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Neuro PT > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

recalling UE and LE synergies

A
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2
Q

automatic mvmt that change the position of a body part when
- another part moving voluntarily
- increased effort is used
- patient sneeze or cough
- artificially stim
- raimiste’s phenomenon

A

Associated reactions

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3
Q

Brunnstorm’s stages of recovery

  • recovery may ____ at any stage
  • ____ skipped stage
  • may still see ____ stages if pt stressed
  • motor recovery ____CNS recovery
A
  • stop
  • NEVER
  • primitive
  • reflects
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4
Q

stage 1 Brunnstorm

A
  • flacid
  • no voluntary/reflexive activity
  • no associated reactions elicited
  • no DTR
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5
Q

stage 2 Brunnstorm

A
  • spasticity developing
    - DTR present
    - MIN voluntary mvmt, all within synergy
    - partial limb synergies elicited reflexively
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6
Q

stage 3 Brunnstorm

A
  • performing basic mvmt synergies voluntarily (may not be able to complete w/in full PROM)
  • Spaticity increased
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7
Q

at which stage is spasticity at its peak (the patient’s “peak”)

A

stage 3

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8
Q

stage 4 Brunnstorm

A

spacticity starts to decrease
voluntarily perform **MIN mvmt out of synergy **

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9
Q

stage 5 Brunnstorm

A
  • spasticity continue to decrease
  • basic synergy losing dominance over movement
  • may perfom combo joint mvmt OUTSIDE synergies
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10
Q

stage 6 Brunnstorm

A
  • slight spasm
  • isolated muscle action with variety of movement patterns
  • slow speed/coordination
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11
Q

stage 7 Brunnstorm

A

no spasm
restoration of normal movement and function

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12
Q

patient’s efferent motor response will be specific to the ____ sensory input applied

A

afferent

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13
Q

the activation of neuromuscular system through stim of proprioceptors

A

PNF
PT helps enhance the patient’s voluntary control by stimulating a deficet NMSK

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14
Q

for MAX learning, keep activities as ____ relevant as possible

A

functionally

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15
Q

main purpose of PNF

  • strengthen ____
  • develop increased ____
  • promote ____
  • improve ____ movement
A
  • muscles
  • mobility (AROM / PROM)
  • learning
  • functional
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16
Q

facilitation of alpha motor neurons of agonist will inhibit antagonist

A

reciprocal innervation/inhibition

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17
Q

contraction of antagonist will allow immediate relaxation of same muscle

A

autogenic inhibition

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18
Q

maximum effort of antagonists will oveflow into agonists if reversal of direction is quick

A

successive induction
(raimestes)

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19
Q

max effort of stronger muscles within a pattern facilitate or overflow into weaker muscles

A

irradiation

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20
Q

7 “commandments” of PNF

A
  1. manual contact
  2. commands/communication
  3. stretch
  4. traction/approximation
  5. maximal resistance: to maximize pt’s response
  6. normal timing: distal to proximal mvmt
  7. reinforcement: timing for emphasis
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21
Q

to stretch, body part is in whcih range before starting pattern?

A

in lengthened range

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22
Q

what facilitates movement?
what facilitates stability?

A

traction
approximation

23
Q

allow _ to occur earliest in pattern

A

rotation

24
Q

stages of motor control

A
  1. mobility
  2. stability or static postural control
  3. controlled mobility/dynamic postural control
  4. skilled mobility
25
Q
  • mvmt; isotonic contractions
  • patient needs adequate ROM and motor unit activation
A

mobility (first stage of motor control)

26
Q

what are PNF techniques to enhance mobility?

A
  • strengthening
  • lengthening shortened muscles
  • getting the full motion “going” (aka rhythmic initiation)
27
Q
  • isometric
  • ability to hold a body position in anti-gravity posture
A

static posture control (STABILITY)
Second stage of motor control

28
Q

PNF technique to enhance stability

A
  • reversals of isometrics/alternating isometrics
  • rhythmic stabilization
29
Q

ability to change position while maintaining postural stability

A

dynamic postural control (controlled mobility)

30
Q

what is a technique used for dynamic postural control (controlled mobility)?

A

slow reversals/reversals of isotonics

31
Q

examples of dynamic postural control

A

shifting weight on one side to free other side for non-WB mvmt
proximal mvmt over fixed distal segment

32
Q

task specific movement (timed and directed) and continue for extended periods and could be combined with other mvmt

A

skilled mobility/skill

33
Q

proximal stability with distal mobility is an example of

A

skilled mobility

34
Q

what are techniques used to enhance skill/skilled mobility?

A

normal timing
agonist reversals (Concentric followed immediately with eccentric)

35
Q

sequence of mvmt that progressively challenges patient to control more body segments/weight against gravity

functional training (part of everyday life of patients activity)

A

developmental activities

36
Q

examples of developmental activities

A

rolling
prone progression (prone on elbows, quadruped, plantigrade, modified plantigrade)
sitting
kneeling
standing
movement transitions
walking

basically functional training

37
Q

applications of developmental concepts

A
  • you need to contorl proximal before working on distal
  • then timing will be distal to proximal
  • use it as prepatory exercises or activities with goal of independent function
  • enhance function via good performance of dev. activity
38
Q

NDT conceptual framework

A
  • mvmt analysis and sensory input; used on wide range of pts and combined with other interventions
  • goal: minmizing limitations and working on participation goals
  • sensation, action, perception, cognition and emotion are interlinked and interactive
  • balance and posture control
  • motor behavior
  • optimizes functional independence

READ slides 38/39

39
Q

T/F NDT allows the patient to be an active co-participant in therapy, slowly giving control the patient and gradually teaches themm how to manage deficits
it’s not a passive participaiton

A

true

40
Q

NDT

A
  • assess and treat at the same time
  • find out what mvmt you wanna facilitate/inhibit
  • decide the functional skill to prepare/environment
  • select a technique and assess patient (if it works, continue. if it doesn’t, re-assess and use a diff one)
41
Q

“every treatment is done in (contrived/functional) situations, preparing for and practiing same activites the patient will have unkertake in dialy life. in this way, rehabilitation and treatment are closely linked and direct caryy over from treatment into daily life is ensured”

A

functional

42
Q

how to challege patients to work at higher levels

A
  • trying without PT help (if not skilled at step A, start doing B,C)
  • turn control over to pt as soon as they begin gaining control
  • grade the amount of control
  • allow errors!!!!
43
Q

T/F you can impose efficient movement on abnormal postural alignment

A

FALSE!!
* you need to consider alignment at the beginning, during, and after movement
* test quesiton

44
Q

elements of postural control
IN ORDER

A
  1. trunk
  2. midline orientation
  3. weight shift over BOS
  4. head control
  5. limb function
45
Q

OR

trunk: how do you progress?

A

lower trunk progress to upper trunk
- anterior/posterior pelvic tilt
- lateral tilt
- separation between shoulders and pelvis (lateral and rotation)

46
Q

what’s the point of reference for mvmt over the base?

A

midline orientation
- need to be able to stabilize it, move away from it and back, cross it

47
Q

weight shifts over the BOS

A

smaller incriments precede larger
- through straigt planes and diagonals

48
Q

what evolves out of trunk control?

A

head control

49
Q

how to progress limb function?

A

establishing selective movements in WB prior to selective mvmt in non-WB
- free mvmt in space requires proximal stability

50
Q

which one is done first, posture control or ability to move transitionally with control?

A

posture control first then being able to move transitionally w/ control

51
Q

isometric, eccentric, concentric sequencing for easier to harder

A

isometric, eccentric, concentric

52
Q

“musts” during clinical practice

A
  • distinguishing typical vs atypical
  • meaningful activity and task-specific
  • optimal selection of practice method, feedback, and environment to max. funcitonal indep
  • position yourself utilizing optimal body mechanics durng therapeutic activity
53
Q
A

Neuro PT (8 decks)

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