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Semester 5 PMNM Exam 1 > Neuro Rehab Interventions > Flashcards

Neuro Rehab Interventions Flashcards

1
Q

PNF

A

Follow developmental sequence

Repetition, carry over to functional activities are both important for learning

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2
Q

Brunnstrom

A

Interventions are primarily to get rid of synergisitc patterns and get back to isolated functional movements

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3
Q

Rood

A

Sensory pieces that we added on PNF

And she is the mob, stability, cont mob, skill of PNF

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4
Q

Neurodevelopmental treatment

A

NDTA trained trainers to standardize care

Living concept to undergo changes with time

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5
Q

NDT - patient as a ___

A

whole

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6
Q

NDT - Examination to determine

A

movement constraints

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7
Q

NDT - inhibiting what

A

abnormal tone for normal movements

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8
Q

NDT - uses what to guide patients

A

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

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9
Q

NDT - what position are the patients in

A

upright postures and not strict adherence to developmental sequence positions

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10
Q

NDT - tx integration

A

Integration of tx throughout the day in functional tasks

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11
Q

NDT - what does it look like when used with a patient

A

Symmetry
Posture
Weight shift

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12
Q

NDT - what does it look like when used with a patient - Posture

A

Midline
Erect with neutral pelvis
Think about UE position for symmetry
Positions easiest to hardest (isometric, eccentric, concentric)

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13
Q

NDT - what does it look like when used with a patient - weight shift

A

Equal wt bearing then subtle weight shifts while controlling trunk alignment

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14
Q

Motor relearning program - strong __ focus

A

strong biomechanical focus on NDT theory and incorporates task oriented techniques

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15
Q

4 steps of MRP

A

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

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16
Q

Task oriented

A

consideration of environment, person, and task
Repetition is valuable
Learn through trial and error and making mistakes

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17
Q

Examples that are task oriented

A

Constraint induced movement and treadmill training (a lot of repetition with both)

18
Q

CIMT

A

Taub - learned non use of the involved UE - restrain good side and force use of involved extremity

19
Q

CIMT protocol

A

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

20
Q

CIMT - Shaping activities

A

Menaingful functional tasks (brushing hair, drinking from cup..) specific to the patient though - developed with them

21
Q

CIMT - Motor Activity Log

A

Transference of training outside of therapy

Log records restraint times and activities

22
Q

Concerns regarding CIMT

A 
Pt compliance (frustration level, time commitment, endurance, need for family support)
Therapists - time and lack of staffing to provide pt feedback, reimbursement
23
Q

Modified CIMT

A

restraint for 5 hours, 5 days/week for 10 weeks

Therapy for 30 min 3 days/week for structured functional practice

24
Q

Forced use

A

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)

25
Q

What patients should try CIMT

A

People with CVA
Depends on available movement
Time of onset since CVA for training to start

26
Q

What patients should try CIMT - Available movement

A

Taub - 10 AROM MCP and ICP, 20 wrist ext
Other studies - 10 thumb abd, 10 ext of any 2 digits
More involved patients - lift and release wash cloth

27
Q

What patients should try CIMT - time of onset since CVA for training to start

A

Initially done 12 months after CVA
Others say 10 days post CVA but with 2 hr/day and 6 hr in mitt
Others 3-9 and 15-21 months s/p CVA

28
Q

What patients should try CIMT - Does it translate to improved function

A

Reports of improved ADL but only with bimanual tasks

Quality of the movement and use of compensatory patterns may still be an issue

29
Q

Locomotor training - ex

A

treadmill with or without body weight support
Unloads a % of body weight
Assist for LE placement during ambulation

30
Q

Advantages to locomotor training

A

Repetition, practice time
Dec lifting by PT and muscle force requirements of pt, safer ambulation
May improve coordination with consistent training
Inc hip extension to facilitate swing phase
Prevent learned non use of involved LE

31
Q

Evidence for BWS - improves

A

gait symmetry, stance time on involved LE, functional balance, walking distance

32
Q

Evidence for BWS - gait speed

A

Conflicting evidence - Faster (More than 2mph) BWS training can improve speed
More effective than cycling or strengthening
And more effective than NDT

33
Q

LEAPS trial

A

Multisite RTC - 36 PT sessions, 75-90 min over 12-16 wks

One group of BWST (2 months and 6 months post CVA) and other had HEP of balance and strengthening (2 months post CVA)

34
Q

LEAPS trial results

A

All inc velocity, motor recovery, balance, function
All had greatest improvements at 12 sessions
Compared to those with usual PT care 6 mo s/p, subjects in study had double gait velocity at 2 months

35
Q

Bilateral Arm Training

A

Using both arms with various activities - specific progressions depending on the severity of the injury

36
Q

Mirror Therapy

A

Using mirrors to give impression that both hands are performing the motion (trick the brain)

37
Q

Neuro-IFRA (Integrative Functional Rehabilitation and Habilitation)

A

whole person approach - restoring function and making it functional to return to independent living and resumption of life roles

38
Q

Robotics

A

Like exoskeleton that can help complete a movement - can set it so that they have to use a certain force before the robot will take over for them

39
Q

Serial casting

A

Putting multiple casts to gradually inc ROM - sustained hold over period of time to decrease spasticity and hypertonicity

40
Q

Tai Chi

A

Improved balance, mobility for those with Parkinsons and also helps balance for the elderly in general

41
Q

Aquatics

A

Unweights the body

42
Q

How do you decide what to do with a given patient

A

You will be doing a lot of different things with each patient - people also may be referred out for an aquatics class for example

Semester 5 PMNM Exam 1 (4 decks)

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