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NMR II > Final: Parkinson's Examination > Flashcards

Final: Parkinson's Examination Flashcards

1
Q

What should be included in your observation of function for a pt with Parkinson’s?

A

Bed mobility, transitions, skill, transfers, ambulation, STOMs

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2
Q

What characteristics of a tremor are important during observation?

A

Location, persistence, severity, resting vs action, triggers

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3
Q

What test is highly recommended to assess for bradykinesia?

A

9 hole peg test

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4
Q

What is a means of assessing for hypokinesia/amplitude?

A

Observation of arm swing during ambulation

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5
Q

How do you assess for akinesia?

A

Duration, triggers, and ability to overcome freezing and reaction time

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6
Q

What should you consider when assessing for rigidity?

A

Leadpipe vs cogwheel, PROM, spinal ROM, distribution, severity

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7
Q

What scale is used to quantify rigidity?

A

UPDRS Rigidity Scale

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8
Q

What is a 0 on the UPDRS Rigidity Scale?

A

Rigidity absent

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9
Q

What is a 1 on the UPDRS Rigidity Scale?

A

Rigidity slight or detectable only when activated by mirror or other movements

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10
Q

What is a 2 on the UPDRS Rigidity Scale?

A

Rigidity mild to moderate

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11
Q

What is a 3 on the UPDRS Rigidity Scale?

A

Rigidity marked, but full range of motion easily achieved

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12
Q

What is a 4 on the UPDRS Rigidity Scale?

A

Rigidity severe, ROM achieved with difficulty

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13
Q

What are common posture deviations for a pt with Parkinson’s?

A

Forward head, rounded shoulders, kyphosis, hip/knee flexion, hand position

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14
Q

What is the typical hand position for a pt with Parkinson’s?

A

MP: flexed
IP: extended
Wrist: flexion, ulnar deviation
Forearm: pronation

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15
Q

What are sensory symptoms a pt with Parkinson’s may present with, and what tests and measures would be indicated?

A

Pain, tingling numbness - superficial, deep, cortical

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16
Q

Will a pt with Parkinson’s have abnormal nerve conduction velocity?

A

No

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17
Q

What are potential causes of sensory impairments for pt’s with Parkinson’s?

A

Age, comorbidity, perceptual

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18
Q

What visual changes occur with Parkinson’s?

A

Blurring, smooth pursuit

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19
Q

How will a pt’s perception of upright change in the late stages of Parkinson’s?

A

It will shift forward of vertical

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20
Q

What clinical measure of postural control and balance are highly recommended for PD?

A

Mini BEST, ABC is also recommended

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21
Q

What are gait parameters to observe?

A

Start time, gait speed, stride length, cadence, stability, turning, safety, quality

22
Q

What STOMs are highly recommended for Parkinson’s?

A

10 m walk, 6 min walk, FGA

23
Q

What does FOGA stand for?

A

Freezing of Gait Assessment

24
Q

What is the FOGA?

A

Assesses gait through a course under single, dual, and triple task conditions

25
Q

What does a 0 on the FOGA indicate?

A

No festination of FOG

26
Q

What does a 1 on the FOGA indicate?

A

Festination of hastening of steps/shuffling

27
Q

What does a 2 on the FOAG indicate?

A

FOG but overcomes

28
Q

What does a 3 on the FOAG indicate?

A

FOG, examiner intervenes or cues

29
Q

What cognitive assessment is highly recommended for PD?

A

MOCA - more sensitive to mild impairment

30
Q

What assessment is used to assess fatigue in pt’s with PD?

A

Parkinson’s Fatigue Scale

31
Q

What tools can be used to assess psychosocial barriers?

A
  1. Geriatric depression scale
  2. Hamilton depression rating scale
32
Q

What tools can be used to assess anxiety in pt’s with PD?

A
  1. Geriatric anxiety inventory
  2. Parkinson’s anxiety scale
33
Q

How can you assess for autonomic dysfunction?

A

Altered HR and BP in response to exercise, RPE

34
Q

How should you assess for orthostatic hypotension, and what changes in BP are significant?

A

Measure BP 1 min following position changes - drop is systolic of 20 mmHG or diastolic of 10 mmHG

35
Q

What three STOMS are specific to Parkinson’s?

A
  1. Hoehn-Yahr Classification of Disability
  2. MDS-UPDRS
  3. PDQ-39
36
Q

What does Stage I on the Hoehn-Yahr indicate in terms of disability?

A

Minimal or absent, unilateral

37
Q

What does Stage II on the Hoehn-Yahr indicate in terms of disability?

A

Minimal bilateral or midline involvement. Balance not impaired

38
Q

What does Stage III on the Hoehn-Yahr indicate in terms of disability?

A

Impaired righting reflexes, unsteadiness turning or rising from chair. Some activities restricted, be can live independently and continue employment

39
Q

What does Stage IV on the Hoehn-Yahr indicate in terms of disability?

A

All symptoms present and severe, standing and walking possible only with assistance

40
Q

What does Stage V on the Hoehn-Yahr indicate in terms of disability?

A

Confined to bed or wheelchair

41
Q

What is the gold standard for measuring disease progression for PD?

A

MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)

42
Q

What is the MDS-UPDRS?

A

Comprehensive tool designed to monitor the burden and extend of PD across the longitudinal disease course

43
Q

What ICF levels are included with the MDS-UPDRS?

A

Body structure, activity, participation

44
Q

What does part I of the MDS-UPDRS assess?

A

Non-motor experiences of daily living

45
Q

What does part II of the MDS-UPDRS assess?

A

Motor experiences of daily living

46
Q

What does part III of the MDS-UPDRS assess?

A

Motor examination

47
Q

What does part IV of the MDS-UPDRS assess?

A

Motor complications

48
Q

What does a higher score on the MD-UPDRS indicate?

A

Increased severity

49
Q

What is the timeframe of symptoms assessed with the PDQ-39?

A

Symptoms in the last month

50
Q

What does PDQ-39 stand for?

A

Parkinson’s Disease Questionnaire

51
Q

What are the 8 QOL dimensions assessed by the PDQ-39?

A
  1. Mobility
  2. ADLs
  3. Emotional wellbeing
  4. Stigma
  5. Social support
  6. Cognition
  7. Communication
  8. Body discomfort

NMR II (27 decks)

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