Neuro practical

Question 1

What kind of exercises are there? (8)

Answer 1

3 Triplets having FUN: one on a TRAIN, one EDUCATing and one with their EX…
their ex plays RS so they decide to train STRENGTH
on a computer in ROMania
clicking so fast they get attacked by THeir own HANDS
so drink a (t)CASK of whisky to cure the pain
which puts them on a STRETCHER
which is too SOFT
so they get their one form HOME

1. Functional: exercises, re-educatrion, training
2. Strength
3. ROM
4. Therputic handling
5. Task
6. Stretch / flex
7. Soft tissue massage
8. Home exercise

Question 2

key 10 principles to score points on?

Answer 2

DO WARM UP
PART VS WHOLE
BLOCK VS RANDOM
PT CENTERED

Question 3

Questions to ask the the pt?

Answer 3

what is your main problem?
diagnosis?
walking aid?

Question 4

Parts of the ICF?

Answer 4

Body / function / structure activities participation

environment ->^^^-

Question 5

What is the definition of Parkinsons?

Answer 5

Parkinson’s is a progressive neurological condition.
- ideopathic parkinsons disease = parkinsons
ie no known cause but presents with predictable ‘cardinal signs / symptoms’

Question 6

What are the clinical features of Parkinson’s?

Name key aspects of each one

Answer 6

Brady kineasea - initiating movement
Postural instability - loss of control, turning = hard, turns
Rigidity - flexed posture kyphosis / cog wheel / lead pipe / increased tone when opposite arm moves
Resting Tremor - Pill roll, gets better with movement , arms / legs / feet / jaw / tounge

Tom Brady and Post Malone Ride a Tumour

Question 7

Evidence / recommended guidelines for treatment of Parkinson’s

Answer 7

DRUGS

Best Evidence: 
Gait speed 
Strengthening 
Tai chi
Functional mobility (PAS)

Dancing (lover evidence)

Question 8

What is the definition of MS?

Answer 8

Unknown cause
Demyelination –> LESIONS –> myelin sheath - allows electrical impulse to SKIP (phospholipid surrounding it) - less electrical signals sent - less able to skip - Slower conduction (saltatory conduction interupted) -> messages not sent

Question 9

What are the clinical features of MS?

Name key aspects of each one

Answer 9

Weakness
Fatiuge
Loss of motor control

Can affect any part of the CNS
-> upper motor neurone -> spasticity / hyper, increased tone / spasm / bilateral problems / weakness / decreased voluntary movement

Benign / relapsing remitting / progressive / secondary progressice

Cerebellar signs :Ataxia, visual, intention tremor, dysmetria - over / under shooting, dysdiadochokinesia, balance difficulties / low tone / delayed initiation / delayed reaction time

weakness, spasticity , pain, gait issues,

Question 10

Evidence / recommended guidelines for treatment of MS?

Answer 10

Drugs

NICE:
regular exercise
esteablish meaningful goals
supervised rehab - resistance training / areobic exercise (help with fatiuge)
vestibular rehab - help with balance / falls

Health promotion / maintainence rehab / restorative rehabiliation

Question 11

Definition of stroke

Answer 11

blood supply to part of the brain is cut off.

ischaemic – where the blood supply is stopped because of a blood clot, accounting for 85% of all cases
haemorrhagic – where a weakened blood vessel supplying the brain bursts

Question 12

Spinal cord clinical features

Answer 12

For ALL: Biceps, rotator cuff, shoulder abduction

C6 + wrist ext
C7 + wrist ext + elbow ext
T6 finger / thumb + trunk stabilisers
T12 + abdominals

Main symptoms: weakness, sensation loss / gain (eg Pain), spasticity (spasm / clonus), balance

Also: automatic dysreflexia, bladder bowel dysfunction, sexual dysfunction, cardiovascular and autonomic dysfunction (sympathetic nervous system lines in spinal cord)

Paraplegia - below the T2 thoracic segment
Tetraplegia - paralysis at the first thoracic segment T1 and above

Question 13

Definition of a spinal cord injury

Answer 13

Disruption of nerve tissue in the spinal cord caused by trauma / diseases / degeneration / cancer

Question 14

Clinical features of a stroke

Answer 14

Hitching / circumduction / reduced weight bearing / inattention of one limb / side

Reduced energy 
Hypo/er tone 
Endurance
Gait disturbance 
Bladder / bowel 
Visio / spatial changes
Unilateral inattention / neglect 
Loss of motor control of the other side 
Contracture / deformity 
Balance issues 
Sensory issues 

Executive function
Cognitive factors ++

Question 15

Treatment of spinal cord / evidence?

Answer 15

Strength training
Aquatic 
Splinting 
Positioning 
Functional mobility
Standing
Gait training 
Orthosis / exoskeleton
Cardiovascular fitness 
Virtual reality

Question 16

Stroke rehab evidence ect baby?

Answer 16

Split into 2 parts - acute / rehabilitations.

• Actue : POSITIONING asap rocky + 45 mins of appropriate theraoy p/d
  intervention within 24-48 hours.. ischemic blah blah
• Rehab :
• FUNCTIONAL
• MIN ARM SUBLUXATIONS / SHOULDER PAIN
• WALKING IF MOBILSE
• ARM FUNCTION - FUNCTIONAL..
• USE HANDS / DEXTERITY