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(3) Neurological Evaluation & Intervention > S1_L2: Postural Stability and Reaching & Manipulation > Flashcards

S1_L2: Postural Stability and Reaching & Manipulation Flashcards

1
Q

Match the following common adaptive sequelae of stroke

  1. pain
  2. sensory loss
  3. contracture
  4. hand posturing
  5. weakness

A. primary impairment
B. secondary impairment

A
  1. B
  2. A
  3. B
  4. B
  5. A

Source: Therapeutic Exercise Course Manual for Pediatric & Neuro PT (Lipardo, 2013)

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2
Q

Impairments that are commonly seen in the UE following stroke include weakness, spasticity, and sensory loss.

Which of the following is believed to be the primary impairment among the three?

A

Weakness

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3
Q

TRUE OR FALSE: Internal perturbation is more functional as a treatment. It should be used more than external perturbations.

A. Both statements are correct
B. Both statements are incorrect
C. 1st statement is correct, 2nd statement is incorrect
D. 1st statement is incorrect, 2nd statement is correct.

A

A. Both statements are correct

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4
Q

_________ emerges from a complex interaction between sensory and musculoskeletal systems within the central nervous system in response to the dynamic internal and external conditions

A

Balance

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5
Q

Based on the functional balance scale, what is the grading of the statement below? Determine whether static or dynamic as well.

“can do handheld support with PT letting go of the guard belt momentarily”

A

Fair, Static

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6
Q

Based on the functional balance scale, what is the grading of the statement below? Determine whether static or dynamic as well.

“needs external support”

A

Poor, Both

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7
Q

Based on the functional balance scale, what is the grading of the statement below? Determine whether static or dynamic as well.

“Can do weight shifting”

A

normal, dynamic

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8
Q

Based on the functional balance scale, what is the grading of the statement below? Determine whether static or dynamic as well.

Balance standing without support & sway

A

normal, static

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9
Q

Based on the functional balance scale, what is the grading of the statement below? Determine whether static or dynamic as well.

“Can do head turning”

A

Fair, dynamic

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10
Q

Based on the functional balance scale, what is the grading of the statement below? Determine whether static or dynamic as well.

“Can pick objects on the floor”

A

Good, dynamic

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11
Q

The following are Adaptive Behaviors of Patients with Balance Problems, EXCEPT:

A. Shifting to the less affected side
B. Stiffening of the body
C. Improper posture
D. Using the hand for support
E. None

A

E. None

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12
Q

The following are Adaptive Behaviors of Patients with Balance Problems, EXCEPT:

A. Moving slowly
B. Widening of BOS
C. Disuse of paretic side
D. Trunk motions instead of distal joint movements
E. None

A

E. None

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13
Q

TRUE OR FALSE: Always take it one step at a time when going up the functional balance scale

A

True

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14
Q

TRUE OR FALSE: Always assess the balance of the pt. when they enter the clinic/room

A

True

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15
Q

Balance scale is applicable for (1)_____ and (2)_____ balance

A
  1. sitting
  2. standing
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16
Q

TRUE OR FALSE: Increasing anterior and posterior pelvic tilt are warranted in acute stroke patients

A

False.

This is warranted on chronic stroke pts.

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17
Q

__________ is the ability to maintain the body’s position in an upright position.

A

Postural Control

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18
Q

What should a PT check during a postural assessment?

A
  1. alignment
  2. muscle bulk
  3. symmetry

NOTE: Possibly looking at signs of swelling in some instances

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19
Q

______ is the body’s ability to maintain center of gravity/center of mass within base of support

A

Stability

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20
Q

______ involves controlling
the body’s position in space for the dual purposes of stability and
orientation.

A

Postural control

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21
Q

_____ is the ability to maintain appropriate relationship between the body and body segments and the environment of task

A

Postural orientation

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22
Q

These are patterns of muscle activation and segmental movements that allow control of body’s segmental linkages relative to the base of support

A

postural adjustment

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23
Q

TRUE OR FALSE: Balance cannot be trained separately from other actions that have to be relearned by an individual

A

True

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24
Q

What stance is used to shift the weight while picking up an object

A

Tripod Stance

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25
Q

TRUE OR FALSE: Proprioception may be altered or affected if muscles are disused.

A

True

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26
Q

______ is the ability to maintain COG within BOS within or beyond the limitation of stability

A

Balance

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27
Q

_____ is known as the ability to stay in position for a period of time

A

Tolerance

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28
Q

Where is the body’s center of gravity?

A

Roughly 1 inch anterior to S2

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29
Q

Adequate UE (1)____ and (2)____ is essential in reaching

A
  1. ROM
  2. strength
30
Q

TRUE OR FALSE: Poor balance should be a deterrent to early training of upper limb function. Restraining the trunk would lead to greater improvement in impairments and function than without trunk resistance in chronic stroke.

A. Both statements are correct
B. Both statements are incorrect
C. 1st statement is correct, 2nd statement is incorrect
D. 1st statement is incorrect, 2nd statement is correct.

A

D. 1st statement is incorrect, 2nd statement is correct.

31
Q

These muscles keep the body in an upright position, EXCEPT;

A. Biceps femoris
B. Gastrocnemius
C. Tibialis Anterior
D. Gluteus maximus
E. Gluteus medius

A

D. Gluteus maximus

32
Q

This is termed as moving asymmetrically towards either the weak or good side

33
Q

What are the impairments related to poor balance

A
  1. Weakness
  2. Tightness
  3. Sensory Impairment
  4. Adaptive Behavior
34
Q

_________ is known as a primary impairment among the commonly seen problems in the UE after stroke

35
Q

TRUE OR FALSE: You cannot train balance separately from other actions that have to be relearned by individuals

36
Q

TRUE OR FALSE: Muscles that typically develop contracture are shoulder adductors and external rotators, elbow flexors, pronators, wrist and finger flexors and thumb abductors
When muscles become shorter and stiffer, hyposensitivity of stretch receptors may develop.

A. Both statements are correct
B. Both statements are incorrect
C. 1st statement is correct, 2nd statement is incorrect
D. 1st statement is incorrect, 2nd statement is correct.

A

B. Both statements are incorrect

NOTE: *internal rotators & thumb adductors + *hypersensitivity

37
Q

To optimize recovery of postural control, the following must be observed, EXCEPT:

A. Manipulate the attributes of the caregiver, tasks, environment to facilitate the action
B. Practicing reaching beyond arm’s length while sitting with supervision/ assistance should be undertaken by people who have difficulty standing
C. Task-specific sitting practice with feedback can be provided for people who have difficulty standing
D. All of the above
E. None of the above

A

D. All of the above

38
Q

Balance training should be specific because ______ cannot be trained in isolation from the actions which must be relearned in a given context

A

postural control

39
Q

_____ is the body’s position in relation to the environment

40
Q

In which landmark must a guard belt be placed?

41
Q

In treating the postural control of a pt in sitting, the following must be observed, EXCEPT:

A. Neutral hips
B. Feet flat on the ground
C. Relaxed Spine
D. Hands on Arm rest
E. None

42
Q

What strategy will be used if perturbation is atleast 50% of the body’s weight?

A

hip strategy

43
Q

What strategy will be used if perturbation is atleast 75% of the body’s weight?

A

stepping strategy

44
Q

What strategy will be used if perturbation is atleast 25% of the body’s weight?

A

ankle strategy

45
Q

What stretch receptor is involved in the stretch reflex?

A

muscle spindle

46
Q

TRUE OR FALSE: In muscle strengthening, step ups may be used with the bad leg elevated first, as long as pt is properly guarded

47
Q

This is the initial line of defense in preventing falling over. It is the most common response to minor anteroposterior translation of the supporting surface.

A

Ankle strategy

48
Q

Determine the muscles in the ankle strategy.

  1. Gastrocnemius
  2. Anterior Tibialis
  3. Hamstrings
  4. Quadriceps
  5. Abdominals

A. Forward Sway
B. Backway Sway

49
Q

Determine the muscles in the hip strategy.

  1. Abdominals
  2. Paraspinal
  3. Hamstrings
  4. Quadriceps

A. Forward Sway
B. Backway Sway

50
Q

When ankle, hip are insufficient to recover balance, a (1)____ or (2)____ is used to bring the support back to alignment

51
Q

TRUE OR FALSE: The ankle, hip, and stepping strategy is all for anteroposterior stability.

52
Q

Which muscle groups are activated for mediolateral stability in an unloaded limb?

A

flexors and abductors

53
Q

Which muscle groups are activated for mediolateral stability in a loaded limb?

A

extensors and adductors

54
Q

mediolateral stability occurs primarily at?

A

hip and trunk

55
Q

TRUE OR FALSE: In treating stroke pts, only the stepping strategy is favorable

A

False

NOTE: only ankle and hip strategy is favorable

56
Q

What calf muscle usually tightens in stroke pts?

A

Gastrocnemius

57
Q

TRUE OR FALSE: Part practice in posture is not applicable

58
Q

______ is the phase where there is fine tuning to grasp the object that was being reached for

A

Manipulation phase

59
Q

This phase aims to lengthen or shorten LE within the space to reach for an object

A

Reaching phase

60
Q

TRUE OR FALSE: BOS is based on an individual’s foot size

61
Q

Determine the phase of reaching.

  1. Occupies more time
  2. Wherein final adjustment to grasp aperture is ,made just prior to grasp
  3. Relies on vision
  4. Relatively ballistic
  5. Final shaping of hand over object

A. Transportation phase
B. Manipulation phase

62
Q

Determine the phase of reaching.

  1. Aims to lengthen or shorten your UE within space
  2. Where the hand moves toward the target object
  3. Speed-accuracy tradeoff with aperture
  4. Adjustment of hand aperture
  5. Relies on huge hand flexibility

A. Transportation phase
B. Manipulation phase

63
Q

Determine the kind of grip.

  1. cylindrical
  2. 3 jaw chuck
  3. spherical
  4. pad to side
  5. hook

A. Power
B. Precision

64
Q

TRUE OR FALSE: Bimanual training should begin early, as soon as the patient has the ability to control simple movements with the affected limb. Bimanual training is thought to permit interhemispheric facilitation of the limbs.

A. Both statements are correct
B. Both statements are incorrect
C. 1st statement is correct, 2nd statement is incorrect
D. 1st statement is incorrect, 2nd statement is correct.

A

A. Both statements are correct

65
Q

How long is the good arm constrained in Constraint Induced Movement Therapy (CIMT)?

66
Q

Fill in the CIMT Criteria.

  1. ______ sitting balance
  2. Active wrist ext. for _____ deg
  3. Active finger ext. for _____ deg
A
  1. Good
  2. 5-10
  3. 5
67
Q

Electrical stimulation is only used for _____ stroke cases

68
Q

How long is mirror therapy given?

A

10 minutes

69
Q

The following must be observed before using mirror therapy, EXCEPT:

A. No cardiopulmonary abnormalities
B. P to F trunk control
C. Unaffected limb should be pain free and with N ROM
D. Unimpaired arm in front of the mirror
E. None

A

B. P to F trunk control

70
Q

Somatosensory impairments are common in persons with acute stroke, with mostly mixed (1)______, (2)______, and (3)______ impairments.

A
  1. exteroceptive
  2. proprioceptive
  3. cortical
71
Q

The following are causes of shoulder subluxation.

  1. Flaccid _____ and _____
  2. Spasticity of humeral ______
  3. Spasticity of _____ and ____
A
  1. deltoid & supraspinatus
  2. depressors
  3. adductors & IRs
72
Q

What directs the direction of reaching?

(3) Neurological Evaluation & Intervention (12 decks)

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