Dykinesias Flashcards
Dystonia
Sustained muscle contractors that cause twisting and repetitive movements and/or abnormal postures
May be triggered by voluntary movement and may overflow into other muscles
Athetosis
Slow, involuntary, convoluted, writhing movements of the fingers, hands, toes and feet
Often due to damage of the basal ganglia
Chorea
Quick involuntary movements of the feet or hands
May occur with athetosis - choreoathetosis
Aims of post-DBS Physio
Posture and balance
Functional mobility
Functional UL use
ADLs/cares
Treatment of post DBS Physio
Strength, stability
Selective motor control
Sensory modulation
PT treatment aims - postural control
Moving to midline
Reduction in internal perturbations
Functional Orientation
PT treatment aims - Gross motor
Functional mobility
Transfers
Mobility equipment selection and training
PT treatment aims - fine motor/UL
ADLs/cares
Education/learning
Recreation/sports
Postural stability treatment
Postural awareness (visual - mirrors, tactile, proprioception)
Task orientation
Graded contraction
Muscle groups for posture, holding, orientation
Selective motor control treatment
Isolated contraction
Purposeful movement
Plastic rings in hands to keep hands in midline
Ladder to stabilise and control movement
Range of motion treatment
Increase and preserve ROM and mobility needed for function
Sensory integration/modulation
Awareness of triggers - strategies to minimise incidence and impact
Teach use of sensory cueing to stabilise posture and movement
Dyskinesia - Motion
Dystonia - may have less movement - stuck in postures
Choreoathetosis - excessive movement, involuntary/unwanted
Dyskinesia - Orientation
Poor antigravity, speed of responses vary, may be absent, difficulty sustaining postures, may use fixation for stability
Dyskinesia - Variety
Poor repertoire of voluntary movement due to interference from unwanted movement and/or fluctuations in tone
Dyskinesia - Ease
CA - tend to have free movement - no contractors
Dystonia - if repeatedly fixating may develop stiffness or pain
Dyskinesia - Modulation
range, speed and effort are poorly controlled
Dyskinesia - Effective
Variable even if can problem solve, due to volume, nature and timing of involuntary/unwanted movement/tone
Dyskinesia - Normal
Most cases show slow acquisition and lower quality for age
Severe cases can show significant and permanent delays
Dyskinesia - Timing
all aspects of movement timing can be interrupted by unwanted posture/movement, even if child can plan
Dyskinesia - safe
Difficulty protecting self
Accidental injury to others due to unwanted movement
Dyskinesia - Senses
Low registration of certain sensory stimuli e.g. vision, hearing, tactile
Dyskinesia - Engages
Avoidance or over-seeking - not common unless concomitant autism
Dyskinesia - Nominates
Poor perception common
Dyskinesia - Symmetry
Depending on area of brain impairment, may experience hemisensory loss, hemianopia, extinction
Dyskinesia - Adjusts
Very poor position adjustments and maintenance due to excessive involuntary movement, limited control of alignment
Dyskinesia - Tunes
Over or under responses to stimuli (e.g. exaggerated parachute reaction or absent postural response)
Dyskinesia - Integrates
Overuse of certain sensory information; over use as well
Dyskinesia - Overrides
Likely problems with unresolved sensory conflict/mismatch due to poor system function and integration, sensory bias
Dyskinesia - Normal
Unsafe - yes, involuntary movement can cause injury to others because of poor control
