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Neuromuscular Control > Interventions For Weakness (2) > Flashcards

Interventions For Weakness (2) Flashcards

1
Q

What are impairments that come along with neuromuscular dysfunctions?

A

Alterations in muscle tone

Impaired sensation

Cognition/communication impaired

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2
Q

What is weakness more than?

A

Muscle atrophy

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3
Q

Does strengthening increase spasticity?

A

No

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4
Q

What is the structural component of strengthening?

A

Stiffness

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5
Q

What is the neural component of strengthening?

A

Recruitment and timing

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6
Q

Should people with neurological disorders participate in strength training?

A

Yes

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7
Q

What should be incorporated with strength training in neurological disorders?

A

Task specificity

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8
Q

What changes with strength training in neurological disorders?

A

Cortical excitability

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9
Q

Why are fewer motor neurons activated with increased strength training?

A

Due to enhanced efficacy of synapses

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10
Q

What does strength training do to motor unit recruitment?

A

Improves it

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11
Q

What does continued challenge to neuromuscular system cause?

A

Adapt and facilitate optimal recovery

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12
Q

What are the secondary strength impairments?

A

Atrophy

Loss of ROM

Contractures

Decreased endurance

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13
Q

What is the 5D practice pattern?

A

Non progressive disorders of CNS (TBI and stroke)

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14
Q

What is the 5E practice pattern?

A

Progressive disorders of CNS (MS, Parkinson’s, and ALS)

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15
Q

What is the 5G practice pattern?

A

Acute or chronic polyneuropathies (GBS)

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16
Q

What is the 5H practice pattern?

A

Non progressive disorders of spinal cord (SCI)

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17
Q

Where does weakness generally occur post stroke?

A

Distal with flexion and extension affected equally

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18
Q

What does stroke cause to happen to muscles?

A

Reduced force generation and slowness in force production (excessive sense of effort and rapid fatigue)

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19
Q

Where is the most struggle in muscle activation post stroke?

A

Shortened ROM of muscles especially with increased velocity (compensate by functioning in midrange - bend knees so quads are not fully shortened)

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20
Q

What type of contraction is most preserved post stroke?

A

Eccentric

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21
Q

What are the motor unit deficits post stroke?

A

Reduced number of motor units

Increased motor unit innervation ratios

Impaired firing rate regulation

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22
Q

What are the muscle fiber changes post stroke?

A

Disuse atrophy after 4-6 weeks

Type 2 fiber selective atrophy

Increased % of type 1 fibers

23
Q

Why does weakness occur in TBIs?

A

Central neural activation deficits with impaired ability to activate motor units

24
Q

Why does weakness occur in MS?

A

Disruption of spinal pathways to motor unit pool (muscle fatigue and reduced force production)

25
Q

What is Parkinson’s more so about rather than weakness?

A

Initiation, timing, and sequencing

26
Q

What is Parkinson’s impacted by?

A

Changes in muscle tone

27
Q

What occurs in GBS?

A

LMN presentation (distal to proximal weakness symmetrically)

28
Q

What occurs in ALS?

A

UMN and LMN presentation (effects hand/trunk first)

29
Q

What occurs in myasthenia gravis?

A

LMN presentation (affects high use muscles first)

30
Q

What occurs in post polio syndrome?

A

LMN presentation (prone to overuse)

31
Q

What occurs in charcot Marie tooth?

A

Hereditary LMN presentation (progressive wasting)

32
Q

What makes for most transfer of increased strength to increased function?

A

Specificity of training

33
Q

What should be combined with strength training in MS?

A

Aerobic training to improve fitness, function, and QOL

34
Q

How should strength training occur in those with mild to moderate MS?

A

2x a week at moderate intensity

35
Q

How should strength training occur in those with moderate or severe MS?

A

Maintain strength and prevent decline

36
Q

When should you not strength train in GBS?

A

While progressive it is contraindicated

37
Q

How should you incorporate strength training in GBS once they are stable?

A

Progress from active assist to active to resistive

38
Q

Why should you train affected muscles in ALS?

A

They are impacted by spasticity

39
Q

How should you train muscles that are not yet affected in ALS?

A

Submaximal strengthening

40
Q

What are the muscles that are key to prevent weakness in ALS?

A

Posture and respiration muscles

41
Q

When should you not strengthen in myasthenia gravis?

A

During active crisis

42
Q

How should you strengthen in myasthenia gravis?

A

Maintenance of non affected areas and strengthening affected areas post crisis

43
Q

How do you train muscle that are 4+/5 in post polio syndrome?

A

Moderate to vigorous exercise

44
Q

How do you train muscle that are 3+ to 4/5 in post polio syndrome?

A

Exercise cautiously

45
Q

How do you train muscle that are 3 or below in post polio syndrome?

A

Stretching and protection (no resistance)

46
Q

How should strengthening occur in those with charcot Marie tooth?

A

Strengthening above affected area and compensations

47
Q

What is the key thing we need to look out for when training in most people with neuromuscular disorders?

A

Overuse and fatigue

48
Q

What are the types of interventions done to help weakness in neurological disorders?

A

NMES

Electromyographic feedback

PNF

Progressive resistive exercise

Isokinetic exercise

Task specific strength training

49
Q

What does electromyographic feedback best help do?

A

Train the timing of muscle contraction (very weak muscles)

50
Q

What should intensity be at for strength training in neurological disorders?

A

60-80%

51
Q

How should NMES be used for neurological disorders?

A

Very weak muscles (make functional if possible)

52
Q

How should progressive resistive exercise be used for neurological disorders?

A

Focus on quality (3+/5 strength is best)

53
Q

How should isokinetic be used for neurological disorders?

A

Teach how to safely use for progressing to independent

54
Q

How should aquatics be used for neurological disorders?

A

Supported movement

Can offer resistance and input

Finish task on ground

Neuromuscular Control (42 decks)

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