Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHTH 528 - Neuro Midterm > Treatment for Parkinson's > Flashcards

Treatment for Parkinson's Flashcards

1
Q

What are the 3 key elements for treatments?

A
  1. depending on stage - teach the ability to move easily and any posture stability strats
  2. seconday problem management (deconditioning, ↓ mobility and comorbidities)
  3. physical activities and future fall prevention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When decreasing compensations, what are some strategies to bypass a bad basal ganglia?

A

↑ reliance on cortical control to start the movement

↑ on attention to keep complex movements going

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How are we able to enhance performance for compensation training?

A
  • breaking big sequences into component parts
  • attention (!!!)
  • perform task separately and one at a time
  • mental practice and visualization

while providing external cues of visual and auditory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are we using in the brain when using external cues?

A

an intact premotor cortex to bypass bad BG-SMA circuits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some visual cues used to help with gait?

A

Theres improvements when visual cues are given like:
- lines on the floor (static)
- inverted cane (dynamic = transportable cues)

these all help ↑ velocity and stride length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some negative effects of visual cues?

A

Freezing - when there is an obstacle, change of direction

Distraction - bad for PD patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some auditory cues to assist with gait?

A

when there is a metronone to keep a steady and easy beat to follow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the benefits of auditory cues for gait?

A

↑ cadence with gait = long term retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In early to middle stages, what are we practicing to assist with strategy training?

A

be able to practice multiple task conditions and have a varying:
- speed
- surfaces
- directions
- sensory input

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do we assist with deconditioning (secondary problem)?

A
  • people with PD need more O2 during walking = more aerobic exercise
  • Any edurance training
  • mild strength but more focused on endurance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are we prioritizing with ↓ mobility and posture?

A

for the axial structures to have more trunk flexibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is included in the HEP for PD?

A

daily exercise 3x per week with focus on flexibility, endurance and some strengthening
- this allows for neuroplasticity
- big part = assistance to prevent future falls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the reasoning behind PT “check ups”?

A
  • Being able to update HEP
  • checking for any functional decline or improvement
  • checking for any safety concerns or increasing possible efficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the environmental constraints for freezing?

A

can nautrally happen out of nowhere and made worse by the task or environment

can possibly have the disorder of the sensory-motor processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What occurs in the brain when there is problems of the sensory-motor processing?

A

the caudate integrates the sensory information –> ↑ attention to the most relevant stimuli needed for the action

theres a sensory overload if theres too much things going on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the task constraints for freezing?

A

happens more likely with long or complex locomotor skills than single isolated movements

to help - breakdown into simple taks with cues to switch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the emotional contraints for freezing?

A

due to anxiety and stressfulness like crossing a busy road or panicking to get a ringing telephone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the medical contraints regarding freezing?

A

usually happens during “off days” in patients who’s been on meds for a while = advanced/late stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do we avoid freezing?

A
  • rhythmical sensory cueing
  • relaxation techniques
  • be able to stop and prepare then restart the task
  • keep it simple silly
  • cognitive compensation
  • avoiding stairs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most efficient strategy for PD?

A

Movement biomechanics - so training with functional context for MAX carryover

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does LSVT teach?

A

An attentional strat that we can use everywhere to ↑ motor output for BIG BAD FAST MOVEMENTS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some multidirectional sustained movements daily whole body exercises?

A

floor to ceiling stretch
side to side stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some multidirectional repetitive movements?

A

Step and reach:
- to the side
- foward
- backward

Rock and reach:
- side to side twist
- foward/backward reach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are some patient driven functional movements?

A

Rolling
floor to stand
out of bed
sit to stand
chair and reach
stand and reach
walk and reach
walk and turn
stand and turn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are some “real-world” big tasks hierarchy?

A

in and out of the car
walking and talking
laundry
playing with grandchildren
hiking
gardening
golf
tennis

some tasks but take account patient driving force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the mantra for sensory re-calibration?

A

if the patient doesn’t feel like they are moving “too big” - not moving big enough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the frequency of cueing training?

A

20-60 minutes
2-5x/wk
3-8 weeks

28
Q

What is visual cueing aimed towards?

A

improve function

29
Q

What is auditory cueing aimed towards?

A

delievered before and during the movement to start or keep a motor action

30
Q

What is rhymic auditory stimulation?

A

pulsed rhythmic or musical stimulation
= improve movement patterns by synching movement with a rhythmic auditory beat

31
Q

What is amplitude training?

A

high velocity and high amplitude movement training
- can be performed as a training program or as indepedent exercises

32
Q

What is somatosensory cueing aimed towards?

A

to heighten afferent input
- i.e vibration

33
Q

What does aerobic moderate- to high-intensity aerobic exercise improve?

A
  • improve O2 consumption
  • reduce motor disease severity
  • improve functional outcomes
34
Q

For patients with balance deficits, what type of aerobic exercise should be done?

A

stationary biking to help minimize risk of falls

35
Q

What is the FITT of aerobic training?

A

F: 3x/wk
I: moderate to high
T: 30-40 min
T: stationary cycling and treadmill walking appear to have the same benefit

36
Q

What is the FITT of resistance training?

A

F: 2 nonconsecutive days per week
I: progress as tolerated with good form
T: 30-60 min per session
T: all muscle groups but mainly extensor muscles

37
Q

What is the intensity for strength training?

A

Progress to 80% of rep max to get those GAINZ
- beginner: 40-60% of 1RM
- experienced: 80% of 1RM

38
Q

What is the intensity of power training?

A

working at higher speeds to improve power
- beginner: 20-30% of 1RM
- experience: 40% of 1RM

39
Q

What does dual task improve?

A

improve gait speed
dual task gait speed
FOG
Balance

40
Q

What is thought to have better outcomes than fall prevention training?

A

progressive resistance training was more effective

41
Q

What is the FITT-VP of fall prevention program?

A

F: 1x/wk for 8 weeks to a 6 months
I: unknown
T: 1-2 hr/session
T: task specific training
V: 16-18 hours total
P: progression based on perceived exertion scale for resistance training

42
Q

What is showing improvement regards to bladder training?

A

To help with voiding (poo) and decrease accidents that interfere with daily life
- doesn’t improve QoL or urgency tho :(

43
Q

What does UE training assist with?

A

To improve pinch grip strength and dexterity
- MAY include to improve sensation and getting to that goal

44
Q

What is the FITT-VP of UE training?

A

F: 2-5 days/wk for 4 weeks
I: high intensity
T: 15-45 min session
T: delivered in a 1:1 manner in clinic or home-based
V: 6-12 total hours

45
Q

What is the goal of turning training?

A

To help with the ability to turn 180 degrees
- theres improvement when hip abductors, hip extensors and knee extensors were fixed

46
Q

What is the FITT-VP of turning?

A

F: 2x/wk for 6 weeks
I: unknown
T: 30 min with 10 min for turning
T: 1:1 instructions
V: 120 min total

47
Q

What is the improvement shown with multi-modal balance training?

A

Getting confidence with overall gait and balance

Can reduce falls in mild PD and can addresss non-motor sx

48
Q

What is the frequency of FITT-VP for multi-modal balance?

A

F: 2-3x/wk for 5-10 weeks
T: 30-120 mins/session
V: 16 to 30 total hours

49
Q

What is better than balance training alone?

A

Treadmill training may be better for dynamic balance during gait

50
Q

What is the FITT of balance with dynamic gait training on a treadmill?

A

F: 2x/week
I: moderate to high
T: 20-40 min

51
Q

What does balance with added technology improve?

A

Helps improve mobility, stability, balance confidence, fall risk, depression and QoL

52
Q

What is the FITT of balance training with added technology?

A

F: 2-3x/wk for 5-8 weeks
T: 30-50 minutes
T: sessions has other activities or other forms of PT interventions

53
Q

What improves of with treadmill gait training?

A
  • motor disease severity
  • balance
  • gait parameters
  • endurance
  • may improve freezing of gait
  • may reduce falls or fear of falling :(
54
Q

What is the FITT of treadmill gait training?

A

3-5 days/week for 6-12 weeks
30-60 sessions

55
Q

What does overground gait training improve?

A
  • decrease motor disease quality
  • balance
  • strength/power
  • stride and gait speed
  • stability
  • baroreflex sensivity
  • cognition
56
Q

What is the FITT of overground gait training?

A
  • 20-60 min sessions
  • 3-5x/week
  • 4-12 weeks total
57
Q

What improves with robotic gait training?

A
  • general motor sx
  • balance
  • functional mobility
  • velocity and step/stride length
  • may improve gait freezing
58
Q

What is the FITT for robotic gait training?

A
  • 3-5x/wk for 4-5 weeks
  • 30-45 min sessions
59
Q

What is the clinical management for mild/early PD?

A
  • heavy exercise
  • keep flexibility with improved strength and cardio
  • learning or keeping lost strats
  • always active (!!!)
  • therapy with task-specific training
  • pt education regarding exercise training
  • fall prevention
60
Q

What is the clinical management for mod/middle PD?

A
  • compensation
  • progessingly less focused on remediation of other problems
  • active lifestyle (with changes if needed) (!!!)
  • compensation cueing strats with task-specific training with wider range of task
  • fall prevention (fall diary and risk reduction program)
  • reduce multitasking
  • exercise to decrease CV and MS systems problems
61
Q

What is the PT model for H&Y stage 1?

A
62
Q

What is the PT model for H&Y stage 2?

A
63
Q

What is the PT model for H&Y stage 3?

A
64
Q

What is the PT model for H&Y stage 4?

A
65
Q

What is the PT model for H&Y stage 5?

A

PHTH 528 - Neuro Midterm (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions