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Neuro Rehab 1 > PT Interventions - Augmented Approaches > Flashcards

PT Interventions - Augmented Approaches Flashcards

1
Q

what is an augmented approach

A

hands on approach to neuro rehab in which the therapist guides and supports normal movements and/or prevents abnormal movement patterns

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2
Q

what is an augmented approach based on

A

outdated theories of motor development and motor control
- prior to knowledge of neuroplasticity

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3
Q

what does the literature say about an augmented approach

A

varied findings

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4
Q

when would you use an augmented approach

A

“jump start” functional recovery
- degree of CNS impairment prevents starting w functional task training
- early stage of motor learning
- early stages of recovery

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5
Q

how do PTs guide patient’s learning in augmented therapeutic interventions

A

via hands on techniques and/or environmentally controlled techniques

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6
Q

how can an augmented approach be transitioned to a task-oriented one

A

augmented approach to allow pt to achieve success w task -> learn task and successful

motivated to continue w therapy -> inc ability -> need less help -> use functional task-oriented approach

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7
Q

what are examples of neuromotor/augmented training strategies (5)

A

PNF
NDT
guided movements
facilitated movement
somatosensory training

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8
Q

what are examples of activity-based, task-oriented training strategies (3)

A

task training
- whole task
- part to whole
environmental structure
behavioral shaping

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9
Q

what are examples of motor learning training strategies (5)

A

feedback: KP, KR, schedule
practice: order, schedule
transfer training
environmental context
problem solving

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10
Q

what are examples of compensatory training strategies (3)

A

substitution
adaptation
assistive/supportive devices

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11
Q

what pt population was NDT originally developed for

A

treat motor deficits in:
- children w CP
- adults post-stroke

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12
Q

what is the theoretical basis behind NDT

A

hierarchal level of reflex integration-model of motor control
- which has been disproved

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13
Q

NDT was based on the theory that ______ controlled the nervous system

A

sensory feedback

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14
Q

what was the focus of NDT

A

sensory input and muscle re-ed
- what the pt experiences results in action they will perform

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15
Q

what impairments does NDT address (4)

A

normalize tone
address postural deficits
improve postural control
improve motor performance

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16
Q

what is NDT

A

neurodevelopmental technique

therapeutic handling to promote learning or aid in re-learning adaptive motor patterns and prevent abnormal, primitive or maladaptive patterns

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17
Q

what are the key points of control that NDT highlights

A

scapula
iliac crests
prox or distal limbs

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18
Q

what are NDT activity level interventions (6)

A

postural control
trunk control
rolling & bed mobility
transitional movements
ambulation
reaching, grasping and releasing, manip objects

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19
Q

what are specific BSF impairments that NDT can address (7)

A

abnormal tone
abnormal posture
impaired sensation & sensory integration
impaired motor control
weakness
impaired ROM
reduced activity tolerance

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20
Q

what population is NDT used heavily in

A

pediatric

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21
Q

what are 4 variables of NDT

A
  1. body position/posture & support surface
  2. manual contacts/key points of control
  3. type/mode of facilitation
  4. prevent extraneous, maladaptive, primitive movement patterns
22
Q

what other interventions is NDT often combined with? why?

A

other augmented approaches
task-oriented retraining

helps person be more functional

23
Q

what is the theory PNF is based on

A

ability, strength, and endurance are developed by active participation
- applying PNF recognizes hidden potential exists and developed by response to a demand; frequency or repetition is important to learning process

24
Q

where can PNF patterns be applied (4)

A

extremity
scapula
trunk
pelvis

25
Q

what is the technique to PNF

A

use resistance, quick stretch, proprioceptive input to improve flexibility, stability, motor control, initiation of movement, strength, function

26
Q

what does the literature say about PNF

A

poorly supported
does improve ms length (per low quality studies, and no more than other approaches would)

27
Q

what is an important consideration in the real-world application of PNF

A

clinically often performed in less pure manner than in class

28
Q

how can you vary components of PNF

A

surface
position
use of resistance bands
cuff weights

29
Q

what is the biggest problem w PNF exercises

A

not functional

30
Q

what was Rood one of the first to propose

A

link b/w motor response & sensory input
- used multi-modal sensory inputs to improve motor funciton

31
Q

what was Rood’s primary contribution

A

described stages of motor control
- mobility-stability concepts

32
Q

what is the relevance of Rood’s stages of motor control now

A

based on outdated neurophys and models of motor control (ie reflex, hierarchal models)

still used clinically

33
Q

how does Rood describe mobility? what is a synonymous term used today?

A

moving into position or posture
involves change in COG and/or BOS
- aka transitional mobility

34
Q

how does Rood describe stability? what is a synonymous term used today?

A

ability to maintain posture or position
- aka static postural control

35
Q

how does Rood describe controlled mobility? what is a synonymous term used today?

A

closed chain WTS or other movement
- aka dynamic postural control

36
Q

how does Rood describe skill? what are examples of this?

A

open chain, distal segment moving on stable proximal base

ex: amb, reaching, grasping, manipulating

37
Q

what are Rood’s stages of motor control

A

mobility -> stability -> controlled mobility -> skill

38
Q

what are examples of mobility per Rood’s definition

A

ex: rolling, sup to sit, sit to stand

39
Q

what impairments might contribute to impaired mobility (6)

A

altered tone
reduced ms length
lack of isolated ms activation/ACOM
lack of coordination
dec strength
impaired sensation

40
Q

what are interventions to improve mobility (7)

A

hold relax
rhythmic rotation
rhythmic initiation
NDT inhibitory handling
NDT facilitaiton
soft tissue/joint mob
task-oriented re-training

41
Q

how is stability achieved

A

tonic holding involving active postural ms, co-contraction in limbs (agonist + antagonist)

42
Q

what biomechanical factors should be considered when it comes to mobility

A

BOS
COM
gravitational forces
postural alignment

43
Q

what are contributing impairments to stability (5)

A

weakness
low ms tone
poor recruitment of tonic motor units
lack of sensation
poor WB tolerance

44
Q

what are interventions to treat stability

A

stabilizing reversals
rhythmic stabilization

facilitation via:
- quick swiping
- maintained touch
- resistance
- joint approx
- external supports

45
Q

what are examples of controlled mobility per Rood’s definition

A

wt shifiting in WB position
- moving w/i posture or position

closed chain movement involving concentric and eccentric control

46
Q

what are impairments contributing to poor controlled mobility (8)

A

pain
weakness
abnormal alignment
impaired postural control
impaired motor control
poor motor planning
lack of coordination
impaired sensation

47
Q

what are interventions to promote controlled mobility (4)

A

NDT facilitation
dynamic reversals
combo of isotonics
task oriented re-training

48
Q

what is required for skilled movements/actions

A

normal timing and sequencing
prox holding/dynamic stability

49
Q

what are characteristics of skill per Rood’s definition

A

distal parts move freely in space; open-chain

rotational components

50
Q

what are contributing impairments to poor skill (4)

A

prox weakness
impaired ACOM/abnormal synergies
impaired sensation
impaired coordination

51
Q

what are interventions for skill (4)

A

task oriented re-training
PNF extremity patterns
resisted progression
NDT facilitation

Neuro Rehab 1 (27 decks)

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