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(3) Neurological Evaluation & Intervention > S1_L4: Neurodevelopmental Technique Using Brunnstrom, Bobath, and Proprioceptive Neuromscular Facilitation > Flashcards

S1_L4: Neurodevelopmental Technique Using Brunnstrom, Bobath, and Proprioceptive Neuromscular Facilitation Flashcards

1
Q

Determine the traditional PT strategy.

uses RIMP to perform isolated movements

A. Brunnstrom Movement Therapy
B. Bobath Technique
C. Proprioceptive Neuromuscular Facilitation

A

B. Bobath Technique

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2
Q

Determine the traditional PT strategy.

Facilitation and normalization of motor function through primitive reflexes and abnormal patterns, pathological responses to facilitate movement

A. Brunnstrom Movement Therapy
B. Bobath Technique
C. Proprioceptive Neuromuscular Facilitation

A

A. Brunnstrom Movement

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3
Q

Determine the traditional PT strategy.

Believed that diagonal and spiral (twisting) movements of limbs, head, neck, and trunk enhance function and mimic the movement

A. Brunnstrom Movement Therapy
B. Bobath Technique
C. Proprioceptive Neuromuscular Facilitation

A

C. Proprioceptive Neuromuscular Facilitation

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4
Q

Determine the traditional PT strategy.

Inhibits abnormal patterns to facilitate motor function

A. Brunnstrom Movement Therapy
B. Bobath Technique
C. Proprioceptive Neuromuscular Facilitation

A

B. Bobath Technique

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5
Q

Who are the proponents of the Bobath Approach?

A

Berta and Karl Bobath

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6
Q

TRUE OR FALSE: Brunnstrom emphasizes hands-on facilitation of movement and positioning to “normalize” tone and reduce the influence of abnormal postures (including primitive reflexes).

A

False.

This is Bobath’s Principle

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7
Q

Enumerate the problems of patients with neurological dysfunction.

A
  1. abnormal tone
  2. loss of automatic postural control
  3. abnormal coordination
  4. abnormal functional performance
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8
Q

This is a condition where limbs are stiff and assume abnormal positions such as synergists.

A

Spasticity

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9
Q

This is a state where limbs feel heavy or floppy and relaxed. It provides no resistance or assistance to passive
motion or range of motion exercises.

A

Flaccidity

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10
Q

These are known as non-functional and involuntary changes in limb
position and muscle tone

A

Associated reactions

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11
Q

Enumerate 3 NORMAL postural reactions.

A
  1. Righting Reactions
  2. Equilibrium Reactions
  3. Protective Extension Reaction
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12
Q

TRUE OR FALSE: Before performing functional skills, there should be a stable posture. If there’s none, it will be difficult for the patient to do normal ADLs

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

A

A. Both statements are correct

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13
Q

TRUE OR FALSE: Abnormal function performance shows of an inability to integrate the 1 side of the body to perform activities. In this state, hemineglect is present.

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

A

D. Only the 2nd statement is correct

NOTE: Pt has the inability to integrate both sides of the body; thus, they do not mind the affected side.

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14
Q

Enumerate the 3 stages of recovery according to Bobath.

A
  1. Initial Flaccid Stage
  2. Stage of Spasticity
  3. Stage of Relative Recovery
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15
Q

Match the stages of recovery with its corresponding description.

  1. Increase in tone may be observed
  2. No interplay whatsoever between the sound & affected side
  3. Goal of treatment: improve quality of gait & use of affected hand
  4. Pt cannot move his affected side & often does not appreciate that he has an arm or a leg on that side
  5. Stage that most pts with residual hemiplegia comes out for out-patient tx

A. Initial Flaccid Stage
B. Stage of Spasticity
C. Stage of Relative Recovery

A
  1. B
  2. A
  3. C
  4. A
  5. B
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16
Q

What will be the PTs goal when his pt is in the stage of spasticity?

A

dissociate the synergy pattern by developing control of intermediate joints

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17
Q

What will be the PTs goal when his pt is in the initial flaccid stage?

A

promote proper positioning & bed mobility

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18
Q

What is the first prerequisite in neurodevelopmental treatments?

A

correct posture

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19
Q

TRUE OR FALSE: Normal movement is learned by experiencing what a
normal movement feels like

A

True

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20
Q

TRUE OR FALSE: Based on the principles of motor learning, spasticity is a hindrance to normal movement pattern. It inhibits even when as low as grade 1 or 2.

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

A

B. Both statements are incorrect

NOTE: We do not think
about the spasticity as being a hindrance to normal
movement pattern, because in theory, spasticity can only be elicited by fast passive ROM. Spasticity should also not inhibit any movement as
long as spasticity is not grade 3 or 4

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21
Q

TRUE OR FALSE: In Bobath, the tone of the muscle dictates the treatment, so spasticity must first be decreased.

A

True

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22
Q

Based on the developmental sequence of the principles of treatment, what must be the progression of the pt’s position during tx?

A
  1. supine
  2. sitting
  3. standing
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23
Q

What is the usual synergy of the UE?

A

Flexor synergy

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24
Q

What is the usual synergy of the LE?

A

Extensor synergy

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25
Q

_________ are partial patterns opposite to the typical abnormal patterns and postural tone that dominate the patient

A

Reflex Inhibitory Movement Patterns (RIMPs)

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26
Q

This approach uses motor patterns available to the patient at any point in the recovery process

A

Brunnstrom Approach

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27
Q

In Brunnstrom’s Approach, synergies, reflexes and other abnormal movement
patterns are _______ parts of the recovery process that the patient must go through before normal voluntary movement can occur.

A

normal

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28
Q

The following are commonly observed in a pt with LE flexor synergy, EXCEPT:

A. Toes DF
B. Ankle Eversion
C. Knee flexion
D. Hip ER
E. Hip Abduction

A

B. Ankle Eversion

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29
Q

The following are commonly observed in a pt with UE extensor synergy, EXCEPT:

A. Forearm pronation
B. Shoulder retraction
C. Shoulder adduction
D. Shoulder IR
E. Elbow extension

A

B. Shoulder retraction

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30
Q

The following are commonly observed in a pt with UE flexor synergy, EXCEPT:

A. Elbow flexion
B. Shoulder depression
C. Shoulder abduction
D. Shoulder ER
E. Forearm supination

A

B. Shoulder depression

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31
Q

The following are commonly observed in a pt with LE extensor synergy, EXCEPT:

A. Toe PF
B. Ankle PF
C. Knee extension
D. Hip Extension
E. Hip Abduction

A

E. Hip Abduction

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32
Q

What is the strongest component in the UE extensor synergy?

A
  1. Forearm pronation
  2. Shoulder IR & Adduction
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33
Q

What is the strongest component in the LE flexor synergy?

A

Hip flexion

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34
Q

What is the strongest component in the LE extensor synergy?

A

Knee extension

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35
Q

What is the strongest component in the UE flexor synergy?

A

Elbow flexion

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36
Q

The following are Attitudinal or Postural Reflexes, EXCEPT:

A. Labyrinthine Reflex
B. Tonic Neck Reflex
C. Tonic Lumbar Reflex
D. All
E. None

A

E. None

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37
Q

Tonic Neck and Labyrinthine Reflex is also known as?

A

Magnus’ and De Kleijin’s Reflexes

38
Q

Determine the Tonic Neck and Labyrinthine Reflex.

With neck extension, there will be elbow extension

A. Symmetric Tonic Neck Reflexes (STNR)
B. Asymmetric Tonic Neck Reflexes (ATNR)
C. Tonic Labyrinthine Reflexes

A

A. Symmetric Tonic Neck Reflexes (STNR)

39
Q

Determine the Tonic Neck and Labyrinthine Reflex.

If you put the patient in prone, the flexor tone would dominate.

A. Symmetric Tonic Neck Reflexes (STNR)
B. Asymmetric Tonic Neck Reflexes (ATNR)
C. Tonic Labyrinthine Reflexes

A

C. Tonic Labyrinthine Reflexes

40
Q

Determine the Tonic Neck and Labyrinthine Reflex.

These reflexes can be seen in infants and obvious in stroke patients.

A. Symmetric Tonic Neck Reflexes (STNR)
B. Asymmetric Tonic Neck Reflexes (ATNR)
C. Tonic Labyrinthine Reflexes

A

C. Tonic Labyrinthine Reflexes

41
Q

Determine the Tonic Neck and Labyrinthine Reflex.

If you turn your head to the right the upper extremity on the face side ® will extend while (L) elbow will flex.

A. Symmetric Tonic Neck Reflexes (STNR)
B. Asymmetric Tonic Neck Reflexes (ATNR)
C. Tonic Labyrinthine Reflexes

A

B. Asymmetric Tonic Neck Reflexes (ATNR)

42
Q

Determine the Tonic Neck and Labyrinthine Reflex.

Stimulus: rotation of the head to one side

A. Symmetric Tonic Neck Reflexes (STNR)
B. Asymmetric Tonic Neck Reflexes (ATNR)
C. Tonic Labyrinthine Reflexes

A

B. Asymmetric Tonic Neck Reflexes (ATNR)

43
Q

In Tonic Lumbar Reflexes, if you do rotation to one side, the face side would have an increase in (1)______ tone, while the side on the direction of the occipital part of the patient would
have a (2)_____ tone domination.

A
  1. extensor
  2. flexor
44
Q

Determine the Associated Reaction.

Movement seen on the affected side in response to voluntary forceful movements in other parts of the
body

A

Mirror Synkinesis

45
Q

Determine the Associated Reaction.

Mutual dependency between the synergies of the UE and LE

A

Homolateral Synkinesis

46
Q

Determine the Associated Reaction.

Presents with an abduction and adduction phenomenon in the LE.

A

Raimiste’s Phenomenon

47
Q

Determine the Associated Reaction.

Passive flexion of the shoulder will cause extension of fingers

A

Soque’s Phenomenon

48
Q

Determine the Associated Reaction.

Passive PF of the toes of a patient in supine with hip and knee in slight flexion elicits mass flexor response including ankle DF

A

Marie-foix Phenomenon/ Bechterev’s reflex

49
Q

TRUE OR FALSE: Weakness has a direct relationship with spasticty.

A

False

NOTE: Strength is different from tone. Pt can have a normal tone but be weak or he can be weak but spastic.

50
Q

Determine the motor center group.

  1. Re-representing the muscles of the body in the most numerous and most voluntary combinations
  2. Do not need volitional control
  3. Re-representing the muscles of the body in numerous combinations
  4. More voluntary, less automatic
  5. Represents all the muscles of the body in a few movement combinations that are mostly automatic activities of the body

A. Lowest motor center
B. Middle motor center
C. Highest motor center

A
  1. C
  2. A
  3. B
  4. B
  5. A
51
Q

Determine the motor center group.

  1. walking
  2. breathing
  3. eye movement
  4. blinking
  5. urination

A. Lowest motor center
B. Middle motor center
C. Highest motor center

A
  1. C
  2. A
  3. A
  4. B
  5. B
52
Q

When the nervous system is injured, an individual goes through “___________”?

A

Evolution in reverse

53
Q

TRUE OR FALSE: Associated Reactions/ Movements can be elicit reflexively or due to resistance

A

True

54
Q

This is a technique of promoting or hastening the response of the neuromuscular system by stimulating its proprioceptors

A

Proprioceptive Neuromuscular Facilitation

55
Q

TRUE OR FALSE: Early motor behavior is dominated by reflex activity. Mature motor behavior is reinforced or supported by a postural reflex mechanism.

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

A

A. Both statements are correct

56
Q

Developing motor behaviour is expressed in a/an _______ sequence of total patterns of movement and posture

A

orderly

57
Q

Normal motor development has an orderly sequence but lacks ______ quality

A

step-by-step

58
Q

Determine the neurodevelopmental technique.

Based on concept that damaged CNS regressed to older or less mature patterns of movements (limb synergies and primitive reflexes)

A. Brunnstrom
B. Bobath

A

A. Brunnstrom

59
Q

Determine the neurodevelopmental technique.

“Avoidance of abnormal, introduction of normal”

A. Brunnstrom
B. Bobath

A

B. Bobath

60
Q

Determine the neurodevelopmental technique.

Patients are taught to use and voluntarily control the motor patterns available to them at a particular point during their rehabilitation

A. Brunnstrom
B. Bobath

A

A. Brunnstrom

61
Q

Determine the neurodevelopmental technique.

Presence of associated reactions, pathologic reflexes to facilitate movement and to train them to perform a certain task

A. Brunnstrom
B. Bobath

A

A. Brunnstrom

62
Q

These are stereotyped, primitive movement patterns associated with the presence of spasticity

A

Basic Limb Synergies

63
Q

These are abnormal automatic response of the involved limb to either voluntary effort or reflex stimulation

A

Associated Reactions/ Movements

64
Q

What is the stimulus to the reflex response of the UE flexor synergy?

A

Resist elbow flexion

65
Q

What is the stimulus to the reflex response of the UE extensor synergy?

A

Resistance to push on the (N)

66
Q

What is the stimulus to the reflex response of the LE flexor synergy?

A

Resist PF on (N)

67
Q

What is the stimulus to the reflex response of the LE extensor synergy?

A

Resist Dorsiflexion on the (N)

68
Q

What is the stimulus to the voluntary movement of the UE flexor synergy?

A

Rot of head to (N)

69
Q

What is the stimulus to the voluntary movement of the UE extensor synergy?

A

Rot of head to the affected

70
Q

What is the stimulus to the voluntary movement of the LE flexor synergy?

A

Rot of head to (N)

71
Q

What is the stimulus to the voluntary movement of the LE extensor synergy?

A

Rot of head to the affected

72
Q

(1)______ synergy is more common in UE. (2)_______ synergy is more common in LE.

A
  1. Flexor
  2. Extensor
73
Q

The following muscles are usually NOT involved in either synergies, EXCEPT:

A. latissimus dorsi
B. ankle evertors
C. teres major
D. teres minor
E. none

A

D. teres minor

74
Q

Which 3 muscle or muscle groups are part of the mixed synergy?

A
  1. pectoralis major
  2. FA pronators
  3. elbow flexors
75
Q

TRUE OR FALSE: Weight bearing on unaffected LE reinforces the extensor synergy

A

False

WB should be on AFFECTED LE.

76
Q

This is an associated reactions wherein the response of one extremity to stimulus will elicit the same responses in its ipsilateral extremity.

A

Homolateral Limb Synkinesis

77
Q

Enumerate the stimulus and response of the instinctive grasp reaction

A

Stimulus: stationary contact over the palm of the hand

Response: “Closure of the hand”

78
Q

Motor developments usually occurs (1)_____ and (2)______

A
  1. CEPHALOCAUDALLY
  2. PROXIMODISTALLY
79
Q

Motor development proceeds from stability to mobility. Gross motor control precedes fine motor control.

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

A

D. Only the 2nd statement is correct

Motor development proceeds from mobility to stability

80
Q

Vertical movements are learned before horizontal movements are learned. Rotary movements are the last to develop.

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

A

A. Both statements are correct

81
Q

In motor development, isometric control precedes isotonic control. Concentric movement precedes eccentric movement.

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

A

C. Only the 1st statement is correct

82
Q

TRUE OR FALSE: The use of external resisatnce is advocated for stroke pts.

A

False

83
Q

Enumerate the RIMP for the UE.

A
  1. Extension of neck and spine
  2. External rotation of the shoulder
  3. Elbow extension
  4. Wrist extension
  5. Supination and abduction of thumb
84
Q

Enumerate the RIMP for the LE.

A
  1. Hip abduction and external rotation
  2. Hip and knee extension
  3. Dorsiflexion of toes and ankle
  4. Abduction of the big toe
  5. Rotation of shoulder girdle against pelvis and vice - versa
85
Q

Proximal stability promotes?

A. stability
B. guided movement
C. coordination
D. facilitation of movements

A

A. stability

86
Q

Distal stability promotes?

A. stability
B. guided movement
C. coordination
D. facilitation of movements

A

C. coordination

87
Q

Digital stability promotes?

A. stability
B. guided movement
C. coordination
D. facilitation of movements

A

D. facilitation of movements

88
Q

Intermediate stability promotes?

A. stability
B. guided movement
C. coordination
D. facilitation of movements

A

B. guided movement

89
Q

Which approach states that there should always be a stimulus to get a certain response

A

Margaret Rood Approach

Note: She advocated for the use of warmth and pressure

90
Q

TRUE OR FALSE: Bobath agrees with the developmental sequence of treating a pt in supine to standing.

A

False

Bobath states that a PT can immediately teach the movement patterns of a certain function

(3) Neurological Evaluation & Intervention (12 decks)

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