Degenerative Diseases

Question 1

What are the diseases?

Answer 1

PD
MS
ALS
HD
Alzheimers

Question 2

What happens in early stages of disease?

Priorities of rehab?

Answer 2

minimal impairments/limitations
usually just starting to struggle.

Priority:
neuro protection* and plan energy conserve but workout.
delays regression*
educate and home modifications

Question 3

Some things to do for early stage?

Answer 3

consider referral
register for Clinical Trial
Membership in societies
support groups.

Question 4

Middle stages of diseases?

Answer 4

impaiments/disabilities pile up
use same type of prevention

WORK ON:
range*
dystonia
bracing
AD* plan for disease progression

Question 5

late stage diseases?

Answer 5

Severe impairments/ completely disabled.

Rehab:
Caregiver training*
prevent contractures/skin.
palliative care.

Question 6

What is MS?

Answer 6

inflammation causing plaque in myelin sheaths.

reduces speed and effectiveness of nerve transmission

Question 7

Dx and Px of MS?

Answer 7

PT can Dx.
2 CNS pathologies*
2 episodes of nerve dysfx.*
lots of sensory issues
CT/MRI.

Favorable Px?
female/35 y/o/ no disability for 5 yrs/
first symptoms are optic neuritis/sensory dysfx

Question 8

What are MS patterns?

Answer 8

relapse/remitting: sudden onset->disappearance of symptoms

Primary progressive: continuous worsening. no remission

2ndary progression:
starts with remitting but then becomes progressive.

Question 9

Sxs and symptoms of fatigue?

Answer 9

FATIGUE: work around this (time/save energy)

Dec heat tolerance: hydrate/cooling vest/hydrotherapy

Weak: prevent disuse/overcome spasticity/strengthen

increased BDNF after exercise. so u want to do that to keep white matter.

Question 10

What is huntington’s disease?

Dx/Prognosis

Answer 10

neuronal loss in caudate and putamen

Dx: genetic testing

Px: survive 15-25 yrs after onset usually 30y/o

Question 11

Sx and symptoms of HD?

Answer 11

Depression/irritable
Slow processing/Dec attention

move slow/dystonia/cant modulate gait/chorea
difficulty turning.

Question 12

Tx for HD?

Answer 12

Cognitive/sensory strategy
Balance retraining
ROM of spastic and strengthen antagonist

neuroprotections.. rn exercise isn’t that great for this like it is for PD

Question 13

Patho of ALS?

Answer 13

Degenerations of motor neurons in Brain/BS/SC.

Dx: UMN/LMN signs
Px: 5-10 yr survival.

Question 14

Signs and symptoms of ALS?

Answer 14

at first weak/sporadic/fatigue
Bulbar impairments
Cognitive symptoms (usually later unlike HD)
Respiratory impairments(dec activity to match impairment)*

Question 15

50% FVC?

25?

Answer 15

orthopnea/ineffective cough

acidosis/coma/death

Question 16

Tx for ALS?

Answer 16

exercise in early stage (strength/endurance)
Support weak muscles
Airway clearance
*progresses rapidly

aerobic exercise ^ QOL

Question 17

Alzheimers notes?

Answer 17

cognitive decline and rule out other stuff.

have neurofibrillary tangles inside. and amyloid plaques outside

Question 18

1st structure to show patho change in alzheimers is

Answer 18

cerebral cortex: no ne memory/lose declarative memory

Late:global memory loss/loss comprehension/ Frontal lobe disinhibition.

Question 19

What is important for demented patients to acquire and retain?

Answer 19

motor-type procedural memories

Question 20

Movement disorders of alzheimers?

Answer 20

akinesia/dystonia
rigidity

similar to parkinson’s.

Question 21

effects of Interventions for Alzheimers

Answer 21

aerobic + strengthen improve ADLs.

decrease fall risk

deterioration slows

decrease caregiver burden

slow development of dementia