Neuro Rehab Interventions Flashcards
PNF
Follow developmental sequence
Repetition, carry over to functional activities are both important for learning
Brunnstrom
Interventions are primarily to get rid of synergisitc patterns and get back to isolated functional movements
Rood
Sensory pieces that we added on PNF
And she is the mob, stability, cont mob, skill of PNF
Neurodevelopmental treatment
NDTA trained trainers to standardize care
Living concept to undergo changes with time
NDT - patient as a ___
whole
NDT - Examination to determine
movement constraints
NDT - inhibiting what
abnormal tone for normal movements
NDT - uses what to guide patients
uses handling or key points to guide patient in normal movements
Righting and equilibrium rxns to facilitate balance but did not use other development reflexes
NDT - what position are the patients in
upright postures and not strict adherence to developmental sequence positions
NDT - tx integration
Integration of tx throughout the day in functional tasks
NDT - what does it look like when used with a patient
Symmetry
Posture
Weight shift
NDT - what does it look like when used with a patient - Posture
Midline
Erect with neutral pelvis
Think about UE position for symmetry
Positions easiest to hardest (isometric, eccentric, concentric)
NDT - what does it look like when used with a patient - weight shift
Equal wt bearing then subtle weight shifts while controlling trunk alignment
Motor relearning program - strong __ focus
strong biomechanical focus on NDT theory and incorporates task oriented techniques
4 steps of MRP
1 Observe and analyze the task - key component
2 Practice missing components (in part for some)
3 Practice task with dec feedback and continue with ongoing evaluation
4 Transference into varied environments
Task oriented
consideration of environment, person, and task
Repetition is valuable
Learn through trial and error and making mistakes
Examples that are task oriented
Constraint induced movement and treadmill training (a lot of repetition with both)
CIMT
Taub - learned non use of the involved UE - restrain good side and force use of involved extremity
CIMT protocol
Restraint of uninvolved UE with mitt, glove, splint, or sling for 90% of awake time
Therapy for 6 hr/day for 10-14 consecutive work days
CIMT - Shaping activities
Menaingful functional tasks (brushing hair, drinking from cup..) specific to the patient though - developed with them
CIMT - Motor Activity Log
Transference of training outside of therapy
Log records restraint times and activities
Concerns regarding CIMT
Pt compliance (frustration level, time commitment, endurance, need for family support) Therapists - time and lack of staffing to provide pt feedback, reimbursement
Modified CIMT
restraint for 5 hours, 5 days/week for 10 weeks
Therapy for 30 min 3 days/week for structured functional practice
Forced use
CIMT and mCIMT are forced use but this is an alternate protocol that calls for restraint but severity limits 1:1 training with PT (backed off on the PT time)
