Experienced-Based Neuroplasticity and Learning

Question 1

which factors must be present for a 98% chance of independent walking 6 months after a stroke?

Answer 1

independent sitting balance in 1st 3 days
LE strength of at least 1/5 hip flexors, knee extensors, & ankle DFs in 1st 3 days

Question 2

what Berg Balance Scale and FIM-L Scores indicate 20x more likely for household ambulation (home bound) upon admission to in-patient rehab post stroke?

Answer 2

BBS < 20
FIM-L = 1 (total A) or 2 (max A)

Question 3

what gait speed is unlimited household ambulation post stroke?

Answer 3

0.27 m/sec

Question 4

what gait speed is limited community ambulation post stroke?

Answer 4

0.58 m/sec

Question 5

what gait speed is unlimited community ambulation post stroke?

Answer 5

0.80 m/sec

Question 6

what gait speed is required to cross a commercial street?

Answer 6

2 m/sec

Question 7

what gait speed is community ambulation for adults without stroke?

Answer 7

at least 1.2 m/sec

Question 8

which gait speed is commonly seen in adults post stroke?

Answer 8

0.8 m/sec

Question 9

what is the ESSENTIAL neuroanatomy for walking?

Answer 9

muscle and peripheral nerves
spinal cord pattern generators
ventrolateral and ventromedial SC paths
medullary reticular formation
mesencephalic locomotor region
subthalamic locomotor region

Question 10

what is the IMPORTANT (but not essential) neuroanatomy for walking?

Answer 10

sensation
dorsolateral spinal cord pathways
pontomedullary locomotor strip
cerebellum (vermal)
red nucleus
lateral vestibular nuclei
substantia nigra
globus pallidus (internal segment)
nucleus accumbens
limbic cortex

Question 11

which structure is the top of the hierarchy for motivation to walk?

Answer 11

hippocampus
*why fear can shut down the system

Question 12

what are the ACCESSORY regions for walking?

Answer 12

motor cerebral cortex
pyramidal tract

Question 13

____ may interfere with walking if attention is required for a task

Answer 13

motor cortex

Question 14

what are the 3 sensory inputs that operate the CPG?

Answer 14

1) stretch of hip flexors
2) unweighting triceps surae
3) WB to facilitate extensor tone in stance limb (muscle receptors in triceps surae, pressure receptors in foot, & joint receptors)

Question 15

what are the absolute requirements for constraint-induced movement therapy?

Answer 15

ability to:
extend wrist 10-20 degrees
slightly extend at least 2 fingers
understand & follow directions
(extend/abd thumb at least 10 deg)

Question 16

constraint-induced movement therapy requires _____ practice

Answer 16

massed