Neuro Treatment Flashcards
What are common treatments for neuro patients?
Sitting balance Standing balance Walking balance Coordination training Transfers Sensation, proprioception, kinaesthesia
What are examples of sitting balance progressions from easier to harder?
Supported to unsupported
Internal perturbations (u/l arm flex, b/l arm flex, b/l abd, u/l abd, u/l knee ext, u/l hip flexion, head rotation, head flex/ext, head and trunk rotation, forward reach, side reach, backward lean
Reactive balance (external perturbations)
Altered BOS, vision, speed, etc.
What are progressions for standing balance from easier to harder?
Wide BOS -> Narrow BOS (feet apart, feet together, tandem, SLS, unstable surface)
Perturbations (none, internal, external)
Full sensory –> No sensory (eyes open stable surface, eyes open unstable, eyes closed stable, eyes closed unstable)
What are walking balance progressions?
Walking steadily without assistance
Walking and talking
Walking and carrying object
Walking and picking up an object without stopping
Walking and turning to look at and object
Walking and stepping over an object
Criss cross lateral walking
What are tips for preventing falls when educating on falls risk?
Maintain adequate light
Keep night lights in halls
Reduce clutter
Remove rugs
Wear proper non slip footwear in the home
If suffers from double vision, wear an eye patch on one eye
What is the bed positioning for side lying on the affected arm? What are the benefits of this position?
Benefits: allows pt to become more aware of affected side, WB will regulate abnormal muscle tone, inhibits abnormal postures
Position: side lying with back parallel to bed rail, affected shoulder to 90 flex, forearm supinated and elbow flex/ext, affected leg slightly flexed, unaffected leg on pillow ahead of other leg. Should be lying on scapula not humeral head
Pillow behind pt to prevent going into supine, between knees and under head
What is the bed positioning for side lying on the unaffected side? What are the benefits of this position?
Benefits: Inhibits extension synergy in LE, allows control for abnormal movement patterns
Position: side lying with back parallel to bed rail, affected scapula in protracted position with arm in 90 flex and elbow extended, affected hand open with wrist neutral. Unaffected leg in slight hip ext and knee flex. Affected leg slightly flexed knee and hip, foot in neutral.
Pillows behind back to prevent supine, between knees, under head, supporting affected arm.
What is the bed positioning for supine? What are the benefits of this position?
Benefits: prevents knee flexion contractures, allows symmetry of trunk and limbs
Position: trunk symmetrical, affected shoulder supported with elbow ext and wrist sup, wrist in neutral and fingers open, knees in full ext
Pillows under head, under affected arm, under affected hip if pelvis is causing ER of hip, towel under affected shoudler only if it’s lower than other shoulder
What are the 4 types of cues and examples of each you could use for Parkinson’s?
Auditory - rhythmic music/clapping, counting, metronome, instructions
Visual - stepping over lines on floor or objects, focusing on objects or colours
Tactile - tapping on hip, thigh, knee, leg, etc.
Cognitive - mental image of appropriate step length
What is the procedure to follow when pt demonstrates autonomic dysreflexia?
Sit patient upright (head above heart level) = trying to induce ortho hypotension
Notify doctor and nurse
Check for kinks in catheter
Loosen or remove restrictive clothing or devices
Check for cuts, scrapes, ingrown toenails below T6 dermatome
Monitor BP every 2-5min
What are some treatment options for MS? (6)
Energy conservation Relaxation techniques Exercise training Flexibility training Spasticity focused treatment (meds, surgery, ROM, stretching, splints) Fall risk education
What are exercise training considerations for MS?
Want to prevent adverse affects from over heating
Perform exercises in the morning due to higher energy levels and cooler temp
Exercise in cool environment
Keep hydrated with cool liquids
Wear light, loose clothing with good ventilation
Take more rest intervals (ex. 3x10min of cardio instead of 30min
Use blowing fans to keep cool
Avoid hot baths or showers
