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Neuro Rehab 1 > PT Interventions - Task Specific Training > Flashcards

PT Interventions - Task Specific Training Flashcards

1
Q

what is neuromuscular re-education

A

therapist promotes active, CHALLENGING YET ACHIEVABLE ACTIVITIES that are important to the client and related to their goals
- address BSF impairments in functional context

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2
Q

what is the task component of task-oriented training

A

functional activities important for daily living
- ex: transfers, balance, amb, reaching, ADLs

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3
Q

what is the training component of task-oriented training

A

happens in context or environment in which task occurs
- ie specificity of training

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4
Q

what is an important component of task-oriented training? what is this based on?

A

extensive practice
- based on motor learning & neuroplasticity principles

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5
Q

what is the goal of task-oriented training

A

facilitate optimal, active movement patterns and promote success

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6
Q

what are some ex of task oriented training (2)

A

wt shift to reach for something
transfers

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7
Q

what is the theoretic basis of task oriented training (4)

A
  1. interacting systems of CNS are organized around functional tasks
  2. neuroplasticity depends on activity and environment
    - want it to be enriching
  3. early activity
  4. motor learning principles
    - consider stages of learning
    - develop strategies via feedback/practice
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8
Q

why is early activity post injury important w task-oriented training

A

first 10wks are crucial

early activity to avoid learned non-use & capitalize on natural recovery phase

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9
Q

what is an example of learned non-use that we try to prevent w task-oriented training

A

place stimuli on side of neglect
- if don’t, person won’t learn to need that side of the body

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10
Q

what are the 3 motor learning stages

A

cognitive
associative
autonomous

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11
Q

what is the cognitive motor learning stage

A

what to do
- requires high level of processing

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12
Q

what is the associative motor learning stage

A

how to do
- refine thru practice

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13
Q

what is the autonomous motor learning stage

A

how to succeed
- performance largely automatic

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14
Q

when is it particularly important to give extrinsic feedback

A

if pt has reduced awareness or insight

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15
Q

what are 5 types of feedback

A

intrinsic
extrinsic
concurrent (during activity)
knowledge of result
knowledge of performance

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16
Q

what are 4 types of practice

A

blocked
random

part
whole

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17
Q

what is blocked practice

A

predictable - one chunk at a time
- become consistently successful in a predictable manner

18
Q

practice progressions

A

blocked -> random
part -> whole task

19
Q

what is random better for? why?

A

retention and learning of motor skill
- requires recall upon skill or knowledge at an unexpected point

20
Q

what is random practice

A

variable expectations

21
Q

what tasks are usually better for whole practice

A

continuous activity
- ex: gait

22
Q

what are general principles of task-oriented approach to neurorehab (4)

A
  1. functional activities that are salient to pt
  2. potential for success “just right challenge”
  3. emphasize activity of affected/involved parts
  4. intensity of practice/dosing
23
Q

what are types of task-oriented approaches (2)

A

repetitive fine motor exercises
- ex: grasping, releasing and placing objects, CIMT

task-related strengthening
- ex: high # reps of rolling, STS, scooting, walking -> results in hypertrophy of associated ms groups

24
Q

what is CIMT

A

constraint-induced movement therapy

forced use or constraint induced therapy to counter learned non-use

25
Q

what is the researched protocol for CIMT and mCIMT

A

CIMT = constrain unaffected extremity 90% of waking hours and get 6hr/day of training for 2wks

mCIMT = less intense, constrain 6hr/day, 2hr in therapy

26
Q

what is the participant criteria for CIMT

A

potential for recovery w some residual active motion of involved UE (wrist and finger ext)

27
Q

what are the effects/impacts of CIMT

A

causes neuroplasticity
see effective, meaningful changes in brain via MRI
- apparent shift in motor cortical activation toward other ipsilateral areas and contralesional hemisphere

28
Q

what are the effects/impacts of bodyweight supported treadmill training (BWSTT)

A

no difference between BWSTT and over ground training
- see gains in both in functional walking ability

29
Q

what significant improvements were seen from repetitive task training (4)

A

walking distance
walking speed
sit to stand
ADLs

30
Q

where were no differences found after repetitive task training (3)

A

hand/arm functional activity
lower limb functional activity scales
siting/standing balance/reach

31
Q

what pt population is there emerging evidence for BWSTT

A

pediatric

32
Q

what are the steps in a task oriented approach

A
  1. task analysis
  2. practice part of task
  3. practice of whole task
  4. transfer of training
33
Q

what are components of a task analysis for a task-oriented approach (5)

A

part of PT exam
identify “abnormal” movement patterns
develop and test HCFs
identify missing components needed for task
note excessive or abnormal ms activity

34
Q

what are components of part task practice in a task-oriented approach (6)

A

identify goal
explain procedure, demonstrate

practice missing component while addressing BSF in safe manner

extensive repetition
give feedback prn
manual facilitation if required

35
Q

what are components of whole task practice in a task-oriented approach (6)

A

identify goal
explain procedures
practice whole task
give feedback appropriately
manual guidance as needed
re-exam

36
Q

what are components of transfer of training in a task-oriented approach (5)

A

practice learned task in context/environment

ensure consistency
self-monitored practice
structured learning environment
involve support system

37
Q

what is the PT’s role in a task oriented approach (4)

A

training coach
minimize sensory inputs asap
monitor progress & re-eval often
doc outcomes

38
Q

how can outcomes be documented by a PT in a task-oriented approach (4)

A

standardized outcome measures
time
RPE
HD response

39
Q

what do restorative approaches have to include

A

functional training
motor learning strategies

40
Q

what does evidence should for the outcomes of task-specific training

A

improved functional outcomes via neuroplastic changes

41
Q

what is the point of task-specific training

A

training that is salient, intensive, and in varied environments when ready

Neuro Rehab 1 (27 decks)

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