General Management of MSDs Flashcards
Goals of tx
Restore lost function, promote use of residual function (compensation), reduce the need for lost function (adjust)
How does medical prognosis influence management?
Don’t treat acute post-CVA if unstable neurologically (alertness), don’t provide tx pre-surgery, treat degenerative and chronic conditions
Define speech-oriented tx approach
Primary focus on improving intelligibility, secondary focus on improving efficiency and naturalness. Reduce impairment and/or increase compensation
Rationale for behavioural management
The brain is not a static organ, cortical organization isn’t fixed, neural adaption with muscle use, nervous system can reorganize and recover post-injury
Principles of motor learning
Improving speech requires speaking, drill is essential, both instruction and self-learning are valuable, feedback is important, specificity and salience of training are important, consistent and variable practice may have different effects, efforts to increase strength should follow principle for strength training, speed and accuracy trade-off
“Improving speech requires speaking”
Most important in recovery or improvement phase, motor imagery may help but is less effective than physical practice
“drill is essential”
Brief periods of practice distributed over time may be more effective than lengthy periods of massed practice
“both instruction and self-learning are valuable”
Find a balance. Client may develop method if you develop goal. Fade instruction ASAP, even if the rate of improvement slows, for better retention
“feedback is important”
Knowledge of performance and knowledge of results. Less frequent or summarized feedback may increase retention.
“specificity and salience of training are important”
Changes in strength are greatest for the trained movement. Training should be as specific as possible.
“consistent and variable practice may have different effects”
Increase consistency in early stages and variability in later stages
“efforts to increase strength should follow principle for strength training”
Overloading muscle, isotonic movements, repetition, maintenance, speech should require less than max effort
“speed and accuracy trade-off”
Accuracy initially, speed later. Consider what is most impacting intelligibility
Stages of motor learning
Cognitive, associate, automatic
