriented training (3-6 hours)

Behavioral Techniques for real-world situations

42
Q

Behavioral techniques are utilized to promote motivation, engagement, and self-efficacy in real-world situations:

A

Goal setting: Helping patients set specific, measurable goals for their therapy

Positive reinforcement: Providing feedback and encouragement to boost confidence and motivation

Task adaptation: Modifying tasks to increase their relevance and challenge level, promoting engagement in meaningful activities

Functional transfer: Encouraging patients to apply skills learned in therapy to everyday activities in their home or community settings

43
Q

BIMANUAL TRAINING

A

Promotes use of both hemiparetic and dominant hand together

Also known as Hand-Arm Bimanual Intensive Training (HABIT)

Consider pairing with CIMT

44
Q

Home Program for Self Care

A

Practice of goal-directed tasks

Select routine-based activities

Support with reinforcement

45
Q

HIPPOTHERAPY

A

Green light for balance and symmetry

Yellow for gross motor and hand function

PT/OT utilizing horse as modality, so not the same as therapeutic riding

Typical Protocol: At least 16 hours – 1 hr, 2x/wk for 8 wks

46
Q

PEDIATRIC GAIT INTERVENTION:
green light

A

mobility training: walking speed

treadmill training: walking speed, walking endurance, gross motor

partial BWSTT: walking speed

47
Q

PEDIATRIC GAIT INTERVENTION
Dosing:

A

2-5x/wk for 2-12 wks
(at least 10 sessions)

Prevention vs Remediation vs Compensation

48
Q

Prevention

A

prevent the onset of secondary impairments or deterioration of functional abilities

Focus on educating families about proper body mechanics, safe mobility practices, and the importance of regular activity.

Incorporate activities that promote balance, strength, and coordination in playful and engaging ways.

49
Q

Remediation

A

address and correct existing gait deviations or impairments that hinder functional mobility

Utilize task-specific training, where children engage in repetitive practice of gait-related activities that are functional and meaningful to them

Use assistive devices (e.g., walkers, orthotics) if necessary, to support the child in achieving more typical gait pattern

Techniques may include motor learning principles, such as feedback, guidance, and varied practice, to help children improve their gait mechanics.

50
Q

Compensation

A

help children adapt to their limitations and improve functional mobility using alternative strategies or assistive devices

Train children to use compensatory strategies that allow them to navigate their environment safely and efficiently despite their gait limitations (e.g., learning to use a wheelchair or scooter)

Modify the environment to reduce barriers to mobility (e.g., using ramps instead of stairs, minimizing obstacles).

51
Q

Partial Body Weight Support Treadmill Training

A

harness system allows for the adjustment of body weight support, typically between 20% to 60% of the individual’s body weight

reduction helps improve stability and balance during walking

Walking on a treadmill provides a controlled environment that allows for repetitive practice of gait patterns

52
Q

Indications for PBWSTT:

A

Neurological Conditions: Such as stroke, traumatic brain injury, multiple sclerosis, and cerebral palsy.

Musculoskeletal Injuries: Where gait retraining is necessary post-surgery or injury.

Developmental Disorders: In children with conditions like spastic diplegia or other gait-related issues.

53
Q

STRENGTH/POWER TRAINING
Typical Protocol:

A

8-12 weeks
2-3 sessions per week
45-60 min sessions

54
Q

STRENGTH/POWER TRAINING
1RM Testing:

A

select weight for movement: guess a weight you think a child can successfully complete <5 times, then use calculator to estimate 1RM

adujst weight: child completed >5 reps of previous weight = increase weight, child unable to complete successful attempt = decrease weight

continue adjusting weight: child completes 1-5 reps = estimate 1RM, child unable to complete repetition or completes >5 reps = adjust

55
Q

power training:

A

6 sets of 6 reps
60-80% of 1 rep max
FAST concentric, SLOW eccentric

56
Q

strength:

A

3 sets of 5-8 reps
>80% 1 rep max
SLOW and CONTROLLED

57
Q

STRENGTH/POWER TRAINING
Functional 1RM Testing:

A

Pushing, pulling, stairs, steps, walking

Distance/steps child can cover unweighted in 25 seconds

Add weight so the child can perform 50-70% of max effort (ie, distance, steps)

Power training in short bursts of approx. 25 seconds, 6-8 reps

Increase weight 10% when child can complete all reps in <25 seconds

58
Q

Yellow Light Motor Interventions:

A

Assistive Technology
Electrical Stimulation
Orthoses
Stretching

59
Q

ASSISSTIVE TECHNOLOGY

A

Standing/Weight-bearing devices

Virtual Reality & Gaming

60
Q

Standing/Weight-bearing devices:

A

Target 60-90 minutes a day

designed to facilitate upright posture, promote weight-bearing through the lower extremities, and support muscle strengthening, balance, and coordination

Regular weight-bearing activities can help strengthen bones and reduce the risk of osteoporosis

Encouraging upright posture can enhance respiratory function and overall body alignment

enable children to engage more actively in their environment, promoting social interaction and participation in daily activities

61
Q

Virtual Reality & Gaming:

A

At least 4 hours (20 min/session, 2x a week, 6 weeks)

provide immersive experiences that can motivate and engage children in therapeutic exercises, making rehabilitation more enjoyable and effective

improve cognitive skills (e.g., memory, attention) alongside motor skills, promoting dual-task performance which is essential in everyday life

62
Q

FUNCTIONAL ELECTRICAL STIMULATION:

A

For better gait mechanics
↑ strength
↓ foot drop
↑DF in swing
↑heel strike

Monitor for comfort and skin reactions

63
Q

ORTHOSES:

A

For better gait mechanics
↑ walking speed
↑ stride length
↑ DF in swing
↑ heel strike

Monitor for comfort and skin reactions

64
Q

What type of shoes should be worn with LE orthoses?

A

extra depth
flexible & lightweight
substantial outsoles
firm heel counter

65
Q

STRETCHING

A

Need sustained stretch to make meaningful changes – think serial casting

Manual stretching is not a skilled activity but can be used to warm up tissues for activity or for pain management

Can teach child/family how to incorporate longer duration stretches into their daily home program

66
Q

Types of Stretching Techniques

A

Static
Dynamic
Prolonged

67
Q

Static Stretching:

A

Involves holding a stretch in a comfortable position for an extended period (typically 15-60 seconds).

Effective for increasing flexibility and improving muscle length.

68
Q

Dynamic Stretching:

A

Involves moving parts of the body through a range of motion in a controlled manner.

Useful as part of a warm-up to prepare muscles for activity.

69
Q

Prolonged Stretching:

A

Similar to sustained stretching, it involves holding a stretch for a longer duration (e.g., 30 minutes to several hours).

Techniques such as splinting or the use of serial casts can facilitate this type of stretch.

70
Q

Begin with green light interventions, based on ___

A

child/family goals

71
Q

Yellow-light interventions may be considered based on ____

A

child/family goals, interests, and access

72
Q

Incorporate ___ training principles

A

strength/power

73
Q

Use functional tasks to target ___ and ___ control

A

reactive

anticipatory postural

Neuro Final (10 decks)

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