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Term 4 > Neuromuscular 2 Unit 1 > Flashcards

Neuromuscular 2 Unit 1 Flashcards

1
Q

IV STEP’s Four P’s

What is Prevention?

A

Prevent the onset of disease (or disability) to stop its progress and minimize consequences

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2
Q

IV STEP’s Four P’s

What is Prediction?

A

Optimal response to intervention choice is fundamental to effective practice; begins with meaningful system diagnosis and measurement
- Task Analysis

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3
Q

IV STEP’s Four P’s

What is Plasticity?

A

Capacity of cerebral neurons and neural circuits to change structrally and functionally in response to experience
- In other words, capacity for CNS to change

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4
Q

IV STEP’s Four P’s

What is Participation?

A

“Involvement of people in all areas of life or the functioning of a person as a member of society. Participation restrictions are problems an individual may experience in involvement in life situations” - WHO ICF framework

  • Quality of Life
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5
Q

With Neuro, what is the Goal of Physical Therapy?

A

Improve motor function and muscle performance

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6
Q

What are the 3 different Intervention Categories to improve Motor Function?

A
  • Restorative Interventions
  • Impairment-specific and Augmented Interventions
  • Compensatory Interventions
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7
Q

Interventions to improve Motor Function

What is Restorative Interventions?

A

Restorative Interventions focus on targeted movement deficiencies and are using activity-based interventions and motor learning strategies to work to improve motor function. Also implementing elements of neuroplasticity principles

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8
Q

Which Neuro Conditions would benefit from Restorative Interventions?

A
  • Stroke, Incomplete SCI, TBI, GBS, RRMS
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9
Q

What are the 3 basic elements of Restorative Interventions?

A
  • Repeatitive and intense practice of the task
  • Strategies that enhance active motor learing and motivation or adherence-enhancing behaviors
  • Strategies that encourage use of the more imparied body segments or segments, while trying to limit or restrict use of the less-impaired body segment
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10
Q

With Restorative Interventions, what are 3 elements of Activty-Based Intervention?

A
  • Resolve or minimize impairments as well as prevent secondary impairments
  • Apply effective task-specific strategies to the re-training of functional activities
  • Adapt strategies to changing task and environmental conditions
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11
Q

Restorative Interventiosn: Motor Learning strategies

What are the 3 stages of Motor Learning?

A
  • Cognitive
  • Associative
  • Automous
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12
Q

Restorative Interventiosn: Motor Learning strategies

What is the difference between Intrinsic and Augmented (Extrinsic) feedback?

A

Intrinsic feedback includes: Visual, Auditory, Proprioceptive, Vestibular, and Tactile

Augmented feedback includes: Knowledge of performance and knowledge of results

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13
Q

Restorative Interventiosn: Motor Learning strategies

With Augmented Feedback, what does Knowledge of results (KR) mean?

A
  • Terminal feedback about the movement outcome
  • This is provided by an instructor or clinician
    –Usually verbal
    –Can be visual or auditory
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14
Q

Restorative Interventiosn: Motor Learning strategies

With Augmented Feedback, what does Knowledge of Performance (KP) mean?

A
  • This is information about the pattern of a movement
    –Kinematic feedback: speed, velocity, displacement
    –Kinetic or EMG feedback if equipment: force and muscle activity
    –Quality of movement: no reference to goal or outcome
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15
Q

Restorative Interventiosn: Motor Learning strategies

What is Summary Feedback?

A

Feedback after a set number of trials

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16
Q

Restorative Interventiosn: Motor Learning strategies

What is Faded Feedback?

A

Feedback given less frequent with ongoing practice

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17
Q

Restorative Interventiosn: Motor Learning strategies

What is Bandwidth Feedback?

A

Feedback given if performance falls outside a predetermined error range

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18
Q

Restorative Interventiosn: Motor Learning strategies

In Practice Progression, What is Massed vs. Distributed progression?

A

Masses: has more practice time vs rest time

Distributed: has more rest time vs practice time

This depends on the patient, either can be chosen, however usually progressed TO massed in the autonomous stage

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19
Q

Restorative Interventiosn: Motor Learning strategies

In Practice Progression, What is the difference between Constant vs. Variable practice?

A

Constant: Task is practiced in the same way with no variety; This is better for performance

Variable: Task is practiced in variable conditions and parameters; This is better for learning

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20
Q

Restorative Interventiosn: Motor Learning strategies

In Practice Progression, What is the difference between Blocked vs. Random practice?

A

Blocked: 1 task repeated throughout whole practice time; This promotes performance

Random: A variety of task are practiced during practice time in random order; This promotes learning

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21
Q

What are Augmented Interventions?

A

These interventions include aspects of guided movement. These movements are guided or facilitated to try to promote some voluntary control and help jump start the recovery or promote positive neuroplastic changes by maybe incorporating a more involved body segment

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22
Q

What are some examples of Augmented Interventions?

A

It inlcudes general neuomuscular facilitation, PNF, Neurodevelopment Treatment (NDT), Bobath, NeuroIFRAH, etc.

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23
Q

Who would benefit from the use of Augmented Interventions?

A
  • Patients early in recovery
  • Patients with limited voluntary movement
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24
Q

Why would you use Augmented Interventions?

A

These interventions can help bridge the gap between absent or severely disordered movements and more active and controlled movements. Once the patient develops more adequate voluntary control these interventions are generally conterproductive and should be discontinued

25
Q

When is Augmented Approach Indicated and Contraindicated?

A

Indicated
- Lack of voluntary movement
- Demonstrates insufficient motor recovery
- Difficulty initiating or sustaining movement

Contraindicated
- Demonstrates sufficient active movement control

26
Q

What are Compensatory Interventions?

A

This involves the resumption of function using less involved body segment(s)

27
Q

Compensatory Interventiosn

What are alternative ways to accomplish tasks?

A
  • Substitution
  • Adaptation

(Not really an alternative way), we also use AD to accomplish different forms of movement

28
Q

With Compensatory Interventions, what is Substitution?

A

Substitutions are going to be changes that are made to the individual’s overall approach to a functional task

Ex. a pt has a Right CVA, L Hemiparesis is taught to do all there dressing tasks with their R UE as opposed to using both UE

29
Q

With Compensatory Interventions, what is Adaptation?

A

Adaptation is going to be the modification of the environment to facilitate the relearning of skills or the performance of movement and to optimize motor performance

30
Q

Augmented Interventions (Neuromotor Approaches)

Augmented Interventions are Indicated to those patients who:

A
  • Lack voluntary movement control
  • Demonstrate insufficient motor recovery
  • Have difficulty initiating or sustaining movement
31
Q

Augmented Interventions (Neuromotor Approaches)

When are Augmented Interventions Contraindicated?

A

When the patient demonstrates sufficient active movement control => activity based/task oriented approaches emphasizing active motor control

32
Q

Intro to NDT Augmented Interventions

NDT was designed to emphasize what?

A

NDT was designed to emphasize inhibition of abnormal reflexes and abnormal tone prior to focusing on function

Neuro-developmental treatment (NDT) is a hands-on therapy that helps people with neurological challenges improve their movement and function

33
Q

Intro to NDT Augmented Interventions

What are Indications of using NDT?

A
  • Poor grading of muscle activity
  • Muscle Imbalance
  • Motor Fatiguability
  • Spasticity
  • Incorrect initiation of movement
  • Incorrect timing and sequencing
34
Q

When should you not use NDT?

A

Pt has sufficient motor control to create effective movement

35
Q

Intro to NDT Augmented Interventions

With NDT, what are 5 body segment that offer key points of control for postural control and movement?

A
  • Head and Neck
  • Upper Trunk
  • Lower Trunk
  • UE
  • LE
36
Q

Intro to NDT Augmented Interventions

With NDT, what is the order in helping a patient progress to produce movement?

A
  • Stability => Mobility => Manipulate
37
Q

Intro to NDT Augmented Interventions

What is the difference between Facilitation and Inhibition?

A

Facilitation: to make easier
Inhibition: to prevent or hinder movement

38
Q

Intro to NDT Augmented Interventions

What are the Goals of NDT Treatment?

A
  • Works in the framework of stability to mobility
  • Optimal Alignment for functional tasks
  • WB of extremities to maintain alignment
  • Use of both sides of body to create normal sensorimotor experience
  • Active participation
  • Repetition and Practice

Overall goal is to utilize hands to facilitate normal
movement and inhibit abnormal movement

39
Q

With NDT, where should you start?

A

Create proximal stability and then add distal mobility
- Always start at the Lower Trunk

40
Q

Augmented Interventions PNF

What is PNF Technique?

A

This is utilized during movement in order to enhance movement facilitation

41
Q

Augmented Interventions PNF

What is PNF Pattern?

A

A movement in one plane of motion that a joint/extremity is taken or resisted through

42
Q

Augmented Interventions PNF

What PNF Diagnal?

A

A movement in two planes of motion that a joint/extremity is taken or resisted through

43
Q

Augmented Interventions PNF

What is Irradiation?

A

Transfer of activaion from agonist to another agonist

If an individual is to perform a supine to sit, activation of the trunk flexors may predispose activation of the hip flexors

44
Q

Augmented Interventions PNF

What is Successive Induction?

A

Transfer of activation from agonist to antagonist

Ex. if we strengthen the biceps during elbow flexion that this path would be carried over to the antagonist direction and would in turn strengthen/activate the tricep during elbow extension

45
Q

PNF Techniques

WHat does Rhythmic Initiation promote?

A

Promotes new movement, re-establishes directions

PNF techniques almost always start with this technique

This technique may be revisited if an individual has trouble with a pattern or feels fatigued

46
Q

PNF Techniques

What does Combination of Isotonics promote?

A

Promotes movement control

This can be delivered in either strengthening or neuromuscular reeducation types

47
Q

PFN Techniques

What does Rhythmic Stabilization/Stabilizing Reversals promote?

A

Promotes stability

The goal is for the patient to remain stable in response to an outside stimulus

48
Q

PNF Technique

What does Dynamic Reversals promote?

A

Promotes coordination of movement

This requires more than 1 plane of movement to be conducted

49
Q

PNF Techniques

What does Repeated Quick Stretch promote?

A
  • Strengthen within the movement
  • Reaffirms correct pattern/diagonal

This is used to provide proprioceptive cueing to increase the resistance of a movement, can also be used to redirect patients to the correct pattern or diagonal

50
Q

PNF Technique

What does Hold/Contract Relax promote?

A

Promotes increased passive ROM

51
Q

PNF Patterns

What are the different Scapular and Pelvic Patterns?

A
  • Anterior Elevation
  • Posterior Depression
  • Anterior Depression
  • Posterior Elevation

These are all in one place of motion

52
Q

PNF Patterns

What are the different UE and LE patterns?

A
  • D1 Flexion and Extension
  • D2 Flexion and Extension
53
Q

PFN Patterns

What are the different Trunk Patterns?

54
Q

PFN Diagonals

What are the different Scapular and Pelvic Diagonals?

A
  • Anterior Elevation and Posterior Depression
  • Anterior Depression and Posterior Elevation

Its both parts of a pattern

55
Q

Which PNF “Techniques” would only warrant a pattern?

A
  • Combination of Isotonics
  • Hold/Relax
56
Q

Which PFN “Techniques” would only warrant a Diagonal?

A
  • Dynamic Reversals
57
Q

Augmented Interventions PNF

What are PNF Barriers?

A
  • Cognition
  • Strength
  • Assistance Level
  • Subluxation (for joint traction)
  • Behavior
58
Q

What are the 3 Principles of Neuroplasticity that are imprortant for Neuro patients?

Term 4 (45 decks)

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