Interventions for addressing Neuromuscular dysfunction Flashcards
1
Q
What is the goal of intervention
A
- functional movement
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
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
4
Q
Functional movements
factors: environment
A
- physical features
- regulatory features: can be controled
- nonregulatory features: cannot control
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
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
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
8
Q
impairments
cardiopulmonary
A
- incorporate physical and aerobic exercise and the ACSM guidelines
9
Q
impairments
integumentary
A
- monitor skin in individuals with mobility limitations
- prevent secondary complications by addressing pressure relief circulation and skin care
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
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
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
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
14
Q
task activity
open vs closed
A
- self paced = closed or
- externally paced = open
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
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
