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
what is the researched protocol for CIMT and mCIMT
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
what is the participant criteria for CIMT
potential for recovery w some residual active motion of involved UE (wrist and finger ext)
27
what are the effects/impacts of CIMT
causes neuroplasticity see effective, meaningful changes in brain via MRI - apparent shift in motor cortical activation toward other ipsilateral areas and contralesional hemisphere
28
what are the effects/impacts of bodyweight supported treadmill training (BWSTT)
no difference between BWSTT and over ground training - see gains in both in functional walking ability
29
what significant improvements were seen from repetitive task training (4)
walking distance walking speed sit to stand ADLs
30
where were no differences found after repetitive task training (3)
hand/arm functional activity lower limb functional activity scales siting/standing balance/reach
31
what pt population is there emerging evidence for BWSTT
pediatric
32
what are the steps in a task oriented approach
1. task analysis 2. practice part of task 3. practice of whole task 4. transfer of training
33
what are components of a task analysis for a task-oriented approach (5)
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
what are components of part task practice in a task-oriented approach (6)
identify goal explain procedure, demonstrate practice missing component while addressing BSF in safe manner extensive repetition give feedback prn manual facilitation if required
35
what are components of whole task practice in a task-oriented approach (6)
identify goal explain procedures practice whole task give feedback appropriately manual guidance as needed re-exam
36
what are components of transfer of training in a task-oriented approach (5)
practice learned task in context/environment ensure consistency self-monitored practice structured learning environment involve support system
37
what is the PT's role in a task oriented approach (4)
training coach minimize sensory inputs asap monitor progress & re-eval often doc outcomes
38
how can outcomes be documented by a PT in a task-oriented approach (4)
standardized outcome measures time RPE HD response
39
what do restorative approaches have to include
functional training motor learning strategies
40
what does evidence should for the outcomes of task-specific training
improved functional outcomes via neuroplastic changes
41
what is the point of task-specific training
training that is salient, intensive, and in varied environments when ready