Lecture 3 - Impairments, facilitation, and inhibition techniques Flashcards
What is the general organization of the motor system
What parts of the brain play a role in motor function (3)
Primary Motor Cortex
Found in a gyrus anterior to the central sulcus that connects with the supplementary and premotor cortex that takes in sensory input and descends via corticospinal tract to produce motor patterns
Explain where each part of the body is found on the homunculus
Supplementary Motor Area
Found on superomedial surface anterior to primary cortex, it connects to primary cortex and directly projects to the spinal cord. Its functions include:
1. Preparation of internally initiated movements
2. Bilateral coordination
3. Postural stabilization
Premotor Area
Located on lateral surface of frontal lobe anterior to primary cortex it connects to the primary motor cortex, supplementary motor cortex, prefrontal cortex, and parietal cortex. It directly projects to the spinal cord via the corticospinal tract and its functions are:
1. Prepare spatial and sensory guided movements
2. Rules to perform specific tasks
Upper motor neurons
Upper motor vs Lower motor neuron lesions
What are the 2 lateral descending motor system tracts, their origin, decussation, termination, and function
Describe the lateral corticospinal pathway
What are the 4 medial descending motor systems, their origin, decussation, termination, and function
Describe the anterior corticospinal pathway
What are 6 symptoms of cerebellar lesions
Cerebellar infarcts populations and signs/symptoms
What are causes of movement impairment after a stroke
Diaschisis and an approach to treat it
Motor programming/planning changes and approaches to treat it
Weak contractions contributing factors and approaches to treat it
Coordination deficits contributing factors and an approach to treat
Motor unit property changes and approaches to treat it
Slow movements contributing factors and approaches to treat it
Behavioral substitution contributing factors and approaches to treat it
Poor endurance contributing factors and approach to treat
Intra and Inter-hemispheric Inhibition and approaches to treat
Muscle tone
NOTE:
-Rigidity is not velocity dependent unlike spasticity which is velocity dependent, rigidity will always be present through any movement
-Rigidity tends to be more Parkinson’s vs stroke is more spasticity
What are the 3 components of tone
Spasticity
A muscle immobilized in a shortened position will experience: (also how does this alter tone)
Segmental Reflex Arc
What is the relationship between tone and movement disorders?
Different stages of tone and movement correlated to them
What should the assessment consist of for tone
For people with stroke explain being able to isolate the muscle and how it affects testing strength or AROM
Physical interventions to manage spasticity
CBPG for stroke care (UE and LE)
What are facilitation techniques
Tapping
Quick stretch
Joint Compression
Quick Icing
Vibration
Resistance
Cutaneous Stimulation
NMES
Inhibition Techniques
To decrease spasticity
Prolonged Stretch - Splinting
Sustained Stretch - Manually
Tendon Pressure
-May not be as effective or comfortable because a lot of pressure in a small area
Local Cooling
Positioning
What are some other techniques for facillitation
Overflow & Associated Reactions
Cycling
Mental Imagery
When should you use facilitation or inhibition
Should we measure spasticity
What are some take home messages in terms of movement and stroke
