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NM 2 > lecture 3: tradtional treatment approahes and evidence based practive > Flashcards

lecture 3: tradtional treatment approahes and evidence based practive Flashcards

1
Q

what are movements synergies

A

group of mm that work together as a bound unit in a primitive/automatic way

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2
Q

where are movements synergies present at

A

spinal cord level

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3
Q

what is the resting LE synergy

A

 Pelvis: elevation and retraction

 Hip: flexion and adduction

 Knee: extension

 Ankle/foot: PF with inversion

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4
Q

what are the UE resting synergy

A

 Scapula: Scapular depression & retraction

 Shoulder: Extension, adduction, & internal rotation

 Elbow: Flexion

 Forearm: Pronation

 Wrist/Hand: Wrist & finger flexion

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5
Q

who are postural/ attitudinal reflexes present in

A

adults with/wtihout brain damage

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6
Q

what are associated reactions of the brunnstrom approach

A

automatic movements that change the position of a body part

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7
Q

an associated reaction is an automatic movement that changed tha position of body part when …. (5 things)

A
  • another body part moves voluntarily
    -increased effort is used
    -patient sneezes , coughs
    -artificially simulated
  • can include raimiste’s phenomenon (1st lab)
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8
Q

When we sneeze our arm moves but when a pateint sneezes their arm doesn’t move this is an example of what reaction

A

associated

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9
Q

do you use brunnstroms stages of recovery for stroke or TBI patients

A

stroke

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10
Q

pertaining to Brunnstroms stages of recovery for strokes …. what are the 5 rules

A
  • recovery can stop at any stage
  • stages are never skilled
  • may see aspects of more primitive stages when patients under stress
  • motor recovery reflects CNS
  • UE and LE staged SEPARATE
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11
Q

• Flaccidity
• No voluntary or reflexive activity is present
• No associated reactions elicited
• No DTRs

this describes what stage for Brunnstrom Approach

A

stage 1

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12
Q
  • Spasticity is developing.
  • DTRs present
  • Min voluntary movement, all within synergy
  • Partial limb synergies elicited reflexively

this represents what stage for the Brunnstrom Approach

A

2

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13
Q

are DTR’s presents for stage 1 for the Brunnstroms Approach

A

no

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14
Q
  • Can perform basic movement synergies voluntarily
  • May not be able to complete within full PROM
  • Spasticity increases to maximum/peak levels

what stage of the Brunnstrom Approach does this represent

A

stage 3

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15
Q

what stage of the Brunnstroms Approach does spasticity increase to maximum levels

A

stage 3

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16
Q

what stage is basic movement shown for the Brunnstrom Approach

A

3

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17
Q
  • Spasticity starts to decrease.
  • Can voluntarily perform min movements out of synergy

this describes what stage of the Brunnstroms Approach

A

stage 4

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18
Q

what happens during stage 4 of the Brunnstrom Approach

A

spasticity starts to decrease and performed voluntary movements out of synergy

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19
Q
  • Spasticity continues to decrease.
  • Basic synergies losing their dominance over movement
  • Can perform some movement combinations outside of synergies

this describes what stage of the Brunnstrom Approach

A

stage 5

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20
Q

what stage of the Brunnstroms APproach is there 2 joints doing differen things at 2 different times and spasticity and synergies is decrease

A

stage 5

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21
Q
  • Slight remnants of spasticity
  • Isolated muscle action with variety of movement patterns
  • Slow speed/coordination

what stage of the Brunnstrom Approach does this describe

A

stage 6

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22
Q

what happens during stage 6 of the brunnstrom approach

A

-decreased spasticity
-isolated mm action w variety of movement patterns
-slow speed/coordination

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23
Q

what happens during stage 7 of the Brunnstrom Approach

A

-no spasticity
- restoration of normal movemtn and function

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24
Q

what is the definition of PNF

A

the activation of the neuromuscular system through stimulation of proprioceptors

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25
Q

patients need ___ for motor learning

A

reps

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26
Q

what are the 4 main purposes of PNF

A
  • mm strength
  • develop increased mobility
    -promote motor learning
    -improve functional movement
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27
Q

what is the agonists mm

A

most hat are shortengin while contracting

it is the direction of the movements desired

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28
Q

ex: shoulder flexion … what is the agonist and antagonist mm

A

agonist is the anterior delt and antagonist is the lats

29
Q

what is the antagonists mm

A

mms that are lengthening within the diagonal

opposite to the desires direction of movement

30
Q

what is reciprocal innervation/inhibiton

A

facilitation of alpha motor neurons of agonist will inhibit antagonist

31
Q

what id autogenic inhibiton

A

contraction of antagonist will allow immediate relaxation of same mm

32
Q

what is successive induction

A

max effort of antagonist will overflow into agonists if reversal of direction is quick

33
Q

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

A

irradiation

34
Q

what are the 7 commandments of PNF

A
  1. manual contacts
  2. commands/communcations
    3.stretch
  3. traction/approximation
    5.maximal resistance
  4. normal timing
  5. reinforcement
35
Q

what is the 1. manual contact used to stimulate for PNF

A

stimulate specific groups of mm and to direct the line of movement

36
Q

what is 2. commands/communcation of PNF

A

-tone of voice
-preparatory instruction
-action commands

37
Q

for teh Stretch commandment of PNF what is activated to stimulate the agonist

A

mm spindles

38
Q

for teh Stretch commandment of PNF how is the body part positioned before starting the pattern

A

in a lengthened range

39
Q

for teh Stretch commandment of PNF what kind of stretch is applied to elongate mms to add reflexive components to movement initiation

A

quick

40
Q

for the 4. traction/approximation commandments of PNF what does traction and approximation facilitate

A

traction facilitates movement
approximation facilitates stability

41
Q
  1. normal timing of the commandments of PNF .. how is the movement and when do u allow rotation to occur
A

distal to proximal movemtn and allow rotation to occur earliest in patttern

42
Q
  1. reinforcement commandments for PNF .. we can use what to increase the strength of a response
A

“timing for emphasis”

43
Q

what are the stages of motor control in PNF

A
  1. mobility
  2. stability/ static postural control
  3. controlled mobility/ dynamic postural control
  4. skill / skilled mobility
44
Q

what are the 3 PNF techniques to enchance mobility

A
  1. strengthening
  2. lengthening shortened mm
  3. getting the full motion going
45
Q

what are the 4 strengthening PNF technihgues to enhance mobility

A
  • Repeated contractions
  • Hold-relax-active-motion
  • Reversal of antagonists/slow reversals
  • Timing for emphasis
46
Q

what are the 2 lengthening shortened mm PNF technihgues to** enhance mobility**

A
  • Hold/contract-relax (with passive repositioning)
  • Hold/contract-relax active contraction
47
Q

what PNF technique to enhance mobility is used for getting the full motion going

A

rhythmic initiation

48
Q

what are the 2 PNF TECHNIQUES TO ENHANCE STABILITY

A
  • Reversals of isometrics/alternating isometrics
  • Rhythmic stabilization
49
Q

what PNF techniques are used for controlled mobility / dynamic postural control

A

slow reversals / reversals of isotonic

50
Q

what are techniques for skilled/skilled mobility for stags of motor control in PNF

A

normla timing
agonist reversals

51
Q

are developmental activities just for babies

A

nooooo

52
Q

what are developmental activities

A

movemtn that progressively challenges the patient to control more body weight aginast gravity

53
Q

what is plantigrade

A

bear walking basically

54
Q

for the application of developmental concepts ___ control needs to happen before ___ skill movements

A

proximal
distal

55
Q

for the application of developmental concepts , once th movement is mature then the timing will be ___ to ___

A

distal to proximal

56
Q

what is the goal for NDT conceptual framework

A

to minimize activity limitation and impairments with in the context of a patients environment and participation goals

57
Q

based on the NDT conceptual framework clinical practice is based upon what understanding

A

the understanding that sensation , action , perception , cognition and emotion are interlinked and interactive

58
Q

what is viewed as the range of motor behavior available to people without
a CNS lesion.

A

typical motor behavior

59
Q

what does NDT allow the person to do and not to do

A

alllows the person to be an active co participant in therapy and does not just do it for the patient as a passive participant

60
Q

t/f: you can superimpose efficient movement on abnormal postural alignment

A

FALSE u cant

61
Q

when do u consider alignment

A

at the beginning of movement
during execution of movement
after completion of movement

62
Q

what are the 5 elements of postural control

A
  1. trunk
  2. midline orientation
  3. weight shift over the base of support
  4. head control
  5. limb function
63
Q

for the elements of postural control what control is required in order to have controle elewhere

A

trunk control

64
Q

does lower or upper trunk control happen first

A

lower

65
Q

what is midline orientation and what is it needed f

A

point of reference from movement over the base

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

66
Q

for the elements of postural control , for weight shift over the BOS does smaller increments precede larger ?

A

yes

67
Q

what control evolves out of trunk control

A

head control

68
Q

Postural control in a position precedes ability to move ____ with control.

A

transitionally

69
Q

what movements are easier to harder ?

A

isometric > eccentric > concentric

NM 2 (17 decks)

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