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Neuromuscular PT 2 > Interventions for addressing Neuromuscular dysfunction > Flashcards

Interventions for addressing Neuromuscular dysfunction Flashcards

1
Q

What is the goal of intervention

A
  • functional movement
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2
Q

Factors for interventions for tasks

A
  • general tasks and demands
  • posture control/balance
  • mobility functions
  • stability functions
  • UE functions/self care
  • LE functions/walking
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3
Q

Functional movement

individuals

factors for individual

A
  • body function
  • mental functions
  • sensory/perceptural functions
  • motor functions
  • cardiorespiratory functions
  • overall health status
  • personal factors
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4
Q

Functional movements

factors: environment

A
  • physical features
  • regulatory features: can be controled
  • nonregulatory features: cannot control
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5
Q

Impairments

Musculoskeletal

A
  • improve capacity
  • strength
  • ROM/flexibility
  • as much as possible within the limitiation of their health condition
  • if return to normal is not possible explore alternative compensatory movement strategies
  • prevent secondary complications from inactivity
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6
Q

Impairments to

neuromuscular

A
  • drive neuroplasticity with intense, repetitive meaningful activity
  • incorporate coordination challenges that include appropriate timing, sequencing, and power production within tasks
  • manage spasticity if limiting active movement through PROM/stretching, reciprocal inhibition or medication through physician
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7
Q

Impairments to

cognitive perceptual

A
  • structure environment, tasks and practice based on stage of learning
  • attention perception and prediction are key abilities for learning and improving motor skills
  • when necessary, provide compensatory or subsitution strategies such as using other sensory systems, scanning, verbalization and supplemental cues, feedback and memory aids such as setting reminders and written instructions
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8
Q

impairments

cardiopulmonary

A
  • incorporate physical and aerobic exercise and the ACSM guidelines
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9
Q

impairments

integumentary

A
  • monitor skin in individuals with mobility limitations
  • prevent secondary complications by addressing pressure relief circulation and skin care
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10
Q

impairments

behavioral/psychosocial

A
  • frame therapy sessions to enhance motivation, autonomy and expectation of success as they are strongly assoicated with improved outcomes
  • refer the patient when mood or psychological or social barriers interfere with participation
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11
Q

Task activity

what is required for success: static balance

A
  • maintaining steady COM within BOS
  • progress from large BOS and low COM to a smaller BOS and higher COM
  • add UE movement, external perturbation , unstable surface, closed eyes, dual task
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12
Q

task activity

what is required for success: dynamic balance

A
  • moving COM over BOS
  • reaching close vs far vs overhead or to the floor, planar vs rotation
  • stand to squat or up on toes
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13
Q

task activity

what is required for success: mobility

Transitional mobility

A
  • moving BOS: transitions
  • supine to sit
  • sit to stand
  • floor to chair or stand
  • walking, multidirectional stepping, running, stairs
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14
Q

task activity

open vs closed

A
  • self paced = closed or
  • externally paced = open
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15
Q

Object manipulation

A
  • typically require conscious attention and can be used to create dual task challenges if performed as part of a stability or mobility activity
  • new learners should explore the object’s properties in a low demand posture but progress to more challenging situations
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16
Q

level challenge

can what to consider

A
  • adjust the level of challenge pressure for optimal effort
  • consider time constrains, DOF, postural control demands, simplification or part task training
17
Q

describe a task-oriented approach to interventions

A
  • designed to promote neuroplasticity
  • therapist acts as coach
  • behavioral shaping

box 10.2 in physical rehab

18
Q

Prinicples of task-oriented training

A
  • promote challenging and meaningful practice (goals, history, experience)
  • determine activities: functional, address impairment and limitiations
  • determine parameters: intensity, time, types of practice, instruction, feedback, assist or guidance
  • behavioral strategies/shaping: promote self determination and self efficacy, emphasize positive, consider fatigue
  • promote problem-solving
  • structure environment
  • outside learning HEP
  • maintain focus on active learning (making the pt apart of the process)
  • montior and document
19
Q

Structuring interventions

stage of motor learning

A
  • cognitive: must actively think about what you are doing while you are doing it
  • assoicative: less instruction/though while doing it; also internalizing it and figuring out the best way to do it
  • Autonomous: can think/do something else while doing the task

consider feedback, environment, techniques for stage of motor learning

20
Q

organizing functional practice

A
  • classification of motor control
  • guidance and discovery
  • task-oriented approach (behavioral shaping, hands on feedback)
  • compensation
21
Q

classification of motor control

A
  • mobility: do you have the necessary ROM to do the motion
  • stability: static postural control - patient is not moving/maintain COM over BOS
  • dynamic postural control - patient is moving/maintain COM over a moving BOS
  • transitional mobility: moving from one position to the next
  • Skill: performing a coordinated series of movements
22
Q

Neurodevelopment postures

A
  • prone
  • POE
  • quadruped
  • kneeling and half kneeling
  • modified plantigrade
  • standning
  • supine
  • hooklying
  • sitting: short sitting, side sitting, long sitting
23
Q

Neurodevelopmental treatment (NDT)

A
  • focus on normal postural control and normal movement statically/dynamically
  • hands on techniques
  • facilitate normal movement
  • inhibit abnormal movement
  • can be effective in childern but no superior to other interventions
  • effect at improving motor function of hand post-stroke
24
Q

PNF

A
  • functional movements to promote functional activities
  • incorporates rotational movement in function
  • precise hands on skills
  • techniques: quick stretch, approximation, joint traction
25
Q

neuromuscular/sensory stimulation techiqnues

A
  • includes techniques used in NDT and PNF
  • sensory integration techniques uses textures, vibration, weights, visual cues, vestibular inpute
  • others: light touch, inhibitory pressure, neutral warmth, prolonged icing
26
Q

other neuromuscular interventions

A
  • T’ai Chi
  • yoga,
  • LSVT BIG
  • e-stim
  • taping
  • treadmill training
  • HIIT
  • manual therapy

Neuromuscular PT 2 (12 decks)

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