L4 EBP for TBI Treatment Flashcards
How does the motor system function in the brain?
posterior sensory cortex sends goal to prefrontal cortex to plan, then to premotor cortex to sequence movement, then to motor cortex to execute the action through the corticospinal tract
posterior parietal cortex
sensory association area
integrates incoming sensory input
planned movement arises from what we see, hear, and feel in our environment
then in response to these stim we plan an action
first step to getting TBI pt to engage in planned movement
gain visual attention
superior colliculus
helps brain automatically respond to enviro stim by generating motor responses to turn towards visual stim
activated by motion in visual fields, increasing orientation
vision and head righting reflex
vision should stimulate the C stim to activate, allowing pt to keep visual attention
superior colliculus connected to CN 11 for SCM
once you gain patient’s visual attention, what’s next?
sit at EOB to see endurance, righting reflexes, visual tracking
then to finding objects in space using recall and following commands
posterior parietal cortex
planning movement in response to enviro stim and sending goals
allows person to attend to some stim and ignore others
requires visuospatial attention
prefrontal cortex role in movement with TBI pt
planning of movement with goals and long term consequences
premotor cortex
selects and prepares the motor plan with correct motions and sequence
mirror neurons
seeing a person perform an action fires the same as when you are performing an action
can be used to elicit more complex movement when patient has a goal and can mimic someone
allow recruitment of functionally interconnected cortex structures between visual and moto execution
mirror therapy dosage
50x day 7 days a week
supplemental motor area
this area plans and coordinates complex movement
10% of corticospinal tracts originate here
connected to primary motor cortex as well as diencephalon, cerebellum
primary motor cortex controls what part of movement?
force, direction, extent, speed of movement
how to incorporate motor pathway into patient treatment w TBI?
choose meaingful activities
demonstrate activtity repeatedly to activate mirror neurons and allow motor planning
provide varying sensory input to better encode the activity into the brain
tilt table for TBI pt - benefits
prevent contractures, esp hamstrings and PF
weight bearing increases loading for bone density
verticality increases vestibular, somatosensory, and postural responses
monitor BP
