Neuro Interventions (PNF), stroke, SCI interventions Flashcards
Rehab for acute stroke
Early mob, education, functional mobility, communication, cueing, reduce distractions
Subacute rehab for stroke
Intensive inpatient, functional outcome training
Chronic >6 mo
HEP, constraint-induced movement therapy, bilateral training, strength, balance, flexibility, endurance, UE function, locomotion
Contraversive pushing
Pushing with a strong unaffected side towards the affected side
DO NOT PUSH BACK
Restore normal vertical sensation
- Mirror/biofeedback training
- Proprioceptive input from involved UE
UE Flexion synergy (shortened)
Stuck in position.
Abduction, retraction, elbow flexion, ER supination and wrist/finger flexion
Tactile cueing, PNF patterns, etc. to break pattern
UE Extension synergy
Protraction, adduction, IR, elbow extended, pronation, wrist and finger flexed
C1-C4
Respiratory consideration b/c diaphragm compromised. (C3, C4, C5 keeps diaphargm alive), Dependent for ADLs, wheelchair sip and puff, head, chin, tongue
C5
Power wheelchair with mods, tilt, Independence require significant modifications b/c no hand or wrist movement
C6
More independent with tenodesis grip for slide boards, manual wheelchair with modifications, drive with adaptive equipment
*start of sit/squat pivot transfer
C7
Manual wheelchair and pressure relief, independent
C8
more finger control and wrist control
Other mobility consideration
Rolling requires flexion of neck and bL rocking with UE
Wheelchair
Reach back and big movement for wheelie
MOve wheel anterior to make wheelie easier, greater leverages (e.g amputree
Move it post to make it more difficult
Early cognitive stage
Mental practice
Breaking tasks down
Associative stage of motor learning
Serial practice - different/variable skills, but with order
Autonomous stage
Changing environments
In squat pivot transfers for c7 or so
Protraction and depression of scap are required to life and clear buttocks
In squat transfers for c7 or so
Elbows should be locked with triceps or using external rotation to “lockout”
Transfer of learning
Start on good side and go to bad side after
BL is too difficult passively moving them is too easy
Think of controlled monility as
dynamic stability (anything moving)
Stability is static stability (anything static)
External feedback
earlier on
Internal feedback
later on
Knoweldge of performace
Early on to improve on how to do movement
Knowledge of results
For refining once got the movement itself down
Inhibition techniques
Deep pressure, prolonged stretch, warmth, prolonged cold
Any other stimulation is facilitation
