Module 10 Flashcards
Resting tremor occurs in the
Earlier stages of disease
Bradykinesia presents as
Reduction in spontaneous movement, mask like expression or decrease in facial expression, shuffling or freezing gait
_% of those with neurological conditions present with depression
25
The Schwab and England ADL scale is used for
PD
The Schwab and England ADL scale assesses
Persons ability to perform ADLs
The Schwab and England ADL scale higher percentage means
Greater independence
The gold standard PD assessment
Unified Parkinson’s disease rating scale
0 on the modified Hoehn And Yahr stages
No signs of disease
1 on the modified Hoehn And Yahr stages
Unilateral disease
1.5 on the modified Hoehn And Yahr stages
Unilateral plus axial involvement
2 on the modified Hoehn And Yahr stages
Bilateral disease without impairment of balance
2.5 on the modified Hoehn And Yahr stages
Mild bilateral disease, recovery on pull test
3 on the modified Hoehn And Yahr stages
Mild to moderate bilateral disease, postural instability, physically independent
4 on the modified Hoehn And Yahr stages
Severe disability, able to walk or stand unassisted
5 on the modified Hoehn And Yahr stages
Wheelchair bound or bedridden
PD QOL questionnaire has _ items
10
PD QOL rates each item on a scale of
0-3, higher number is more severe involvement
Four sub scales on the PD QOL
Parkinsonism symptoms, systemic symptoms, emotional functioning, social functioning
In functional gait assessment a score of 15/30 indicates
Fall risk
Brief BeSTest has _ items and is good for
9, PD
What is sinemet
Levodopa combined with carbidopa
Four types of drugs for treatment of PD
Sinemet, dopamine agonists (requip, mirapex), anti cholinergics and MAO-B inhibitors
Deep brain stimulation targets the
Subthalamic nucleus and globus pallidus
The four exercises in flewitt Hanford exercises for PD
Long sitting flexion extension, hook lying rocking knees, supine lying flexion extension and standing exercises
Practice technique best used to learn a new task
Blocked
In PD patients There is a better retention of learning when knowledge of results was given
After every trial
Studies show that rhythmic ____ stimulation is effective with PD
Auditory
LSVT stands for
Lee Silverman Voice Treatment
LSVT program lasts
4 days per week for 4 weeks
LSVT focus is on
Amplitude - big movements
LSVT has _ different exercises
7
Most common cause of hemorrhagic stroke
Uncontrolled HTN
The 6 common signs and symptoms of CVA
Acute onset of numbness or weakness, decreased level of consciousness, aphasia/dysarthria, nystagmus or visual changes, ataxia and Vertigo and headache
This CVA will present with more depression
Left
This side CVA will present with more language deficits
Left
This side CVA will present with more cautious behaviors
Left
This side CVA will be more aware of their deficits
Left
This side CVA will have more difficulty performing new tasks
Left
Motor programming deficits in left side CVA
Difficulty with sequence of movement, requires increased time for learning, slower movement
Strategies in therapy for left CVA
Speak slowly to allow processing, use visual cues, prevent distractions
Side CVA to present with inappropriate positive emotions
Right
Side CVA more likely to present with safety concerns
Right
Side CVA to present with spatial lesions
Right
Side CVA to present with right vs left side discrimination deficits
Right
Motor programming deficits in right CVA
Difficulty sustaining movement and or posture, tends to move too fast
Strategies for therapy with right CVA
Decrease environmental distractions, maximize verbal cues and address safety issues
Tripp’s model for evaluating stroke patients
Motor neuron response, fractioned movements, movement consistency, mental status and functional assessment
The Carr and shepherd motor assessment scale outlines
Problems and compensatory strategies
The Carr and Shepard motor assessment scale is on a _ point scale
7
Tonus is included on the
Carr and Shepard motor assessment scale
What is pusher syndrome
Postural imbalance due to ipsilateral pushing
In Pusher syndrome they push away from the
Unaffected side
Motor function limitations of pusher syndrome : overuse of ___ on uninvolved side and predominant ____ pattern on affected side
Extension, flexion synergy
Motor function limitations with pusher syndrome : increased weight bearing on the ___ side, and shifting of trunk away from ___ side
Involved, uninvolved
Explicitl information is good for those with ____ damage
Cerebellar
Explicit learning interferes with learning in those with
Basal ganglia damage
In subjects who had a stroke involving the MCA, they had decline in learning with addition of
Explicit information
According to ____ guidance has a negative impact on learning
NDT
Guidance is a form of ____ that occurs ___ In learning process
Feedback, early
Feedback for stroke should be in __% of trials
50
Risk factors for Alzheimer’s
Age, history, APOE 4 genotype, obesity, insulin resistance, vascular factors, dyslipidemia, HTN, inflammatory markers, Down syndrome, traumatic brain injury
Older adults with dementia retain ___ memory but have almost no ___ Memory
Implicit, explicit
Stage 1 Alzheimer’s is characterized by
Forgetfulness, mild memory deficit, difficulty with novel tasks, apathy and social withdrawn
Middle stage (2) Alzheimer’s is characterized by
Moderate to severe objective memory deficit, disorientation to time and place, requires supervision, language disturbance, apraxia, personality and behavioral changes
Late stage (3) Alzheimer’s is characterized by q
Intellectual functions untestable, verbal communication severely limited, incapable of self care, incontinence
Terminal stage 4 Alzheimer’s is characterized by
Bedridden, mite, unaware of environment, joint contractors and myoclonus
Plaques and tangles are widespread and brain atrophy occurs in stage
Late stage Alzheimer’s
The most widely used staging system in dementia research is
Clinical dementia rating scale
The functional assessment staging (FaSt ) is used for
Alzheimer’s
The global deterioration scale for assessment of primary degenerative dementia (GDS) divides disease process into _ stages
7
What is sundowning
A syndrome seen in late afternoon and early evening of confusion, hallucinations and agitation
Sundowning occurs in what stages of Alzheimer’s
Middle and late
Patients with Alzheimer’s are able to achieve near transfer with ____ practice
Constant
Alzheimer’s patients are unable to learn new tasks with ____ practice
Random
There is impaired learning with ___ practice in those with Alzheimer’s
Blocked
The four primary neurological impairments
Resting tremor, bradykinesia, rigidity and postural instability
