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PTRS 853 Midterm > Motor Control Impairments > Flashcards

Motor Control Impairments Flashcards

1
Q

Describe the neural and non-neural causes of muscle tone

A

neural: AMN more sensitive to input

non-neural: stiffness due to immobilization/atrophy

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2
Q

Motor Neuron: response to quick stretch (high velocity, low amplitude)

A

Type 1a

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3
Q

Efferent fiber: contracts mm spindles

A

gamma motor neuron

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4
Q

List the Tx options for hypertonicity (3)

A
  • Drugs (baclofen, valium, botox)
  • Surgerical (block/cut)
  • PT (slow sustained stretching = short term effects)
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5
Q

Describe the theory behind prolonged stretch on tone

A

Thought of “Reflex Inhibiting”

Prolonged stretch activates GTOs autogenic inhibition which may allow for functional task practice but won’t necessarily have long term effects

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6
Q

Describe the key features of the GTO (4)

A
  • Stretch sensitive
  • Results in inhibition
  • Facilitates opposite mm
  • Must use an interneuron
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7
Q

List the neural and non neural causes of stiffness

A

neural: “relfex stiffness”

non-neural: effect of immob, limb inertia, heterotopic ossification, effect of aging, pain, arthritis, scoliosis

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8
Q

List the Tx options for stiffness (6)

A
  • stretching
  • splinting
  • serial casting
  • joint mobilization
  • heat modalities
  • surgical release
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9
Q

Describe the effect of stretching in healthy individuals vs. those with neurologic pathologies

A

Healthly: 30 sec hold or shorter duration over 15 min increases PROM

Non-healthy: standard stretching (above) is ineffective), 20-30 minute daily positioning may be effective in preventing contracture but not in reducing contracture

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10
Q

Describe Brunnstrom Stage 1

A

no movement

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11
Q

Describe Brunnstrom Stage 2

A

Involuntary movement only

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12
Q

Describe Brunnstrom Stage 3

A

abnormal synergy only

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13
Q

Describe Brunnstrom Stage 4

A

isolate 1 joint

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14
Q

Describe Brunnstrom Stage 5

A

isolate 2 joints

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15
Q

Describe Brunnstrom Stage 6

A

isolate all joints

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16
Q

Describe Brunnstrom Stage 7

A

normal movement

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17
Q

List the Tx options for synergy (3)

A
  • task specific training
  • varied timing demands
  • varied force demands
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18
Q

List the peripheral factors of strength and power (2)

A
  • L/T properties
  • Viscoelasticity
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19
Q

List the central factors of strength and power (4)

A
  • Motor units
  • Firing rate
  • Sequencing
  • Postural stabilization
20
Q

List causes of decreased force production in those with CNS pathology (8)

A
  • inadequate input from AMN (plegia)
  • alpha-gamma coactivation
  • incoordination
  • spasticity/synergy
  • sensory loss
  • ROM loss
  • atrophy
  • endurance/fatigue
21
Q

Describe alpha gamma co-activation

A
  • When the mm shortens, the mm spindle also shorterns
22
Q

Describe the adverse effects if alpha-gamma coactivation doesn’t occur

A

If this doesn’t occur the loose spindle can’t response to stretch which lessens the input from the mm spindle, this can result in weaker/smaller mm contraction (even when concentrating)

23
Q

Term: weakness as a secondary impairment

A

deconditioning

24
Q

List the tx options for weakness if your pt’s strength is > 3+ (2)

A
  • resisted exercise
  • task specific training
25
List the tx options for weakness if you pt is unable to move (2)
- facilitation techniques (stretch reflex, tapping, vibration) - task specific training
26
Describe the mechanisms behind the following tx for weakness in a pt. who is unable to move: 1. stretch reflex 2. tapping 3. task specific training
1. autogenic facilitation, no activation of M1 2. autogenic facilitation w/the opportunity for the brain to make connections with the AMN 3. activate alpha and gamma motor neurons via voluntary movement pathways
27
List the tx options for weakness in your pt who has some movement (grade 2-3) (2)
- gravity eliminated - task specific training
28
List skill acquisition strategies (4)
- immediate feedback - manual guidance (learning + safety) - blocked pratcie (little variation) - MOTIVATION
29
Term: ability to carry out any motor task precisley and quickly
coordination
30
Term: multiple joints and muscles activated at appropriate times to work together
coordination
31
Describe the effect of weights on coordination
Weights dampen movement, may improve accuracy with or with out alteration of speed However, may have extra incoordination when the weight is removed
32
Exercise: reciprocal movements of hands/feet; trace shapes and numbers
Frenkels exercises
33
List the tx options for unilateral neglect (4)
- task specific training - visual feedback (mirror, video) - mental imagery - encourage cross midline movement
34
Describe why it is important to minimize verbal feedback in the treatment of those with left sided neglect
The language center of the brain is located on the brain. Verbal feedback activates the L side of the brain, thus competing with the activation of the R side of the brain to over come neglect. When language centers are kept quiet, the R side of the brain is more activated than the L side
35
Describe the effec tof crossed arm activity on neglect
With arms crossed, the accuracy of the neglected side improves
36
Syndrome: leans to weak side
Pusher syndrome
37
Condition: motor planning disorder
Apraxia
38
Syndrome: grasping behavior withouth conscious awareness of pt.
Alien hand syndrome Stroke in corpus callosum
39
Syndrome: unable to communicate or move but cognitively intact
Locked in syndrome
40
Describe the STREAM and S-STREAM
Stroke Rehabilitation Assessment of Movement STREAM = 30 items (UE, LE, Function), 15 min S-STREAM = 15 item, 10 min
41
Type of PNF: pt. holds position with isometric resistance of agonists followed by antagonists
alternating isometrics
42
Type of PNF: modificaiton of AI with isometric resistance provided in rotation motion
rhythmic stabilization
43
Treatment Strategy: ADV: readily modifiable to allow facilitation or resists DISADV: complex, indirection functional relevant AFFECTS: mm strength/power, multi-mm activation, coordiantion
PNF
44
Describe the levels of the NDT approach
1st level (basis) = normalize tone 2nd level = automatic reaction (balance/trunk control) 3rd level = isolated/normal movement
45
Treatment Strategy ADV: readily modifiable for facilitation, manual guidance DISADV: complex, strength not addressed, limited functional relevance EFFECTS: multi-mm activation, coordination, tone, PROM
NDT
46
Treatment Strategy: ADV: readily modifiable to inc/dec difficulty, based on function DISADV: cognitive impairment EFFECTS: mm strength/power, multi-mm activation, coordination, tone, PROM, sensation/perception/vision
Task specific training

PTRS 853 Midterm (12 decks)

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