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Neuromuscular > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Neuroplasticity

A

neural system continuously remodeled throughout life and after injury by experience and learning in response to activity and behavior

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2
Q

Cell Body Damage

A

Neurons not replaced

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3
Q

Zone of Ischemia

A

reversible, insufficient blood supply, natural healing process

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4
Q

Zone of injury

A

reversible, medication can help tissue, area of edema or swelling next to infarct

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5
Q

Zone of Infarction

A

Damage is permanent, cell body damaged, axonal damage,

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6
Q

Penumbra (core zone)

A

area of mild to moderately affected tissue adjacent to the area of ischemia

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7
Q

Ischemic Stroke (tissue plasminogen activator)

A

stared within 3 hours after ischemic stroke, 50% with no clinical benefits, MCA main challenge

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8
Q

collateral sprouting

A

4-5 days after injury, replace vacant synaptic fields, do not replace original circuitry

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9
Q

You have been asked to treat a patient in the acute care hospital on Friday. You note that following her ischemic CVA she has very little movement in her Right Upper Extremity. When you come back to work on Monday, you notice great improvement in her UE function. You suspect that she has had natural healing and has responded to medication in which area?

A

zone of Ischemia

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10
Q

Principle 1:

A

Use it or Lose it …Neural circuits can degrade without activity, brain area can shift responsibility

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11
Q

Principle 2:

A

Use it or Improve It….practice of specific tasks can increase areas of the brain that respond during the task

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12
Q

Principle 3:

A

specificity matters: changes in specific brain areas occur relative to the task is practiced….skilled practiced results in changes in neural connectivity

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13
Q

Principle 4

A

Repetition Matters

Repetition of new task required to see neural changes

Changes at the neuronal level not observed until significant repetition of new task, even when behavioral improvements observed

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14
Q

Principle 5

A

Intensity Matters

Need to differentiate between intensity
and repetition

High intensity stimulation = long-term potentiation
Low intensity stimulation = long-term depression

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15
Q

Human Brain Derived Neurotrophic Factor

A

Responsible for:

axon targeting
neuron growth
maturation of synapses during development
synaptic plasticity
Prevents neuronal cell death after cerebral ischemia

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16
Q

Human Brain Derived Neurotrophic Factor affects what:

A

Affects neuroplasticity by facilitating long-term potentiation
Strengthening of connections through dendritic growth & remodeling
Secreted in CNS by:
Constitutive pathway
Activity-dependent pathway

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17
Q

Principle 6

A

Time Matters

Neuroplasticity is a process

Gene expression→synapse formation→motor map reorganization

Earlier rehabilitation post-infarct prevents loss and promotes dendritic growth more so than delayed rehab

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18
Q

Principle 7

A

Salience Matters

Neural system that mediates saliency
Engaging system is critical for driving experience-dependent plasticity

If task is salient:
 attention to task
 acetylcholine
Lack of ACH prevented re-organization of motor cortex

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19
Q

Principle 8

A

Age Matters

Neuroplasticity altered in older brain

Neuroplastic changes can occur but may be slower

Effects may be lessened with history of greater physical and mental activity

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20
Q

Principle 9

A

Transference

Ability to improve in 1 area may make it easier to improve in similar tasks

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21
Q

Principle 10

A

Interference
Ability of plasticity within given neural circuitry to impede induction of new or expression of existing plasticity within same circuitry ≠ learning

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22
Q

Motor Learning

A

A set of internal processes associated with practice or experience leading to RELATIVELY PERMANENT CHANGE in the capability for skilled behavior

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23
Q

Law of Effect

A

Behaviors that are rewarded will be repeated at the cost of other behaviors while those that produce adverse effect will be less likely to occur

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24
Q

Motor learning Manual guidance

A

 increase Performance
 decrease Learning
 decrease Retention

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25
Q

Motor learning Observational learning

A

increase performance, decrease learning, decrease errors

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26
Q

Types of practice: constant

A

Practice of same task for multiple repetitions

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27
Q

Types of practice: Variable

A

Training that includes same basic task, but frequent changes so that the performer is constantly confronting novel instances of “to-be-learned” information

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28
Q

Length of practice session: massed

A

time spent in practice > rest

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29
Q

Length or practice: distributed

A

– rest periods are scheduled t/o the practice session

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30
Q

Type of task: whole

A

To allow person to understand movement in its entirety

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31
Q

Type of Task: part

A

For tasks that have discrete stop & start

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32
Q

Stages of learning: Cognitive

A

planning, early, what to do

33
Q

Stages of learning: associative

A

practice, intermediate, how to do

34
Q

Stages of learning: autonomous

A

automatic, final, how to succeed

35
Q

Optimal Theory of Motor Learning

A

how the person is doing the movement going to optimize the quality of the movement, make sure the patient is motivated to do the movement, attentional focuse and what is expected for success

36
Q

Speed/accuracy trade off

A

the faster you go the there will be a decrease in accuracy

37
Q

Maximizing learning of skill

A

Person

Motor learning emerges from a complex system of perception/cognition/action processes

38
Q

Maximizing learning of skill

A

ATTENTION Is foundation

39
Q

Environmental: closed

A

All variables such as the setting and objects remain the same.

40
Q

Environmental: constant motion

A

Objects or support surface are in motion, but do not change over successive attempts.

41
Q

Environmental: open

A

Environment changes between trials; support surface is in constant motion

42
Q

Environmental: variable motion

A

The environment is stationary, but features within the environment change.

43
Q

Facilitating Acquistion

A

effortful practice –> varied learning styles –> active engagement w/task

44
Q

Recovery of Function

A

Refers to reacquisition of movement skills lost through injury

Reorganization of both perception and action systems in relation to specific tasks and environments

Person uses Task Solutions

45
Q

Learning a Motor Skill

A

Complex process that reflects spatial, temporal and hierarchical organization of the CNS that contributes to organized and purposeful motor behavior

46
Q

Single Nucelotide Polymorphism

A

BDNF Gene Val66met

1 of many genetic variants that could potentially affect aerobic exercise effects on brain & post stroke rehabilitation

47
Q

Polymorphism individuals with it have:

A

Decreased cognition (object recognition) when engaged in 4 weeks of aerobic exercise

increase intensity

48
Q

Individuals without polymorphism

A

Greater motor map plasticity

Greater retention on motor learning task

Novel motor skill vs simple repetition of familiar task

May be dependent on fact that CNS has been impaired

49
Q

Factors that Influence Cognition

A

Side effect of medication
Depression
Sleep deprivation

50
Q

Depression in Stroke

A

affect: Cognitive Function

51
Q

Basic Principles of Exercise Prescription: overload

A

Increased effort above normal
See increase in strength, flexibility & aerobic capacity
Results in fatigue & temporary decrease in capacity

52
Q

Basic Principles of Exercise Prescription: Adaptation

A

Capacity of exercise (strength, flexibility & aerobic capacity) increases to level greater than original value due to adaptation

53
Q

Basic Principles of Exercise Prescription: progression

A

Exercise stimulus MUST INCREASE over time to elicit continued improvements

54
Q

Basic Principles of Exercise Prescription: specificity

A

Adaptations induced by training are SPECIFIC to the stress

55
Q

Weight Acceptance

A

Transfer weight from one leg to another

Most difficult task of gait

56
Q

Weight Acceptance Goals:

A

forward progression
stability
shock absorption

57
Q

Single Limb Support

A

Maintain stability on one leg while the body advances over it

58
Q

Single Limb Support Goal

A

Stability

Forward progression

59
Q

Swing Limb Advancement

A

unload the leg and advance it forward

60
Q

Swing Limb Advancement

Goals

A

foot clearance

limb advancement

61
Q

The Functional Tasks of Gait

A

Weight Acceptance

Single Limb Support

Swing Limb Advancement

62
Q

The three tasks must be accomplished while:

during gait training:

A

changing direction and elevation
performing other tasks

encountering changes in ground surfaces

avoiding obstacles

withstanding perturbations
minimizing energy expenditure

63
Q

Gait speed:

A

Common units: meters/sec, meters/min
Ranges of speed:
Adult males: 1.36 m/sec
Adult females: 1.32 m/sec

64
Q

Gait cadence:

A

Ranges of cadence
adult males: 111 steps/minute
adult females: 121 steps/minute
Cadence is not a good measure of gait quality by itself
See: normal cadence with decrease step length & decrease speed

65
Q

Gait Step length and stride length

A

ranges of stride length
adult males: 1.48 meters
adult females: 1.32 meters

a stride length = two consecutive step lengths

step lengths can be unequal, but stride lengths are always equal

66
Q

Gait foot angle:

A

normally 7 degrees, increases base of support

67
Q

Gait trunk rotation

A

Pelvis rotates 5 degrees one direction

Trunk rotates 5 degrees other direction

68
Q

Gait Arm Swing

A

Normal
24 degrees extension
6 degrees flexion
Restrict arm motion increases energy cost

69
Q

Dynamic Stability what muscles are required:

A 
Hip extensors (LR)
Hip abductors (LR, TSt)
Knee extensors (LR)
Ankle plantarflexors (MST, TSt)
70
Q

Muscle Activity – Initial Contact

A

Ankle
Anterior tibialis isometric contracts

Knee
Quads and Hamstrings isometric

Hip
Glut max and adductor magnus isometric

71
Q

Muscle Activity – Loading Response

A

Ankle
Anterior tibialis eccentric

Knee
Quadriceps eccentrically –peak activity

Hip
Extensors, adductors, abductors stabilize

72
Q

Muscle Activity – Mid Stance

A

Ankle
Soleus and gastroc control forward progression of tibia

Knee
Quadriceps for stability

Hip
Abductors only

73
Q

Muscle Activity – Terminal Stance

A

Ankle
Gastroc/Soleus peak activity
Control tibia forward movement

Knee
No quad activity
Possible Hamstring activity

Hip
TFL

74
Q

Muscle Activity – Pre Swing

A

Ankle
Gastroc/soleus

Knee
Minimal knee flexor activity

Hip
Adductor longus and Rectus Femoris

75
Q

Muscle Activity – Initial Swing

A

Ankle
Tibialis anterior concentric
Extensor hallucis and digitorum longus peak activity

Knee
Biceps femoris concentric- peak activity

Hip
Iliacus, gracilis and sartorius peak activity

76
Q

Muscle Activity – Mid Swing

A

Ankle
Tibialis anterior

Knee
Hamstrings eccentric in late part

Hip
Hamstrings late in phase

77
Q

Muscle Activity – Terminal Swing

A

Ankle
Tibialis anterior

Knee
Hamstrings peak in activity eccentrically
Quadriceps start contracting

Hip
Hamstrings peak in activity eccentrically
Hip musculature begin to activate to prepare for IC

78
Q

Gait deviations can cause

A

increased energy expenditure

abnormal stresses on muscles, joints, etc.

safety risk

79
Q

Four major categories of problems:

A

Impaired Motor Control
Abnormal ROM (↑ or ↓)
Decreased Sensation/Perception
Pain

also due to: balance disorder, impaired cognition

Neuromuscular (1 decks)

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