neurophysio

Question 1

systems approach to motor control

Answer 1

movement is organised around abehavioural goal/function & results from an interation between
- enviroment (moving obstacles, different light levels)
- task (turning, dual task, picking up objects)
- individual

and sends info to the
- musculoskeletal system
- sensory-motor control system
- cognitive processes

Question 3

neuro rehab guiding principles

Answer 3

self management
patient centered care
team work
.
ICF
.
Skill acquisition
functional movement re-education
systems model of sensory motor control
neural plasticity

Question 4

neural plasticity definition breakdown of words

Answer 4

neuro- nerve cells
plasticity - changeable

Question 5

neuroplasticity

2

Answer 5

any enduring changes in neurone structure or function and occurs in everyone (kleim 2009)

can be changes in the anatomy structure of the brain or changes in the physiology function of areas of the brain

Question 6

developmental plasticity

Answer 6

modification in structure (anatomy) and function (physiology) of the CNS during embryonic growth and development

Question 7

functional plasticity

Answer 7

changes in the adult CNS induced by the enviroment = learning e.g professional violinists found to have greater cortical representation of left hand

Question 8

definition & 2 points

adaptive plasticity

Answer 8

changes induced by injury or lesions to specific components of the CNS

• in neurological injury often combination of both functional and adaptive plasticity
• not always a positive thing use it or lose it

Question 9

damage induced changes to cns - stroke

damage to nerve tissue at the site of the primary injury

Answer 9

• core ischemia (necrosis) (minutes)
• delayed cell death (penumbra) (hours-days)

Question 10

damage induced changes to cns - stroke

remote secondary damage and dysfunction distal to site of injury

Answer 10

• due to **diaschisis **
• diaschisis with a heamorrhige is bigger due to the increased pressure in the brain (is reversible if the heamorrhig reduces naturally or surgically reduces pressure)

Question 11

spontaneous natural recovery after stroke

Answer 11

through reduction in inflammation surrounding a lesion (penumbra) reversal/ resolution of diachisis

Question 12

motor training after stroke can induce recovery by what mechanisms?

Answer 12

1. resoration
2. reorganisation
3. recruitment

Question 13

restoration

Answer 13

function within damaged area of the motor cortex restored with rehabilitation
- making pathways easier/ faster/ more efficient (physiological)

Question 14

reorganisation

Answer 14

• rehab can drive residual neural tissue to reorganise in order to compensate for lost function
• finding new routes (physiological)

Question 15

recruitment

Answer 15

• when insufficient resources are found within the damage area, others may take over or the contralateral motor cortex may be recruited
• making new pathways (anatomical)

Question 16

making pathways easier (physiological)

Answer 16

• more neurotransmitters
• stronger link between neurones

Question 17

10 principles that drive neuroplasticity

Answer 17

1. use it or lose it - neural circuits not actively engaged will start to atrophy or degrade
2. use it and improve it
3. specifcity - plasticity is experience specific to the individual
4. repetition matters - have to practise a lot of times to see neural changes
5. intensity matters- need the right amount of physical activity to cause brain changes
6. time matters - waiting to late to start the activity means a decreased capability to change
7. salience matters - has to be motivating & important to that person
8. age matters- younger patients brains adapt and change more easily
9. transference - if you practice something in a nearby area of the brain it will transfer to other areas of the brain
10. interference - sometimes neural plasticity can be delayed

Question 18

10 principles that drive neuroplasticity

use it or lose it

Answer 18

neural circuits not actively engaged will start to atrophy or degrade

Question 19

10 principles that drive neuroplasticity

specifcity

Answer 19

plasticity is experience specific to the individual

Question 20

10 principles that drive neuroplasticity

repetition matters -

Answer 20

have to practise a lot of times to see neural changes

Question 21

10 principles that drive neuroplasticity

intensity matters-

Answer 21

need the right amount of physical activity to cause brain changes

Question 22

10 principles that drive neuroplasticity

time matters -

Answer 22

waiting to late to start the activity means a decreased capability to change

Question 23

10 principles that drive neuroplasticity

salience matters -

Answer 23

has to be motivating & important to that person

Question 24

10 principles that drive neuroplasticity

age matters-

Answer 24

younger patients brains adapt and change more easily

Question 25

# 10 principles that drive neuroplasticity transference

Answer 25

- if you practice something in a nearby area of the brain it will transfer to other areas of the brain

Question 26

# 10 principles that drive neuroplasticity interference

Answer 26

- sometimes neural plasticity can be delayed

Question 27

skill aquisition

Answer 27

1. early learning phase (declarative phase) - attempting to understand basic phases and movements of functioning 2. intermediate associative phase (implicit and explicit learning - eg. often dropping bslls but able to identify and correct the problem through trial and error by practising 3. autonomous phase (procedural learning) - able to juggle automatically with few errors and able to focus on uni-cycling at the same time

Question 28

# 6 how to use it in practice

Answer 28

- repetition - fascilitates normal movement - provide sensory and proprioceptive feedback - functional tasks - minimise abnormal recovery of movement and spasticity - think about stages of learning

Question 29

late rehab

Answer 29

change fastest early after injury/disease (kwakkel et al 2004) - functional change has been evident even when the rehab programme was inititated 20 hears after the lesion (ward et al 2018)

Question 30

# 4 key aims of neuro physiotherapy

Answer 30

all affect optimal function 1. restore 2. adapt 3. maintain 4. prevent

Question 31

restore

Answer 31

- aim to restore functional activities and increase participation as identified by patient led goals (edwards 2002) - current evidence suggents that practice of motor skills needs to be both task and contex specific - if impairments make it difficult to practice the task directly, address impairments ensuring theres carry over into functional activity

Question 32

adapt

Answer 32

* can be viewed both negatively and positivly * promotes compensatory startergies that are neccessary for function and discourgae thoses that may be detrimental * initiaition of compensation stratergies may vary

Question 33

maintain

Answer 33

- maintance of function can be as important as therapy - in progressive conditions eg. MS, PD, physiotherapy can help maintain functional ability despite deteriorating impairments

Question 34

prevent

Answer 34

- impairements there may be an increased risk of developing secondary complications - contractures - pressure areas and reduced skin integrity - respiratory or urine infections

Question 35

Bobath

Answer 35

aims to stimulate sensory and motor pathways to encourage normal movement patterns and the recovery of selective movement as a prerequisite for efficient postural control, alignment, and function. Rehabilitation is a process of learning to regain motor control and should not be the promotion of compensation

Question 36

Carr and Shepherd / Movement Science

Answer 36

improves functional ability by making treatment task-specific and encouraging active involvement throughout the rehabilitation process, as with Bobath the development of compensatory movement patterns that may hinder recovery are avoided

Question 37

context or goal & reference

Answer 37

The presence of a meaningful context or goal has been shown to enhance motor learning (Ma 1999; Wu 2000)

Question 39

extrinsic feeback & reference

Answer 39

Extrinsic feedback enhances motor learning after stroke (van Vliet 2006)