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Neuromuscular Phys > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

T or F: There are specific named approaches for physical therapy of neuro conditions that are better than others

A

F, according to Cochrane review there’s no evidence that one is better than the other

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2
Q

T or F: according to the Brunnstrom approach, Patient’s can skip stages of recovery

A

F, they will progress through each phase no matter what

Patient’s can also plateau at any stage

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3
Q

What is a movement synergy

A

Group of muscles that work together as a bound unit in a primitive/automatic way

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4
Q

What is an associated reaction and what can cause it?

A

Automatic movements of one bodypart due to

-another bodypart moving
-increased effort
-sneeze/cough
-artificially stimulated
-raimiste phenomenom

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5
Q

T or F, in brunnstrom stages of recovery the UE and LE are staged together

A

F, they are staged separately

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6
Q

What stage has flaccidity, no reflexes, and no associated reactions?

A

Brunnstrom’s stage 1

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7
Q

What brunnstrom stage is the first where you can ilicit reflexes

A

Stage 2

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8
Q

Stage 2 of brunnstrom includes what kind of movement

A

minimal voluntary movement only within synergies

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9
Q

How much spasticity does stage 2 of brunnstrom have?

A

Developing spasticity

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10
Q

What brunnstrom stage has peak spasticity?

A

Stage 3

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11
Q

Which Brunnstrom stage can the patient preform basic movement synergies voluntarily

A

stage 3

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12
Q

At what brunnstrom stage can a patient break synergies “1 joint out of synnergy with spasticity”

A

stage 4

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13
Q

at what brunnstrom stage does a patient start to have decreasing synnergy

A

stage 4

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14
Q

At what brunnstrom stage can a patient have multiple joints moving outside of synergies, with spasticity also decreasing

A

stage 5

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15
Q

What is the difference between Brunnstrom stage 4 and stage 5 synergies?

A

Stage 4 can only minimally move outside of synnergies

stage 5 can move 2+ joints outside of the synnergies

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16
Q

At what stage do you start to see minimal spasticity with simularity between the affected and non-affected side with slow speed/coordination

A

stage 6

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17
Q

At what stage is spasticity completely gone and normal movement recovered

A

stage 7

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18
Q

How are brunnstrom classifications used?

A

Descriptively in research and in the clinic to describe limbs

“Pt has a brunnstrom stage 5 R UE”

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19
Q

What theory states that you can activate the neuromuscular system through stimulation of proprioceptors

A

PNF

20
Q

T or F, PNF states that patients need repetitions for motor learning

A

T

21
Q

What is successive induction

A

maximal efforts of antagonist muscles will overflow into the agonist muscles if reversal of direction is quick

22
Q

what is irradiation

A

maximum effort of stronger muscles within a pattern will overflow into weaker muscles

23
Q

What are the 7 elements of PNF

A

1. Manual contacts- hands are used to stimulate muscles
2. Commands - short and directive instructions timed with movement
3. Stretch - Activation of muscle spindles
4. Traction/approximation - Traction facilitates movement, approximation facilitates stability
5. Maximal resistance - depends on patient, apply the max they can take without breaking
6. Normal Timing - Distal to proximal movement, allow rotation to occur earliest
7. Reinforcement - can use timing for emphasis to increase strength of response

24
Q

What are the 4 stages of motor control in PNF

A
  1. Mobility - pt needs adequate ROM
  2. Stability
  3. Controlled mobility/ dynamic posture control
  4. Skilled mobility - coordinated movements that allow interaction with environment
25
Q

What is quadruped?

A

on hands and knees

26
Q

What is plantigrade

A

Weight bearing through the feet and hands

27
Q

What is modified plantigrade?

A

PT is weightbearing with feet on floor and hands on a raised surface

28
Q

What is the prone progression of developmental activities in PNF

A

Prone on elbows -> quadruped -> plantigrade -> Modified Plantigrade

29
Q

T or F: In PNF, developmental concepts must be fully mastered before moving onto the next progression

A

F, you should simultaneously work on multiple stages at the same time, whatever the patient can manage

example: Pt can work on walking even if they havent mastered sitting balance

30
Q

In PNF, ___________ needs to happen before skilled distal movement

In PNF, when a movement is mature the timing will be ________________

A

proximal control

Distal to proximal

31
Q

the NDT approach emphasizes what?

A

Neuroplasticity

32
Q

How does NDT technique’s teaching differ from what we know about motor learning

A

A therapist gradually gives over control to the patient (which minimizes mistakes)

With motor learning we should be letting the patient make mistakes

33
Q

You cannont super impose _________________ on abnormal postural alighment

A

efficient movement.

Meaning you can’t force patients with abnormal posture to move perfectly throughout their therapy activities

34
Q

When must alignment be considered during therapy activities in NDT

A

At beginning/initiation

during execution of movement

after completion/termination of movement

35
Q

What is the first element of postural control in NDT

A

Trunk

36
Q

Which part of the trunk is emphasized first in postural control

A

Lower Trunk progressing to upper trunk

37
Q

What is the second component of postural control in NDT

A

midline orientation

pt must be able to stabilize in midline, move away and back to midline

38
Q

Before a patient has midline orientation, they have to have ___________

A

trunk control

39
Q

What is the 3rd element of postural control in NDT

A

Weight shift over base of support
-through straight planes and diagonals
-smaller incriments first

40
Q

what is the 4th element of postural control in NDT

A

head control
-evolves out of trunk control

41
Q

What is the 5th element of postural control in NDT

A

Limb function
-establish selective movements in WB before non-WB
-LE to support full bodyweight

42
Q

What are the 5 elements of postural stability in order

A

-trunk

-midline orientation

-weight shift over BOS

-head control

-limb function

43
Q

What is easiest and what is hardest amongst these 3:

Isometric, concentric, eccentric

A

Easiest: Isometric

Eccentric

Hardest: Concentric

44
Q

___________ in position precedes the ability to move transitionally with control

A

postural control

45
Q

What is NEURO-IFRAH

A

different approach for treating neuro patients with no evidence

46
Q

5 Elements of postural control:

Trunk -> ______ -> weight shift over BOS -> head control -> limb function

A

Midline orientation

47
Q

NDT posture control:

________ -> Midline orientation -> Weight shift over BOS -> Head control -> __________

A

Trunk

Limb Function

Neuromuscular Phys (26 decks)

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