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Neuro Rehab 2 > SCI 8 - Neuromotor Recovery > Flashcards

SCI 8 - Neuromotor Recovery Flashcards

1
Q

what is a critical part when dc a patient from inpatient rehab

A

community re-integration
- accessible housing, nutrition, transportation, finances, employment, fitness

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2
Q

where is a pt dc if they meet their LTG in inpatient rehab

A

home

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3
Q

where is a pt dc if they don’t meet their LTG in inpatient rehab

A

SNF

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4
Q

what is a helpful mindset to encourage SCI patients to have as they recover

A

“yes you can”
- think ab what you can do
- not what you can’t do

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5
Q

what are considerations to individualize the program transitioning to outpatient programs

A

BSF
activity
participation
pt/caregiver goals
resources
accessibility

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6
Q

what does the ACSM recommend for CV training in SCI

A

endurance training 3-5 days/wk
20-60min/day
at 50-80% of peak HR

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7
Q

what are examples of CV training

A

UE ergometry
wc propulsion
swimming
BWSTT
HIT
FES induced walking, cycling

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8
Q

what type of training will improve the aerobic fitness in the SCI population

A

endurance training

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9
Q

what is FES

A

functional electrical stim
stims ms contraction to facilitate functional mvmts

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10
Q

what are the benefits to using FES

A

maintain ms viability / ms mass
promotes CV health
mental health - rewarding
counteracts secondary complications

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11
Q

what are uses for FES

A

shoulder subluxation
functional rowing
bicycle ergometry

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12
Q

what is the SCI rehab machine Erigo

A

combines gradual verticalization w robotic mvmt therapy
- allows intense training safely in very early stage of rehab

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13
Q

what is the trend of ASIA classifications w regard to potential for gait w/o physical (A) but use of ADs

A

increases
- lowest w ASIA A and highest potential w ASIA D

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14
Q

what are nonfunctional ambulator benefits to gait training

A

bone density
CV
mental health

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15
Q

what are considerations for determining if SCI pt is appropriate for gait training

A

ROM:
>10deg hip ext
~110 SLR
full knee ext
adequate lumbar ext
minimum of 5deg DF

UE strength
tolerance to upright
MSK integrity
endurance/cardiac condition
time since injury/acuity

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16
Q

why is it important for good lumbar ext and DF in SCI pts for gait training

A

pts often hang on y ligs

17
Q

what is the NeuroRecovery Network (NRN)

A

network of rehab centers charged w developing and providing therapies that promote functional recovery and improve health of people living w paralysis

  • founded thru Christopher Reeve Foundation
18
Q

how does locomotor training work neurophysiologically speaking in SCI

A

tapping into neuroplasticity to restore locomotion

enhancing afferent input to SC

activates CPGs embedded in lumbosacral SC
- CPGs associated w reciprocal pattern of walking

19
Q

where are plastic changes induced w locomotor training

A

SC level

sensory motor cortex via intensive locomotor training, ONLY in incomplete SCI

20
Q

what are principles of neuroplasticity

A

use it or lose it
use it and improve it
specificity
repetition matters
intensity matters
time matters
salience matters
age matters
transference or generalization
interference

21
Q

what does BWST locomotor training target

A

relearning of nervous system motor patterns associated w walking
- kicks into CPGs w reciprocality of walking

22
Q

what does BWST locomotor training enable

A

early initiation of gait training (& standing)
integration of WBing activities
stepping and balance using task-specific approach
symmetrical gait pattern

23
Q

what provides sensory input for SCI during locomotor training and where is this input set

A

sensory info from:
- actual stepping
- manual contacts of PT
- contact of foot on ground

sensory info from legs and trunk repetitively sent to SC to CPGs

24
Q

what is a progression of BWST locomotor training

A

overground walking training
community ambulation

25
Q

how can maximal afferent input into LE be ensured during BWST locomotor training

A

LE maximally loaded for WB
- minimizing or eliminating loading of UEs

26
Q

what manual cues is the therapist providing during BWST locomotor training

A

bring LE into enough hip ext to trigger hip flex to take a step
- provide cues consistent w walking, facilitating flex/ext ms activation

27
Q

what component of BWST locomotor training is important to tap into neuro-motor recovery

A

inc speed as quickly and safely as possible
- HIT type of exercise

28
Q

what are the 2 main types of robotic assisted devices

A

move on their own regardless of what client is doing

augment or assist the active mvmts of the client

Neuro Rehab 2 (48 decks)

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