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

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2
Q

what motor fxns are enhanced by cycling?

A

balance, walking capacity, and walking speed

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3
Q

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

A

true

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4
Q

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

A

true

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5
Q

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

A

when applied as a long term regimen

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6
Q

what is high cadence cycling?

A

cycling with the motor maintained at 75-85 rpm

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7
Q

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

A

true

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8
Q

how often is high cadence cycling done?

A

40 min sessions 3-5x/week

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9
Q

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

A

3x/wk for 30-40 minutes

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10
Q

what is the recommended HR range for aerobic exercise?

A

70-85% of HRmax

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11
Q

what is the recommended RPE for aerobic exercise?

A

5-8/10

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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

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13
Q

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

A

long term care

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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

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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

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16
Q

who can be trained in PWR!?

A

PT/OT

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17
Q

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

A

fitness professionals

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18
Q

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

A

posture

weight shifting

trunk rotation

transitional movts

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19
Q

what is the prepare portion of PWR! targeting?

A

rigidity

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20
Q

what is the activate portion of PWR! targeting?

A

bradykinesia

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21
Q

what is the flow portion of PWR! targeting?

A

incoordination

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22
Q

what positions are included in PWR!?

A

low floor

high floor

sitting

standing

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23
Q

what fxns are targeted in PWR!?

A

bed mobility

getting off the floor

getting in/out of the car

posture/balance

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24
Q

is certification required for LSVT BIG and LOUD?

A

yes

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25
is certification required to provide large amplitude, high velocity interventions in clinical practice to address the impairments of a person with PD?
nope
26
t/f: LSVT started as a speech program
true
27
t/f: LSVT BIG is based on the principle of LSVT LOUD
true
28
what are the principles of LSVT?
intense amplitude based program
29
what is the focus of LSVT?
high intensity and amplitude exaggerated movts
30
what is the goal of LSVT?
to make bigger moves more automatic to improve posture, flexibility, and balance recalibrate the system to make normal movts
31
what are the fundamentals of LSVT?
amplitude sensory calibration intensity
32
what is often the biggest limiter to using LSVT programs?
pt and caregiver buy in
33
what is the fundamental principle of amplitude used in LSVT?
the largest ROM that can be performed, with highest effort and most biomechanical efficiency
34
what is the fundamental principle of sensory calibration in LSVT?
teaching the pt to self monitor pt must accept that what feels too big is actually normal and create new motor memories
35
what is the protocol for LSVT?
4 sessions (1 hour each) per week for 4 weeks (total of 16 sessions)
36
t/f: LSVT has a long hx of national funding
true
37
pre-treatment in LSVT, what is the cycle creating decreased movt in PD?
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
what is the cycle in treatment with LSVT?
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
t/f: LSVT tries to bring awareness to PD pts' off calibration
true
40
the amount of effort needed for an individual with PD to reach normal movt feels similar to what for a healthy individual?
the effort to perform big movts
41
what a pt with PD perceives as ____ movt is actually _____ movt
big, normal
42
what are the maximal daily exercises included in LSVT?
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
what are the functional tasks included in LSVT?
5 everyday tasks (ie STS, pulling keys out of pocket, buttoning shirt) - 5 reps
44
t/f: STS are usually included in most pts in the functional tasks of LSVT
true
45
what are the hierarchy tasks in LSVT?
pt identified tasks (ie. getting out of bed, playing golf, getting in/out of car) that involve multiple steps
46
t/f: hierarchy tasks in LSVT should build in complexity across the 4 weeks to work towards long term goals
true
47
LSVT can be modified to ___, ___, or ____ according to ability
supported standing seated supine
48
the get ready signal in PD is _____
too weak
49
what is the consequence of the get ready signal in PD being too weak?
inadequate set for movt
50
what is the clinical result of weak get ready signal?
bradykinesia/hypokinesia
51
the go signal in PD is ____
too weak
52
what is the consequence of the go signal in PD being too weak?
inadequate selection/initiation of movt
53
what is the clinical result of a weak go signal in PD?
freezing/hesitation
54
the no-go signal in PD is ____
too weak
55
what is the consequence of a weak no-go signal in PD?
inadequate completion of a movt
56
what is the clinical result of weak no-go signal in PD?
festination movts run together
57
what are the teaching techniques used in LSVT?
model shape drive stabilize calibrate
58
what does the teaching technique "model" mean?
show, don't tell "do what I do"
59
what is the purpose of modeling in LSVT?
to minimize cognitive overload
60
what does the teaching technique "shape" mean?
create the largest amplitude movt with optimal alignment
61
what cues can be used to shape movt in LSVT?
visual, auditory, and propriceptive cues
62
what does the teaching technique "drive" mean?
give big effort to increase motor output
63
what does the teaching technique "stabilize" mean?
repetitions of practice are needed to reinforce and motivate
64
what does the teaching technique "calibrate" mean?
retrain sensory perception to make movt look normal
65
t/f: LSVT should be errorless learning
true
66
should we correct mistakes in LSVT?
yes!
67
what are the strengths of LSVT?
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
what are the weaknesses of LSVT?
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
t/f: there is no single mode of exercise or program that fits all PD pts
true
70
beware of programs with _____ mentality
all or nothing
71
t/f: caregiver and family education is key
true
72
should we incorporate community exercise programming into our POC for PD?
yes!