PD Interventions Outside the CPG Flashcards

1
Q

what are the benefits of cycling in PD?

A

neuroplastic and neuroprotective effects

enables individuals with significant motor impairment and FOG to safely engage in CV training

improve motor fxn

reduce tremors, rigidity, and freezing

improve mental health and QoL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what motor fxns are enhanced by cycling?

A

balance, walking capacity, and walking speed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

t/f: intensity levels and cadence in cycling didn’t significantly affect outcomes

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

t/f: there is a limited focus on FoG in cycling

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

are cycling benefits are more pronounced when applied as a long term regimen or as a single session intervention?

A

when applied as a long term regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is high cadence cycling?

A

cycling with the motor maintained at 75-85 rpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

t/f: high cadence cycling showed significant improvements in UPDRS motor 3 and TUG times in a study

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how often is high cadence cycling done?

A

40 min sessions 3-5x/week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the aerobic recommendations for how often it should be done?

A

3x/wk for 30-40 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the recommended HR range for aerobic exercise?

A

70-85% of HRmax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the recommended RPE for aerobic exercise?

A

5-8/10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

t/f: use of RPE scale may be more helpful than HR in determining exercise intensity if HR response is blunted

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

is pedaling for parkinson’s better for long or short term care that is motivating and sustainable?

A

long term care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how long is a session in pedaling for parkinson’s

A

1 hour w/40 minutes of high cadence cycling with a warm up and cool down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is PWR! (Parkinson’s wellness recovery)?

A

a community wellness program that started as a gym in AZ that now uses PTs/OTs coordinating with fitness professionals with whole body movts to improve PD specific changes in posture, weight shifting, trunk rotation, and transitional movts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

who can be trained in PWR!?

A

PT/OT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PTs/OTs coordinate with who to follow PWPD along a continuum of care?

A

fitness professionals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

the whole body movts included in PWR! target what changes in PD?

A

posture

weight shifting

trunk rotation

transitional movts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the prepare portion of PWR! targeting?

A

rigidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the activate portion of PWR! targeting?

A

bradykinesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the flow portion of PWR! targeting?

A

incoordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what positions are included in PWR!?

A

low floor

high floor

sitting

standing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what fxns are targeted in PWR!?

A

bed mobility

getting off the floor

getting in/out of the car

posture/balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

is certification required for LSVT BIG and LOUD?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

is certification required to provide large amplitude, high velocity interventions in clinical practice to address the impairment soft a person with PD?

A

nope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

t/f: LSVT started as a speech program

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

t/f: LSVT BIG is based on the principle of LSVT LOUD

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the principles of LSVT?

A

intense amplitude based program

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the focus of LSVT?

A

high intensity and amplitude exaggerated movts

30
Q

what is the goal of LSVT?

A

to make bigger moves more automatic

to improve posture, flexibility, and balance

recalibrate the system to make normal movts

31
Q

what are the fundamentals of LSVT?

A

amplitude

sensory calibration

intensity

32
Q

what is often the biggest limiter to using LSVT programs?

A

pt and caregiver buy in

33
Q

what is the fundamental principle of amplitude used in LSVT?

A

the largest ROM that can be performed, with highest effort and most biomechanical efficiency

34
Q

what is the fundamental principle of sensory calibration in LSVT?

A

teaching the pt to self monitor

pt must accept that what feels too big is actually normal and create new motor memories

35
Q

what is the protocol for LSVT?

A

4 sessions (1 hour each) per week for 4 weeks (total of 16 sessions)

36
Q

t/f: LSVT has a long hx of national funding

A

true

37
Q

pre-treatment in LSVT, what is the cycle creating decreased movt in PD?

A

pts don’t recognize their movts are small–> they continue scaling reduced amplitude of movt patterns in self cueing–> reduced amplitude of motor output–> produce slow, small movts

38
Q

what is the cycle in treatment with LSVT?

A

improve pt’s self-perception of amplitude required to produce normal movt–>improve self-cueing to habitually scale increased amplitude of movt patterns–>increase amplitude of motor output–>produce larger movt

39
Q

t/f: LSVT tries to bring awareness to PD pts’ off calibration

A

true

40
Q

the amount of effort needed for an individual with PD to reach normal movt feels similar to what for a healthy individual?

A

the effort to perform big movts

41
Q

what a pt with PD perceives as ____ movt is actually _____ movt

A

big, normal

42
Q

what are the maximal daily exercises included in LSVT?

A

floor to ceiling - 8 reps

side to side - 8 reps

forward step - 8 reps

sideways step - 8 reps

backward step - 8 reps

forward rock and lean - 10 each side (working up to 20)

sideways rock and lean - 10 each (working up to 20)

43
Q

what are the functional tasks included in LSVT?

A

5 everyday tasks (ie STS, pulling keys out of pocket, buttoning shirt) - 5 reps

44
Q

t/f: STS are usually included in most pts in the functional tasks of LSVT

A

true

45
Q

what are the hierarchy tasks in LSVT?

A

pt identified tasks (ie. getting out of bed, playing golf, getting in/out of car) that involve multiple steps

46
Q

t/f: hierarchy tasks in LSVT should build in complexity across the 4 weeks to work towards long term goals

A

true

47
Q

LSVT can be modified to ___, ___, or ____ according to ability

A

supported standing

seated

supine

48
Q

the get ready signal in PD is _____

A

too weak

49
Q

what is the consequence of the get ready signal in PD being too weak?

A

inadequate set for movt

50
Q

what is the clinical result of weak get ready signal?

A

bradykinesia/hypokinesia

51
Q

the go signal in PD is ____

A

too weak

52
Q

what is the consequence of the go signal in PD being too weak?

A

inadequate selection/initiation of movt

53
Q

what is the clinical result of a weak go signal in PD?

A

freezing/hesitation

54
Q

the no-go signal in PD is ____

A

too weak

55
Q

what is the consequence of a weak no-go signal in PD?

A

inadequate completion of a movt

56
Q

what is the clinical result of weak no-go signal in PD?

A

festination

movts run together

57
Q

what are the teaching techniques used in LSVT?

A

model

shape

drive

stabilize

calibrate

58
Q

what does the teaching technique “model” mean?

A

show, don’t tell

“do what I do”

59
Q

what is the purpose of modeling in LSVT?

A

to minimize cognitive overload

60
Q

what does the teaching technique “shape” mean?

A

create the largest amplitude movt with optimal alignment

61
Q

what cues can be used to shape movt in LSVT?

A

visual, auditory, and propriceptive cues

62
Q

what does the teaching technique “drive” mean?

A

give big effort to increase motor output

63
Q

what does the teaching technique “stabilize” mean?

A

repetitions of practice are needed to reinforce and motivate

64
Q

what does the teaching technique “calibrate” mean?

A

retrain sensory perception to make movt look normal

65
Q

t/f: LSVT should be errorless learning

A

true

66
Q

should we correct mistakes in LSVT?

A

yes!

67
Q

what are the strengths of LSVT?

A

certification is affordable

it is a marketable program for clinics

it provides quick results

it is customizable and salient to the pt

it can help slow disease progression and drive neuroplastic change

68
Q

what are the weaknesses of LSVT?

A

pt time commitment

it is dependent on compliance

it must be done by a certified therapist

it is inflexible to modification

there is a potential insurance limitation

it is not effective in late stage PD

69
Q

t/f: there is no single mode of exercise or program that fits all PD pts

A

true

70
Q

beware of programs with _____ mentality

A

all or nothing

71
Q

t/f: caregiver and family education is key

A

true

72
Q

should we incorporate community exercise programming into our POC for PD?

A

yes!