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NPTE: Neuromuscular and Nervous Systems > CVA, Motor Control, PNF, and Synergies > Flashcards

CVA, Motor Control, PNF, and Synergies Flashcards

1
Q

Agonistic Reversals

A
  • Controlled mobility, skill
  • Isotonic concentric contraction against resistance followed by alternating concentric and eccentric contractions with resistance.
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2
Q

Alternating Isometrics

A
  • Stability, strength
  • Isometric contractions are performed alternating from muscles on one side of the joint to the other side without rest.
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3
Q

Contract-relax

A
  • Mobility
  • Passive movement to point of limitation, then maximal ISOTONIC contraction of antagonist muscle group through full ROM against resistance.
  • You are contracting and relaxing the range limiting muscle.
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4
Q

Hold-relax

A
  • Mobility
  • Passive movement to point of limitation, then maximal ISOMETRIC contraction of antagonist muscle group through full ROM against resistance.
  • Holding (isometric) and relaxing the range limiting muscle.
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5
Q

Hold-Relax Active Movement

A
  • Mobility
  • Passive movement to shortened range within the pattern and isometric hold of range limiting muscle in its shortened position there.
  • Relaxation and passive movement to lengthened muscle position to stretch.
  • Pt isotonically moves exxtremity back to shortened muscle position.
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6
Q

Joint Distraction

A
  • Mobility
  • Constant manual traction to joint, usually in combo with other joint mobs.
  • Proprioceptive technique to increase range at a particular joint.
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7
Q

Repeated Contractions

A
  • Mobility, strength
  • Quick stretch then isometric or isotonic contraction of range limiting muscle.
  • Used to initiate movement in a weak movement pattern or a weak point in the pattern.
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8
Q

Rhythmic Initiation

A
  • Mobility
  • Movement through pattern progressing from passive, to active-assisted, to active, to resisted.
  • Used for hypertonia
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9
Q

Rhythmic Stabilization

A
  • Mobility, Stability
  • Isometric contractions of all muscles around a joint with perturbations by the therapist.
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10
Q

Slow Reversal

A
  • Stability, Controlled mobility, Skill
  • Slow resisted concentric contractions of agonists and antagonists around a joint through the full ROM within the pattern.
  • No break between reversals
  • Improve control of movement and posture
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11
Q

Slow Reversal Hold

A
  • Stability, Controlled mobility, Skill
  • Same as slow reversal + isometric hold at each extreme of ROM to gain stability.
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12
Q

Sensory Facilitation Techniques

A
  • Joint approximation
  • Joint compression
  • Icing
  • Light touch
  • Quick stretch
  • Resistance
  • Tapping
  • Traction
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13
Q

Sensory Inhibition Techniques

A
  • Deep pressure
  • Prolonged stretch
  • Warmth
  • Prolonged cold
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14
Q

How many stages are in Brunnstrom’s stages of recovery (CVA)?

A

7

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15
Q

Brunnstrom Stage 1

A

No volitional movement initiated

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16
Q

Brunnstrom Stage 2

A
  • Appearance of basic limb synergies
  • Beginning of spasticity
17
Q

Brunnstrom Stage 3

A
  • Synergies performed voluntarily
  • Spasticity increases
18
Q

Brunnstrom Stage 4

A
  • Spasticity begins to decrease
  • Some out of synergy movement
19
Q

Brunnstrom Stage 5

A

Further decrease in spasticity with independence from synergy patterns.

20
Q

Brunnstrom Stage 6

A

Isolated joint movements are performed with coordination.

21
Q

Brunnstrom Stage 7

A

Normal motor function restored.

22
Q

Mobility

A

The ability to initiate movement through a functional range of motion.
- Can you get there?

23
Q

Stability

A

The ability to maintain a position or posture through cocontraction and tonic holding of a joint.
- Can you hold it?

24
Q

Controlled Mobility

A

The ability to move within a weight bearing position or rotate around a long axis.
- Can you multitask and move while you are there?

25
Q

Skill

A

The ability to consistently perform functional tasks and manipulate the environment with normal postural reflex mechanisms and balance reactions.
- Can you put it all together into something functional?

26
Q

Synergy

A

A group of muscles working together to produce a purposeful motion.

27
Q

UE Flexor Synergy

A
  • Scapular elevation and retraction
  • Shoulder ABduction and external rotation
  • Elbow flexion
  • Forearm supination
  • Wrist flexion
  • Finger flexion and adduction
  • Thumb flexion and adduction
28
Q

UE Extensor Synergy

A
  • Scapular depression and protraction
  • Shoulder adduction and internal rotation
  • Elbow extension
  • Forearm pronation
  • Wrist extension
  • Finger flexion and adduction
  • Thumb flexion and adduction
29
Q

LE Flexor Synergy

A
  • Hip ABduction and ER
  • Knee flexion
  • Ankle dorsiflexion and supination
  • Toe extension
30
Q

LE Extensor Synergy

A
  • Hip extension, IR, and adduction
  • Knee extension
  • Ankle plantar flexion and inversion
  • Toe flexion and adduction
31
Q

Characteristics of Left CVA

A
  • Weakness and paralysis of R side
  • Increased frustration
  • Decreased processing
  • Possible aphasia
  • Possible dysphagia
  • Possible motor apraxia
  • Decreased discrimination between R and L
  • R hemianopsia
32
Q

Characteristics of Right CVA

A
  • Weakness and paralysis of L side
  • Decreased attention span
  • Left hemianopsia
  • Decreased awareness and judgement
  • Memory deficits
  • Left inattention
  • Decreased abstract reasoning
  • Emotional lability
  • Impulsive behaviors
  • Decreased spatial orientation
33
Q

Characteristics of Brainstem CVA

A
  • Unstable vital signs
  • Decreased consciousness
  • Decreased swallowing ability
  • Bilateral weakness
  • Bilateral paralysis
34
Q

Characteristics of Cerebellar CVA

A
  • Decreased balance
  • Ataxia
  • Decreased coordination
  • Nausea
  • Decreased ability for postural adjustment
  • Nystagmus
35
Q

Anterior Cerebral Artery Occlusion

A
  • Paraplegia
  • Incontinence
  • Abulic aphasia
  • Personality changes due to frontal lobe damage
  • Akinetic mutism due to frontal lobe damage
36
Q

Middle Cerebral Artery Occlusion

A
  • Cerebral cortex damage
  • Contralateral hemiplegia and sensory impairment
  • Dominant hemisphere impairment results in Broca’s, Wernicke’s, or global aphasia.
  • Lobe dependent impairments due to damage to larger portion of cortex.
37
Q

Posterior Cerebral Artery Occlusion

A

Thalamic Pain Syndrome:
- Abnormal sensation of pain, temp, touch, and proprioception.
Cortical Blindness:
- Vision loss due to damage to visual portion of occipital cortex
- Physically normal eye, still constricts and dilates with light/dark

38
Q

Vertebral-basilar Artery Occlusion

A
  • Wide variety of presentations due to complex vascularity of this artery system.
  • Wallenberg Syndrome (lateral medullary infarct): ipsilateral facial pain and temp impairment, ipsiateral ataxia, vertigo, contralateral pain and temp impairment of body.
  • Severe: locked-in syndrome, coma, vegetative state.

NPTE: Neuromuscular and Nervous Systems (9 decks)

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