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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
Q

List the tx options for weakness if you pt is unable to move (2)

A
  • facilitation techniques (stretch reflex, tapping, vibration)
  • task specific training
26
Q

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
A
  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
Q

List the tx options for weakness in your pt who has some movement (grade 2-3) (2)

A
  • gravity eliminated
  • task specific training
28
Q

List skill acquisition strategies (4)

A
  • immediate feedback
  • manual guidance (learning + safety)
  • blocked pratcie (little variation)
  • MOTIVATION
29
Q

Term: ability to carry out any motor task precisley and quickly

A

coordination

30
Q

Term: multiple joints and muscles activated at appropriate times to work together

A

coordination

31
Q

Describe the effect of weights on coordination

A

Weights dampen movement, may improve accuracy with or with out alteration of speed

However, may have extra incoordination when the weight is removed

32
Q

Exercise: reciprocal movements of hands/feet; trace shapes and numbers

A

Frenkels exercises

33
Q

List the tx options for unilateral neglect (4)

A
  • task specific training
  • visual feedback (mirror, video)
  • mental imagery
  • encourage cross midline movement
34
Q

Describe why it is important to minimize verbal feedback in the treatment of those with left sided neglect

A

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
Q

Describe the effec tof crossed arm activity on neglect

A

With arms crossed, the accuracy of the neglected side improves

36
Q

Syndrome: leans to weak side

A

Pusher syndrome

37
Q

Condition: motor planning disorder

A

Apraxia

38
Q

Syndrome: grasping behavior withouth conscious awareness of pt.

A

Alien hand syndrome

Stroke in corpus callosum

39
Q

Syndrome: unable to communicate or move but cognitively intact

A

Locked in syndrome

40
Q

Describe the STREAM and S-STREAM

A

Stroke Rehabilitation Assessment of Movement

STREAM = 30 items (UE, LE, Function), 15 min

S-STREAM = 15 item, 10 min

41
Q

Type of PNF: pt. holds position with isometric resistance of agonists followed by antagonists

A

alternating isometrics

42
Q

Type of PNF: modificaiton of AI with isometric resistance provided in rotation motion

A

rhythmic stabilization

43
Q

Treatment Strategy:

ADV: readily modifiable to allow facilitation or resists

DISADV: complex, indirection functional relevant

AFFECTS: mm strength/power, multi-mm activation, coordiantion

A

PNF

44
Q

Describe the levels of the NDT approach

A

1st level (basis) = normalize tone

2nd level = automatic reaction (balance/trunk control)

3rd level = isolated/normal movement

45
Q

Treatment Strategy

ADV: readily modifiable for facilitation, manual guidance

DISADV: complex, strength not addressed, limited functional relevance

EFFECTS: multi-mm activation, coordination, tone, PROM

A

NDT

46
Q

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

A

Task specific training

PTRS 853 Midterm (12 decks)

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