Overview of PT Interventions for People w/ Neurological Dysfxn Flashcards
what is any approach to tx based on
assumptions as to how the CNS works
who’re these assumptions explained by
originators of the techniques
change in philosophy occurs b/c
interventions are not adequate enough
knowledge of CNS workings change
it is best to not be
purist about anything
before the 1950s there was
poliomyelitis
poliomyelitis was a
LMN dz
dominant intervention for poliomyelitis
muscular re-education
w/ the focus on individual muscles
why was MMT developed
identify weak muscles and pts were taught specific exercises to strengthen these muscles
what was the focus on w/ poliomyelitis
isolating muscles and working on them
in the 1950s, hemiplegia and CP were treated as
orthopedic problems w/ bracing and surgery
how was polio eliminated
Salk vaccine
what didnt work for CNS dysfxns
muscle re-education
since the CNS controls movements through complex integrations and not individual muscles
what did PT’s change
their outlook
to focus on the CNS
what developed through the 1950s and 1960s
several “neurophysiological” approaches
“neurophysiological” approaches
Brunnstrom
Bobath (NDT)
Rood
what did John Hughlings Jackson say
the brain controls movements not muscles
what did what John Hughlings say imply
that there should be more emphasis on movements patterns
not individual muscles
what did all approaches assume
that lesions of particular areas of the CNS will lead to disordered movement patterns
rather than paralysis or weakness
all approaches focused on
movement patterns
one technique would…while another would…
suppress any kind of pathological response
use that response to facilitate movement
what did all the approaches commonly assume
an abnormal movements pattern resulted from the lesion itself
rather than the pt’s attempt to compensate for the lesion
how is the CNS organized
hierarchical manner
CNS hierarchy
higher center normally in command of lower centers
lower centers in command of primitive and more automatic behaviors
what does the CNS hierarchy imply
damage to higher centers (cerebral cortex) leads to release of lower centers from higher control
what is the result of this hierarchy
pt fxns at a more primitive level and cannot suppress the automatic movement patterns
d/t lack of inhibition by the higher centers
pts are…
“locked” into stereotypical movement patterns
what should tx be aimed towards
re-establishing inhibitory control by higher centers
recovery from brain damage
follows a predictable sequence that mimics normal development of movement during infancy
hierarchal organization
how were developmental and recovery viewed
progressive control of higher centers over lower centers
what has the hierarchal organization led to
idea of developmental sequence to progression of interventions
what was overriding the assumption of the neurophysiological approaches
all motor phenomena associated w/ brain damage have a neurophysiological basis
what doesnt the overriding assumptions account for
biomechanics
mucsle biology
behavioral science
