Neuro Rehab Concepts And Theories Flashcards
Massed practice
Practice time in a trial > amount of rest between trials
Distributed practice
Amount of rest between trials is = or > amount of practice time for each trial
Constant practice
Practicing under a uniform condition
Variable practice
Practicing under differing condition
Random practice
Varying practice among different tasks
Blocked practice
Consistent practice of a single task
Closed system model
Transfer of information that incorporates multiple feedback loops and larger distribution of control.
Nervous system is an active participant with ability to initiate movement (as opposed to just reacting to stimuli)
Open system model
Single transfer of information without any feedback loop (reflex hierarchical theory).
Nervous system waits to react to stimuli
Non-associative learning
Learning associated with a single stimulus (e.g. Habituation)
Associative learning
Gaining understanding of a relationship between two stimuli (e.g. Conditioning)
Procedural learning
Developing a habit through repetitive practice
Declarative learning
Learning that requires attention, awareness, and reflection in order to attain knowledge that can be consciously recalled (mental practice)
Performance
Temporary change in motor behavior seen during a particular session of practice.
Does not necessarily = learning (multiple variables affect performance at any given time)
Can be observed
Learning
Acquiring knowledge that leads to permanent change in ability to perform a certain skilled action
Cannot be observed (according to motor learning theory)
Plasticity
Change at the synapse level (temporary or permanent)
Sensitization
Increase in response that occurs as a result of a noxious stimulant (opposite of habituation)
Motor relearning approach
Idea that factors that are involved with learning are also involved in relearning
Relies on therapist observing strategy and and identifying variations in normal movement.
Bobath: Neuromuscular Developmental Treatment
Based on hierarchical model of neurophysiological function
Patient learns to control movement through activities that promote normal movement patterns that integrate function.
Postural control = key. Develops by assuming progressive positions in which there is an increase in the distance between the center of gravity and base of support.
Uses facilitation, inhibition, key points of control, and reflex inhibiting postures
Compensatory techniques should be avoided
Utilizes developmental sequence
Brunnstrom: Movement therapy in hemiplegia
Based on hierarchical model
Created and defined synergies
Developed the 7 stages of recovery for eval and documentation of progress. Believes limb synergies should initially be encouraged as a necessary milestone for recovery.
Homolateral synkinesis
Flexion of involved UE facilitates flexion of involved LE
Raimiste’s phenomenon
The involved LE will abd or add with applied resistance to the uninvolved LE in the same direction.
(Overflow)
Souque’s phenomenon
Raising involved UE above 100 degrees with elbow extension will produce extension and abduction of the fingers
PNF
Based on hierarchical model
Premise: establish gross motor patterns within CNS. Stronger body parts are utilized to stimulate and strengthen weaker parts.
Emphasis on manual contacts and correct handling.
PNF patterns each include:
Flexion, extension, and rotatory components and are directed toward or away from midline
PNF chopping
Combination of bilateral UE asymmetrical patterns performed as a closed chain activity
Developmental sequence (PNF)
Mobility> stability> controlled mobility> skill
Mass movement patterns (PNF)
Hip, knee, and ankle move into flexion or extension simultaneously
Overflow (PNF)
Muscle activation of an involved extremity due to intense action of an uninvolved muscle or group of muscles.
Controlled mobility definition (PNF)
Ability to move within a weight bearing position or rotate around a long axis
E.g. Prone on elbows, weight shifting in quadruped
Rood theory
Based on Sherrington and reflex stimulus model
All motor output is result of past and present sensory input
Movement is considered autonomic and noncognitive
Goal: Obtain homeostasis in motor output and activate muscles to perform a task independent of a stimulus
Facilitation Techniques (Rood):
Approximation Joint compression Icing light tough Quick stretch Resistance Tapping Traction
Inhibition Techniques (Rood):
Deep pressure
Prolonged stretch
Warmth
Prolonged cold
Heavy work (Rood):
A method used to develop stability by performing an activity against gravity or resistance
Focuses on strengthening of postural muscles
Light work (Rood):
Used to develop controlled movement and skilled function by performing an activity without resistance
Focuses on extremities
Key patterns (Rood):
Development sequence that directs patient’s mobility recovery from synergy patterns through controlled motions
