Review Flashcards
4 stages of PNF motor control:
Mobility -> _____ -> controlled mobility -> _____
Stability
Skilled mobility
4 stages of PNF motor control:
____ -> stability -> _____ - skilled motor control
Mobility
Controlled mobility/ dynamic posture control
5 elements of postural control
Trunk -> _________ -> weight shift over BOS -> ________ -> limb function
Midline orientation
Head control
5 elements of postural control:
_____ -> midline orientation -> ________ -> head control -> _______
Trunk
Weight shift over BOS
limb function
A patient will be 92% unlikely to leave home (home bound) upon discharge if….
BERG under 20 and FIM-L is 1 or 2 (total or max assist) at admission to inpatient rehab
What are the 3 key inputs to central pattern generators
Stretch of hip flexors
Unweighting of triceps surae (PLANTARFLEXORS)
Weight bearing to facilitate extensor tone in stance Limb
Criteria for deciding if patients will walk post stroke:
LE Strength of _____________________________________
_______________________________________
1/5 in hip flexors, knee extensors, and ankle dorsiflexors
Independent sitting balance
if criteria unmet after 3 days, 27% will walk
if criteria walked after 9 days, 10%
What are the 4 components of a movement schema stored in memory
Initial Movement conditions
Parameters of general knowledge of motor program
Knowledge of results
Sensory consequences of movement
Patients need an ashworth scale of _____- to get an intrathecal bacolofen pump
What age?
How long since injury?
3+ Ashworth
Over 4 years old
over 1 year since injury
not dependent on spasticity for function
movement disorder is not the main problem
What outcome measures does StrokeEDGE recommend students learn
FIM
Fugl-Meyer assessment
Postural assessment
Stroke impact scale
Trunk Impairment scale
FIM scores
1- Total assist
2- Maximum assist
3- Moderate assist
4- min assist
5- supervision set up
6- modified independence
7- complete independence
A baclofen pump works better for spasticity where?
A spinal cord stimulator works better for spasticiy where?
LE
UE
What essential structure to gait does these things:
Final integrative center for locomotion b4 spinal cord
driving center for locomotion in all animals
provides drive to central pattern generators
medial medullary formation
Absolute requirements of a candidate for CIMT treatments:
AROM Wrist extension of 10-20 degrees
Must be able to extend 2 fingers
Ability to understand and follow directions
Considerable ncrease in muscle tone, passive movement is difficult
MA grade 3
Affected part(s) rigid in flexion/extension
MA grade 4
“No increase in tone”
MA scale 0
Slight increase in tone with a catch and release, or by minimal resistance at the end of the ROM when the joint is moved
MA scale 1
Marked increase in muscle tone throughout most of the ROM, but affected part is easily moved
MA scale 2
What 3 criteria signal emergence from minimally conscious state
Awake most of the time, but confused
Functional object use
Functionaly accurate communication
What are the main predictors of UE recovery in a stroke
AROM of shoulder
AROM of middle finger
predicted the variance in UE function at 3 months
What kind of brain injury is most likely to have spasticity
Cerebral palsy
What kind of brain injury is most likely to have HO
TBI and SCI
What lab value is elevated in patients with HO
serum alkaline Phosphatase
What does v1, v2, and v3 on the tardieu scale mean?
V1- as slow as possible
V2- speed of limb falling w gravity
V3- as fast as possible
What does R1 and R2 mean on the tardieu scale?
R1 - PROM until catch point
R2- full PROM
Botox contraindications
Neuromuscular transmission disease
Inflammation at projected infection site
Pregnancy
Children under 2
What factors have a higher incidence of HO?
Sex
Spasticity
Smoking
Completeness of injury
Pneumonia
pressure ulcers
What are the 7 commandments of PNF
Manual contacts
Commands/communication
Stretch
Traction/approximation
Maximal resistance
Normal timing
Reinforcement
What tendons is tendon release most commonly done on
Achilles and hamstring tendons
What PNF technique do you use to get the motion going
Rhythmic initiation
What 4 PNF Techniques are for strength
Repeated contraction
Hold relax- active motion
Reversal or antagonists/ slow reversal
Timing for emphasis
What 4 PNF Techniques are for strength
Repeated contraction
Hold relax- active motion
Reversal or antagonists/ slow reversal
Timing for emphasis
What principle does timing for emphasis use?
Irradiation
What principle does slow reversals use
Successive Induction
When a movement is mature, timing is ______
Distal to proximal
How is the evidence: moderate to high intensity gait training for CNA injury
Evidence strong for post stroke
No evidence for post TBI
How is the evidence: virtual reality walking training
Evidence high post stroke
No evidence post SCI or TBI
How is the evidence: strength training
Evidence weak for post stroke and SCI
no evidence for post TBI
How is the evidence: Cycling
Weak or no evidence
How is the evidence: circuit or combined training
Evidence weak post stroke
No evidence SCI or TBI
How is the evidence: sitting balance and standing balance for postural stability and WB symmetry
Evidence to NOT do it
How is the evidence: preforming balance w vibration
Evidence NOT to do so
How is the evidence: static/dynamic balance paired with virtual reality
Post stroke- strong
Limited evidence for TBI
no evidence for SCI
How is the evidence: body weight supported treadmill training
Evidence NOT to use for post stroke
Limited evidence for SCI and TBI
How is the evidence: robotic assisted walking training
Evidence NOT to use for post stroke or SCI
What are the 2 dimensions of gentiles taxonomy?
Environmental Context (stationary vs. motion)
Function of Action (body stability vs. body transport)
What does a closed task consist of
Involve stationary objects
Does not change trial to trial
Least interaction with environment
As movement variability decreases this skill needs less attention
Closed skill.
As movement variability increases, new movement patterns are generated
Open skill
What are the 2 categories of regulatory conditions of tasks
Stationary- example: stairs
Motion- people walking around
What is a variable motionless task
A stationary task with intertrial variability
What is a motion task with no intertrial variability
Consistent motion task
What is a motion task with intertrial variability
Open tasks
What is a stationary task with no intertrial variability
Closed task
What are the 3 levels of movement analysis in gentiles taxonomy
Action level: outcome
Movement level: what movement strategy?
Neuromotor level: underlying processes
The best kind of practice for retention is:
For performance:
Variable
Progressive
The best kind of scheduling for retention is:
For performance:
Random
Blocked
The best kind of feedback for retention is:
For performance:
Low frequency
High frequency
We need to push our chronic patients into periods of _____ in order to reach a new pattern of stability
Instability
What kind of scale is the Fugl Meyer
Body structure/function
What kind of scale is the trunk impairment scale
Body structure/function
What kind of scale is the postural assessment scale for stroke
Body function/structure or activity
What kind of scale is the stroke impact scale?
Participation
What kind of scale is the FIM?
Activity
Can you use an AFO for spasticity post-stroke?
NO
What 2 scales can assess PTA
Orientation log (O-log)
Galveston orientation and amnesia scale (GOAT)
What does FITT and ATEM stand for?
Frequency
Intensity
Time
Type (ATEM)
Activity
technique
elements
Motor learning
What are the 6 core tasks of ANPT movement system
Sitting
Sit to stand
Standing
Gait
Step up/step down
UE reaching and manipulation
