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NeuroPT2 > NeuroPT 1 REVIEW #1 > Flashcards

NeuroPT 1 REVIEW #1 Flashcards

1
Q

What is Motor Learning?

A

Acquisition of NEW SKILLS w/ Practice

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2
Q

Learning is NOT _____

A

Passive

*experience and active problem-solving are necessary for learning to take place

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3
Q

What facilitates a permanent change in behavior?

A

Result of experience and (perfect) practice

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4
Q

In terms of Motor Learning…adult pts are not learning new skills, but rather ___________

A

relearning OLD skills w/ a damaged CNS

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5
Q

More _______ gen leads to _______

A

GOOD practice leads to better performance

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6
Q

Fundamental unit of therapy

A

TASK and all learning is GOAL-ORIENTED

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7
Q

practice needs to be accurate

A

Practice makes permanent

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8
Q

Most effective interventions are……

A

Functional!

*Practice must have PURPOSE!!!

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9
Q

3 Trad. Stages of Motor Learning

A
  1. Cognitive
  2. Associative
  3. Autonomous

*NOTE: Attentional demands DEC from cognitive to autonomous stages

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10
Q

Motor Learning:

Cognitive stage

A

Understand task, develop strategies, high deg. of attention*

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11
Q

Motor Learning:

Associative Stage

A

Best strategy selected, skill refinement

*associate the skill w/ the task and refine it

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12
Q

Motor Learning:

Autonomous Stage

A

Skill is automatic, low deg. of attention

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13
Q

Process of motor learning:

Acquisition

*exactly what it sounds like

A
  • Skill Acquisition: initial dev. of motor skill, impossible w/out practice!
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14
Q

Process of Motor Learning:

Retention

*exactly what it sounds like

A
  • Skill Retention: remembering a motor skill
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15
Q

Process of Motor Learning:

Generalizability

*incorporating it into your life

A
  • Skill Generalizability: positive influence that a prev. practiced skill has on the learning of a new skill
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16
Q

Process of Motor Learning:

Application in Altered Contexts

*exactly what it sounds like

A

Will this pt be able to perform the same activity in a diff context?

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17
Q

FEEDBACK***

A

return to the brain of info. regarding the result of action or process

Trad. feedback in PT informs pt of how they performed or completed an activity

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18
Q

Feedback Timing:

Frequent

A

distracts and interferes w/ info processing, NEGATIVELY impacts learning

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19
Q

Feedback Timing:

Concurrent & Continuous

A

MOST EFFECTIVE for performance, maximizes dependency

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20
Q

Feedback:

Intrinsic

A
  • gen’d from pts sensory organs
    • Proprioceptive (jt pos. sense), tactile (pressure sense), visual, vestib.
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21
Q

Feedback:

Extrinsic

A
  • Provided by some EXT. source
    • YOU, device
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22
Q

Feedback:

Knowledge of Performance

KP

A
  • Feedback on execution→ gives info on mvmt components→ building block
    • EX. Goal→ transfer from sit→ stand <5s
      • Tell them what happened
        • insuff trunk flex
        • incorrect sitting pos. @ initiation
        • Incorrect pos. of feet
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23
Q

Feedback:

Knowledge of Results

KR

“How it Went”

A
  • Feedback on outcome (info about task completion) whether they did task correctly→ better for long-term learning
    • EX. Goal to transfer from sit→ stand <5s
      • tell them how it went
        • successful completion of transfer
        • Time to complete
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24
Q

KP vs. KR

EXAMPLE: watching someone don their shirt and they put it on backwards

A

KP: they did not turn shirt around first before they put their head thru neck opening

KR: Their shirt is on backwards

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25
Q

Feedback:

Immediate

A

Given after ea. trial

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26
Q

Feedback:

Summary

A

Given after a given # of trials

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27
Q

Bandwidth Feedback

“Are you in the range?”

A

Provided when a certain lvl of accuracy is not achieved

Given when the person exceeds the target range or when person fails to meet target range

Overshot it or Came up short

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28
Q

NOTE: Use of Feedback

A
  • “Faded” Feedback→ MOST EFFECTIVE for long-term retention*
  • Early feedback→ frequent and concurrent
  • Once performance improves→ feedback should be → LESS FREQ., very brief, focused on precision, given in summary
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29
Q

Error detection:

A

we want the pt to have the opportunity to sense and correct errors in order to make improvements

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30
Q

Goals of Practice

A

Acquisition: initial learning

Retention & Transfer (Generalizability): long-term learning

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31
Q

Practice

What combo is most effective?

A

Physical AND Mental

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32
Q

Partial-Task practice

A

select portion of the action

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33
Q

Whole-Task practice

A

do the whole task

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34
Q

MOST USEFUL for Part-Task practice

A
  1. Long task
  2. Diff aspects
    1. must gradually integrate to minimize transfer problems
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35
Q

Most useful for Whole Practice

A
  1. Learner has prereq. skills
  2. Task <1sec
  3. min. cognitive processing
36
Q

Blocked Practice

A

*improves skill acquisition (initial learning)

  • task or seq of tasks repeated in a very predictable way
37
Q

Serial Learning

A

*improves skill retention & transfer

  • tasks are predictable, but the order is changed
38
Q

Random Practice

A

*improves skill retention & transfer (long-term results)

  • tasks are ordered unpredictably and out of seq.
39
Q

Distributed Practice vs. Mass Practice

A

see pics

40
Q

Facilitation of Skill Acquisition

A

Feedback: freq and concurrent w/ performance

Practice: blocked, correct only sig. errors, allow for prob-solving

Guidance: manual guiding, verbal cues

41
Q

Facilitation of Skill Retention & Generalizability

A

Feedback: Extrinsic→ Faded and summary feedback

Practice: promote ENTIRE mvmt pattern, encourage active prob-solving, tasks oriented practice, random practice, diversify

42
Q

Tx Implications

A

MINIMIZE block practice, use early random practice, change environment, min. inapprop feedback

43
Q

Optimize Skill Learning

A

achievable, functional tasks

change environment

vary cond’s

consider spectrum of diff.

44
Q

Optimally structure Tx:

A

Unclear goal is NOT achievable!

instruct pt about goal carefully

promote selective attn

suggest mvmt patterns

45
Q

4 Steps to Motor Relearning Program:

A
  1. Analysis of Task
  2. Practice of Task
  3. Practice of Missing Components
  4. Transference of Training
46
Q

Modifiers to Disablement Model

A
  • Indv factors:
    • lifestyle/health
    • psychosocial attr’s
    • ability to adapt to limits
47
Q

ENABLEMENT models

A

from perspective of what the indv is ABLE TO DO vs. cnt do

48
Q

EXAM:

3 components

A
  1. Hx
    1. hx current cond, PMH, social hx/habits, living environment, activity lvl, functional statue,
    2. holistic picture of pt and how affected by patho
    3. PIPs and NPIPs
  2. Systems review
  3. Tests and Measures
    1. Reliability→ will it produce same results again
    2. Validity→ does it tell me what I want to test?
49
Q

EVAL, Dx, Prognosis

A
  • body structure/function probs
  • act. limits
  • clinical impression
  • prognosis
  • EVAL is:
    • analysis of all info collected thru exam
    • prioritized list of PIPs, NPIPs
    • Determine appropriate, measurable, achievable goals
  • POC
    • anticipated goals
    • expected outcomes
50
Q

Hypothesis-oriented clinical practice

A

Gen. mult. hypotheses

select/perform tests to R/O one or more hypotheses

Continue until cause is understood

51
Q

Neuro Screening

Purpose:

A
  • localizes source of patho
  • where to focus in-depth
  • tests/measures to use
  • determines pts gross capabilities and limits.
  • ID
    • s/s suggesting deterioration
52
Q

Components of screen:

A
  • mental status
  • Pt hx
  • vitals
  • UQS/LQS
  • mm tone
  • DTRs
  • patho reflexes
  • coord
  • posture
  • CN’s
53
Q

Sx Investigation

A
  • Consider
    • loc
    • pattern of change
    • hx of onset
  • Interpret pts description of sx’s, act/part limits, exam findings
  • LINK b/w probs and body structure/function and act/part limits
54
Q

Diff Dx

A

GOAL:

  • recognize s/s
  • communicate findings
  • Create PT Dx
55
Q

Clinical Decision

A

Treat

Treat & Refer

Refer

56
Q

Asthenia

A

weakness

57
Q

Bradykinesia

A

extreme slowness of mvmt

58
Q

Akinesia

A

Inability to initiate mvmt

59
Q

Apraxia

P for Planning

A

inability to perform purposeful mvmt even tho there are no sensory or motor impairs

*prob w/ motor Planning

60
Q

Interventions for weakness

A
  • PREs
  • absence of active mvmt (0 or 1 on MMT)
    • facilitation
      • stretch reflex for autogenic facilitation
  • lack anti-gravity power (2 or 3 MMT)
    • gravity eliminated pos’s
      • functional tasks
  • lack full mm power (3+ or higher MMT)
    • resistance
    • man. resistance
    • consider body pos.
61
Q

PNF

A

Proprioceptive Neuromuscular Facilitation

*dev’d to combat weakness assoc’d w/ polio (LMN)

62
Q

PNF principles

A
  1. mass mvmt is characteristic of normal motor act.
    1. brain knows only mvmt
  2. Mass mvmt reqs tissue short + lengthening
63
Q

NDT

A

challenge trunk mm’s , prox mm stability

64
Q

Constraint Induced Mvmt

“Forced Use”

A

GOLD STANDARD FOR CVA

motor learning principles

65
Q

Discoordination

*prob w/ timing and amplitude of mvmt

A
  • manifests several ways
66
Q

Discoordination:

Ataxia

A

abnormal coordination

*deficits in speed, amp, directional accuracy, force of mvmt

67
Q

Discoordination:

Dysmetria

A

inacc amp and timing of mvmt

overshoot→ hypermetria

undershoot→ hypometria

68
Q

Discoordination:

Dysdiadochokinesia

A

diff performing rapid alt mvmts

clumsy, slow

69
Q

Discoordination:

Tremor

A

alt contractions of agonists & antagonists

Intention→ voluntary→ occurs during mvmt of limb→ cerebellum issues

Resting→ present @ rest→ not assoc’d w/ dyscoord.→ BG probs

70
Q

Intervents for impaired coord:

A

Encourage reference to smoooooth mvmts w/ verbal cues and alter lvl of diff

  • Placing activities
    • targeted mvmts
    • stairs
    • darts
    • TM walking
71
Q

PNF

A

Proprioceptive→ sensations of body pos and mvmt

Neuromuscular→ regarding mms and nerves

Facilitation→ make easier, inc ease of performance of action or task

72
Q

Resistance w/ PNF

A

approp. resistance

“correct” amt

smooth contraction w/out being too easy or too dif

INC mm fibers

INC kinesthetic awareness by INC force of contraction

73
Q

PNF

Irradiation

A

spreading of nmsk response from one muscle group to another by altering emphasis or resist

where we provide resistance**

74
Q

Successive Induction

A

Incd response of agonist results AFTER contraction of its antagonist

*contract tri’s b4 bicep curl

75
Q

Reciprocal Inhibition

A

Facilitation of agonist results in simultaneous inhibition of the antagonist

*bridge to turn off hip flexors

76
Q

Autogenic Inhibition

A

Stimulates GTOs and results in muscle relaxation

*bicep curls to relax biceps

77
Q

UE diagonal pattern

Scapula

A

D1 flex: elevation/protraction

D1 ext: depression/retraction

D2 flex: elevation/retraction

D2 ext: depression/protraction

78
Q

Pelvic PNF patterns

A
  1. Ant elevation/post depression (1-7:00)
  2. Ant depression/post elevation (10-4 or 9-3)
79
Q

PNF Activation:

Rhythmic Initiation

A

Passive→ Active Assistance→ Resistive

80
Q

PNF Activation:

Combination of Isotonics

A

Conc←→ecc, stabilizing contractions

81
Q

PNF activation:

Reversal of Antagonists

A
  • Isotonic Reversal
    • alternating isometrics or maintained isometrics
  • Stabilizing Reversals
    • alternating isometrics or maintained isotonics
82
Q

PNF Activation:

Quick Stretch

A

used to facilitate strong mm contraction

83
Q

PNF Stretching:

Contract Relax

A

contraction of agonist followed by PROM

84
Q

PNF Stretching:

Hold Relax

A

Isometric or stabilizing contraction followed by PROM

85
Q

Rigidity

A

non velocity dependent inc in resist to PROM

86
Q

Decorticate

flexion one

A

UE→ flexion

trunk & LE→ extension

87
Q

Decerebrate

all the e’s!→ EXTENSION one

A

EXT of trunk & all extremities

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