ms 9

Question 1

Adaptive features in UMN Syndrome

Answer 1

• MUSK adaptations
• Hypertonia
• Decline in endurance and physical fitness
• Learned non-use
• Poor neuroplasticity adaptation
• Extension of central function – brain starts to shut down if not being used

Question 2

UMN adaptive features

Answer 2

• Shoulder Hitching,abd,
• Elbow F
• Forearm supination
• Wrist F
• Fingers F

Question 3

Prevent shoulder pain

Answer 3

-	Improve motor control
o	Intramuscular stimulation
o	Facilitate Motor activity 
o	Practive
o	Goal directed, task orientated
o	Stretches
1.	Stretching alone will not reduce pain, but can maintain optimal biomechanical alignment which can help

Question 4

splints

Answer 4

• Splints do not help with contracture

Question 5

Assessment and management of increased tone and abnormal posturing
Excitatory Tracts

Answer 5

• Brain stem and vestib nucleus and run via reticulospinal and vestibulospinal tracts

Question 6

Assessment and management of increased tone and abnormal posturing
Inhibitory Tracts

Answer 6

• Arise in ventro-medial reticular formation
• Run via dorsal reticulospinal
• Damage to inhibitory pathways cause spinal reflex dysfunction

Question 7

Dystonia

Answer 7

: Continuous muscle contractions in absence of voluntary contraction

Question 8

Botox

Answer 8

• Injected into muscle to turn muscle off to increase mobility of muscle, decrease spasms or reflexes, decrease pain
• Expensive, repeated doses needed, long waitlists, can cause sensory loss or motor unit death

Question 9

Baclofen Pump

Answer 9

• For extreme features, to minimise contracture and development of deformity, reduce pain, improve quality of life, reduce pain
• Places at T10-L1 level

Question 10

Neuroplasticity

Answer 10

• Need lots of training
• Imagining movement
• Observing movement can promote learning
• FES
• Sleep promotes learning
• Pay attention

Question 11

UL

Answer 11

• Normal reaching is a Smooth, well timed movement performed using a straight line trajectory with initial ballistic phase the followed by second phase where velocity decreases
• If target is beyond arm the trunk motion is integrated
  Phases of reach
• Transport -> pre-shaping -> grasp -> release

Question 12

ul muscles normally lacking

Answer 12

Muscles often lacking in UL
-	Serratus – protracts
-	External rotators 
o	Infraspinatus
o	Teres minor
-	Anterior delts – flexes shoulder, IR
-	Triceps
-	Supinator
-	Wrist extensors
-	Finger flexors