Intervention Flashcards
1
Q
What is the primary intervention for contractures
A
prevention of them
2
Q
green light intervention for contractures
A
- LE serial casting
- AROM
- strengthening
- standing/walking
- surgery
- Botox
3
Q
yellow light interventions for contractures
A
- passive stretching
- LE/UE splinting at night
- dynamic braces
- standing frames if not ambulatory
4
Q
red light interventions for contractures
A
- hip abduction braces
- bracing that impedes active movement or participation
5
Q
what movements do you want to focus on for prevention of UE contractures
A
wrist ext
finger ext
forearm supination
elbow ext
6
Q
T or F: early on in CVA you should avoid night splinting unless there are signs of reduced PROM
A
T
7
Q
what movements are combined with botox during a restorative clinical approach
A
1 - botox
2 - serial casting
3 - WBing and task-specific activities
8
Q
T or F: one modality is enough to prevent/improve contractures
A
F: must be combined and continued with other modalities for long term effects
9
Q
T or F: short static stretches are enough to improve/prevent contractures
A
F: need long static stretching - closer to 24 hours
ex. serial casting, splinting
10
Q
T or F: fatigue is present in most neuro diagnoses and there are many factors that go into it
A
T
11
Q
fatigue is _______ while fatigability is ________
A
subjective
objective
12
Q
a common complaint in patients with neuro diagnoses is fatigue with…
A
walking!
*use rest breaks
13
Q
is fatigue or fatigability more difficult to treat? why?
A
fatigue because it is perception
14
Q
green light interventions for fatigue
A
- energy conservation
- aerobic conditioning
- sleep hygiene
- medications
- team approach
15
Q
yellow light intervention for fatigue
A
natural lighting
16
Q
green light interventions for fatigiability
A
- psychiatry
- intermittent exercise
- velocity training
- task specific training
- LE progressive resistive exercise
- mindfullness
17
Q
yellow light interventions for fatigiability
A
- high intensity aerobic exercise
- FES cycling
- BWSTT
- robotic gait
- cooling
18
Q
red light intervention for fatigability
A
heavy eccentric loading in progressive disorders and NMD
*not PD
19
Q
muscle performance
A
capacity of a muscle to generate forces
20
Q
strength
A
force exerted by a muscle to overcome resistance
21
Q
power
A
ability to exert max face in a short amount of time
strength and speed
22
Q
endurance
A
ability to produce and sustain muscle forces repeatedly or over a sustained period of time
23
Q
common mechanisms of weakness
A
- UMN
- LMN
- NMJ
- muscle (myopathies)
24
Q
how does UMN lesions cause muscle weakness
A
inhibition to LMN is lost > increased tone and spasticity > spastic muscles are weak muscles
25
how does LMN lesion cause weak muscles
disrupts reflex arcs causing hyporeflexia and decreased tone > muscles atrophy
26
what is the most common disorder of the NMJ
myasthenia gravis
27
myasthenia gravis
autoimmune neuromuscular disorder characterized by fluctuating weakness that worsens w/ activity and lessens w/ rest
28
does diffuse muscle dysfunction tend to be more noticeable in proximal or distal muscle groups
proximal
29
green light interventions for improving muscle performance
- strength training
- power training
- functional training
30
yellow light interventions for improving muscle performance
- e-stim
- biofeedback
- whole body vibration
31
red light interventions for improving muscle performace
- vojta
- therasuit
- PNF
32
4 principles of resistance training
1 - specificity
2 - overload
3 - progression
4 - reversibility
33
guidelines for resistance training
2-3 days a week
60-70% 1RM
8-12 reps
1-3 sets per exercise
1-2 min rest after each set
34
3 key elements of power training
1 - functional loaded multi-joint exercise
2 - high movement velocity
3 - progressive load
35
what is the objective of functional electrical stimulation?
activate targeted muscle groups to facilitate performance of functional activities
36
Is FES primarily used in upper or lower motor neuron diseases
upper
37
is NMES and biofeedback primarily used in upper or lower motor neuron disease
lower
38
T or F: NMES is effective if there is complete denervation
F
39
EMG biofeedback
method of retraining muscle by creating new feedback systems as a result of the conversion of myoelectrical signals in the muscle into visual and auditory signals
*can be used in weak or paretic muscle
40
enriched environment
the provision of equipment and organization of the environment facilitates physical, cognitive, and social activity
41
enriched environments enhance... (3)
learning
memory
neuroplasticity
42
3 components of enriched environment
1 - cognitive stimulation
2 - social interaction
3 - task specificity
43
T or F: enriched environment alone is effective
F: you need to pair with exercise
44
what are two of the basic mechanisms of infant brain development
- neurogenesis
- activity-dependent plasticity
45
components of goals, activity, and motor enrichment (GAME) intervention
1 - goal-oriented intensive motor training
2 - parent education
3 - environmental enrichment
46
START - Play
- sitting together and reaching to play
- aims to advance cognition by targeting the early motor skills of sitting and reaching through motor based problem-solving strategies
47
T or F: moderate intensity exercise can prime the nervous system
T
48
how does aerobic priming work
- brain-derived neurotrophic factors are secreted which facilitate neuroplasticity
- secreted at higher rate when HR is between 60-85% HRmax
49
what is the targett zone on the RPE scale pending there are no cardiac precautions
6-7 or 14-16
between moderate and vigorous
50
how can you assess if your pt has motor automaticity with a certain skill
dual task!
- also increase task or environment challenge
51
what are the 2 types of memory
explicit (facts)
implicit (automatic)
52
do simple, repetitive tasks drive motor learning?
no -- challenge your pts!
53
T or F: mental practice/motor imagery can improve performance of skills developed during actual practice
T: have your pts visualize movements
54
error based learning is driven by the response to...
an external perturbation
55
discovery based learning
allow the pt to problem solve
56
what kind of cues should you give your pts
external
57
fractionated movement
the ability to move isolated muscles without other muscles moving along with them
58
the degree of impairment of fractionated movement is directly related to the degree of... (2)
weakness
spasticity
59
what outcome measure looks at fractionation of movement
fugl-meyer scale
60
what are green light interventions for coordination? (4)
- task specific training
- constrained induced movement therapy
- FES
- BWSTT
61
what are green light interventions for automaticity
- task specific training
- dual task balance training
- dual task walking
- implicit learning
62
does WBSTT or robot assisted treadmill training have better outcomes
BWSTT
63
how much BWS should you give pts during treadmill training
only what is needed for them to walk -- challenge them!
64
is constraint induced movement therapy more effective in chronic or sub-acute strokes?
chronic
65
mirror and augmented reflection technology helps with what kind of tasks
- functional (gripping, pouring)
- good for motor planning and pain control
66
how many hours a day should you do constraint-induced movement therapy
2-3.5
67
what are 2 deficits TMS can help with
- neglect in stroke
- bradykinesia and freezing in parkinson's
68
entrainment
auditory - motor synchrony caused by consistent auditory rhythm
69
what is the goal of rhythmic auditory stimulation (RAS)?
entrainment and return of automaticity with ambulation
70
what kind of music should you use for rhythmic auditory stimulation
whatever your pt likes!!
71
what are some populations where RAS is effective?
- stroke
- incomplete SCI and TBI
- MS
- PD
- CP
72
How to implement RAS
- assess baseline gait speed (count steps)
- start rhythm at 110% of usual cadence
- continue to modulate frequency
73
what are some things you can do to prep for sit to stand?
ankle ROM, anterior pelvic tilt, proximal stability
*only spend 5-10 minutes addressing BS/BF then move to function
74
What are 4 neuromotor/augmented training strategies?
1 - PNF
2 - NDT
3 - guided/facilitated movements
4 - somatosensory training
75
What are some options for strengthening muscles less than 3/5 or poor fractionation of movements
NMES
FES
Robotics/lokomat
76
How can you manually assist someone with a bridge or supine hooklying rotation
quick stretch
- pull femurs towards you
77
irradiation principle
if there is max resistance on strong leg the theory is it will create movement in weaker leg
78
what is the top priority when considering exercise programs
medical/surgical precautions
79
in a study, what strength exercise elicited the greatest maximum voluntary isometric contraction of the glute max
step ups
80
pelvis/scapular PNF D1 pattern
anterior elevation
posterior depression
81
pelvis/scapular PNF D2 pattern
posterior elevation
anterior depression
82
UE D1 Flexion
-Scapula: Elevation / Abduction / Upward Rotation
-Shoulder: Flexion / Adduction / ER
-Forearm: Supination
-Wrist: Flexion + Radial Deviation
-Thumb: Adduction
83
UE D1 Extension
-Scapula: Depression / Adduction / Downward Rotation
-Shoulder: Extension / Abduction / IR
-Forearm: Pronation
-Wrist: Extension + Ulnar Deviation
-Thumb: Abduction
84
UE D2 flexion
-Scapula: Elevation / Adduction / Upward Rotation
-Shoulder: Flexion / Abduction / ER
-Forearm: Supination
-Wrist: Extension + Radial
-Deviation
-Thumb: Extension
85
UE D2 extension
-Scapula: Depression / Abduction / Downward Rotation
-Shoulder: Extension / Adduction / IR
-Forearm: Pronation
-Wrist: Flexion + Ulnar Deviation
-Thumb: opposition
86
LE D1 flexion
-Pelvis: protraction
-Hip: flexion, adduction, ER
-Knee: flexion or extension
-Ankle/Toes: DF, inversion
87
LE D1 extension
-Pelvis: Retraction
-Hip: Extension, Abduction, Medial Rotation
-Knee: Flexion or Extension
-Ankle and toes: Plantar flexion, Eversion
88
LE D2 flexion
-Pelvis: elevation
-Hip: flexion, abduction, IR
-Knee: flexion or extension
-Ankle/Toes: DF, eversion
89
LE D2 extension
-pelvis: depression
-hip: extension, adduction, ER
-knee: flexion or extension
-ankle and toes: PF, inversion
