Neurophysiological Theories

Question 1

Brunnstrom & Rood

Answer 1

both look at reflexes
look in a heretical way 
look at developmental and sequencing of person (developmental sequences)
both began with children 
address tone --aim to normalize 
sensory component

Question 2

Brunnstrom

Answer 2

ATNR
uses resistance
contraindicated for anyone with unstable skill system (MS, osteoporosis, osteoprena, weakness)
look at synergies

Question 3

Rood

Answer 3

primitive

moving through a mvnt

Question 4

Bobath (NDT)

Answer 4

sensory

deep pressure/joint compression

Question 5

Bobath (NDT)

Answer 5

proximal to distal
incorporate R and L sides more functionally -use both sides
trunk- sit to stand transfers or bed mobility

look at 3 things typically-
normalizing tone (re-assess under dif. positions)
inhibitory or facilitory - techniques to normalize tone
muscle re-ed - maintain strength and integrity, teach pt how to move more normal again, certain level of cues (cognitive ability)
sensory in-put- heavy deep pressure (when pt explains infected side as painful)
tapping

5 stages 
observation/analysis
-looking at initial mvnt
-hot much act. they have in affected side
preparation
-normalize tone (air splint) 
-sense mid-line 
simulated activity/functional exercise
-practice sit to stand (block ex)
-verbal/tactile commands
-forward sh. flexion 
functional task
-go into bathroom- on and off toilet seat/shower seat ect. 
-turning one and off sink with sh. flexion
carryover
-family teaching (observation)
-walk and carry purse 
-walk and take wallet out of packet 

muscle re-ed.
isometric- placing and holding (put sh. in dif ranges and hold) build strength
eccentric- lengthening muscle (slowly lower back to bed)
concentric- lift arm back up

Question 6

MRP vs. NDT

Answer 6

MRP
break down each step/practice-put into function
-a lot of clinical judgement/ reasoning
-need cognition

hands off-let pt problem solve/practice
set-up act. to elicit mvnt (reaching, standing, ect).
positioning of task*

NDT
hands on to normalize mvnt
focus on tone
normalize
activate weak muscles 
better for lower level cognition pts.

Question 7

Brunnstrom vs. NDT

Answer 7

NDT
look at trunk, normal mvnt (don’t look at synergies) normal mvnt is goal, wouldn’t use resistance to elicit that mvnt, hands, not a stage approach, therapist driven tx., broad, eval ->observations

Brunnstrom
stages, stroke pts., eval -> FMA/ gives structure (fit some pts. but not others)
recovery model for hand - hot to direct tx to hand-resistance with
head position-> impact tone

Question 8

PNF

Answer 8

not used for pt. with sternal precautions (no push or pull)

can be used with pt. w dif. levels of cognition (NOT dementia)- need some cognition

Question 9

PNF overview

Answer 9

Basic facilitation procedures are used to:
Increase the ability of the pt. to move and maintain stability
Use proper grips and resistance to guide the motion
Assist the pt. in achieving coordinated movement through timing.
Increase stamina and avoid fatigue

Question 10

Basic PNF procedure for facilitation

Answer 10

Resistance 
Irradiation and reinforcement 
Manual Contact 
Body position and body mechanics 
Verbal commands 
Vision 
Traction and approximation 
Stretch 
Timing 
Patterns

Question 11

(Lab Notes) PNF Resistance is Used in NeuroRehab to

Answer 11

Facilitate a muscle contraction
Strengthen a weak muscle
Increase motor control
Give the pt. an increased awareness of movement through propioceptive control