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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
Motor learning Observational learning
increase performance, decrease learning, decrease errors
26
Types of practice: constant
Practice of same task for multiple repetitions
27
Types of practice: Variable
Training that includes same basic task, but frequent changes so that the performer is constantly confronting novel instances of “to-be-learned” information
28
Length of practice session: massed
time spent in practice > rest
29
Length or practice: distributed
– rest periods are scheduled t/o the practice session
30
Type of task: whole
To allow person to understand movement in its entirety
31
Type of Task: part
For tasks that have discrete stop & start
32
Stages of learning: Cognitive
planning, early, what to do
33
Stages of learning: associative
practice, intermediate, how to do
34
Stages of learning: autonomous
automatic, final, how to succeed
35
Optimal Theory of Motor Learning
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
Speed/accuracy trade off
the faster you go the there will be a decrease in accuracy
37
Maximizing learning of skill
Person | Motor learning emerges from a complex system of perception/cognition/action processes
38
Maximizing learning of skill
ATTENTION Is foundation
39
Environmental: closed
All variables such as the setting and objects remain the same.
40
Environmental: constant motion
Objects or support surface are in motion, but do not change over successive attempts.
41
Environmental: open
Environment changes between trials; support surface is in constant motion
42
Environmental: variable motion
The environment is stationary, but features within the environment change.
43
Facilitating Acquistion
effortful practice --> varied learning styles --> active engagement w/task
44
Recovery of Function
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
Learning a Motor Skill
Complex process that reflects spatial, temporal and hierarchical organization of the CNS that contributes to organized and purposeful motor behavior
46
Single Nucelotide Polymorphism
BDNF Gene Val66met 1 of many genetic variants that could potentially affect aerobic exercise effects on brain & post stroke rehabilitation
47
Polymorphism individuals with it have:
Decreased cognition (object recognition) when engaged in 4 weeks of aerobic exercise increase intensity
48
Individuals without polymorphism
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
Factors that Influence Cognition
Side effect of medication Depression Sleep deprivation
50
Depression in Stroke
affect: Cognitive Function
51
Basic Principles of Exercise Prescription: overload
Increased effort above normal See increase in strength, flexibility & aerobic capacity Results in fatigue & temporary decrease in capacity
52
Basic Principles of Exercise Prescription: Adaptation
Capacity of exercise (strength, flexibility & aerobic capacity) increases to level greater than original value due to adaptation
53
Basic Principles of Exercise Prescription: progression
Exercise stimulus MUST INCREASE over time to elicit continued improvements
54
Basic Principles of Exercise Prescription: specificity
Adaptations induced by training are SPECIFIC to the stress
55
Weight Acceptance
Transfer weight from one leg to another Most difficult task of gait
56
Weight Acceptance Goals:
forward progression stability shock absorption
57
Single Limb Support
Maintain stability on one leg while the body advances over it
58
Single Limb Support Goal
Stability | Forward progression
59
Swing Limb Advancement
unload the leg and advance it forward
60
Swing Limb Advancement | Goals
foot clearance | limb advancement
61
The Functional Tasks of Gait
Weight Acceptance Single Limb Support Swing Limb Advancement
62
The three tasks must be accomplished while: during gait training:
changing direction and elevation performing other tasks encountering changes in ground surfaces avoiding obstacles withstanding perturbations minimizing energy expenditure
63
Gait speed:
Common units: meters/sec, meters/min Ranges of speed: Adult males: 1.36 m/sec Adult females: 1.32 m/sec
64
Gait cadence:
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
Gait Step length and stride length
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
Gait foot angle:
normally 7 degrees, increases base of support
67
Gait trunk rotation
Pelvis rotates 5 degrees one direction Trunk rotates 5 degrees other direction
68
Gait Arm Swing
Normal 24 degrees extension 6 degrees flexion Restrict arm motion increases energy cost
69
Dynamic Stability what muscles are required:
``` Hip extensors (LR) Hip abductors (LR, TSt) Knee extensors (LR) Ankle plantarflexors (MST, TSt) ```
70
Muscle Activity – Initial Contact
Ankle Anterior tibialis isometric contracts Knee Quads and Hamstrings isometric Hip Glut max and adductor magnus isometric
71
Muscle Activity – Loading Response
Ankle Anterior tibialis eccentric Knee Quadriceps eccentrically –peak activity Hip Extensors, adductors, abductors stabilize
72
Muscle Activity – Mid Stance
Ankle Soleus and gastroc control forward progression of tibia Knee Quadriceps for stability Hip Abductors only
73
Muscle Activity – Terminal Stance
Ankle Gastroc/Soleus peak activity Control tibia forward movement Knee No quad activity Possible Hamstring activity Hip TFL
74
Muscle Activity – Pre Swing
Ankle Gastroc/soleus Knee Minimal knee flexor activity Hip Adductor longus and Rectus Femoris
75
Muscle Activity – Initial Swing
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
Muscle Activity – Mid Swing
Ankle Tibialis anterior Knee Hamstrings eccentric in late part Hip Hamstrings late in phase
77
Muscle Activity – Terminal Swing
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
Gait deviations can cause
increased energy expenditure abnormal stresses on muscles, joints, etc. safety risk
79
Four major categories of problems:
Impaired Motor Control Abnormal ROM (↑ or ↓) Decreased Sensation/Perception Pain also due to: balance disorder, impaired cognition

Neuromuscular (1 decks)

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