Treatment Ideas (1) - Parkinsons Flashcards
interventional recommendations
prevention
compensation
remediation
interventions target
all stages of PD
stages of PD
early HY 1-2.5
moderate HY 2-4
advanced HY 5
early HY 1-2.5
evaluate pt response to meds
on/off times
educate on –> early HY 1-2.5
presence/timing of sxs and ways to overcome
tx –> early HY 1-2.5
decrease inactivity
fear
educate
improve aerobic capacity
strength
balance
group and active lifestyle
moderate HY 2-4
assist in increasing movement speed/amplitude
what should we optimize –> moderate HY 2-4
postural alignment
what should we maintain –> moderate HY 2-4
postural stability when meds not helping
what should we prevent –> moderate HY 2-4
reduce multi tasking
focus on –> moderate HY 2-4
cognitive and motor movement strategies
cueing strategies
advanced HY 5
continue w/ strategies for hypokinesia
what should we strongly integrate –> advanced HY 5
kinesthetic management
what should we maintain-> advanced HY 5
vital fxns
selection of activities for intervention
challenge
empower
engage
PT interventions (1)
strengthening exercises
stretching/ROM exercises
breathing and relaxation exercises
aerobic exercise
motor learning
gait training
PT interventions (2)
balance training
fxnal training
adaptive and supportive devices
HEP
pt/caregiver education and training
LSVT programs are administered
in an intensive manner to challenge the impaired system
LSVT techniques that are specific to PD
bradykinesia/hypokinesia
kinesthetic awareness
LSVT should be
loud
what should we think of w/ LSVT
“loud”
what does LSVT force the pt to do
use of louder speech
fundamentals of LSVT
target
mode
calibration
target –> LSVT
BIG
single target
BIG –> target –> LSVT
large amplitude whole body movement
single target –> target –> LSVT
triggers activation across motor systems
mode –> LSVT
high intensity
requires consistency over a 4 wk period
high intensity –> mode –> LSVT
modulated by certified LSVT specialist
calibration –> LSVT
calibration of perception of movement
mismatch b/w pt perception of output and how others perceive it
what else could we use as a tx for PD
PNF
NDT
what is NDT focused on
relationship b/w sensory input and motor output
what is the primary NDT intervention
therapeutic handling
what does intervention involve –> NDT
both facilitatory and inhibitory influences
what should training be –> NDT
task specific
what should we be doing during NDT
getting the pt actively involved
thinking about motor learning
principles of NDT
know the pt
know the pt’s impairments
tx the whole person
know the pt –> NDT
life roles
support system
home environment
pt’s goal of for therapy
know the pt’s impairments –> NDT
co morbidities
fxnal activity abilities and limitations
keys of NDT tx
starting posture
missing components of movement
manual cues
manual cues of NDT are
“key points of control”
what do manual cues facilitate
effective alignment/movement
what do manual cues inhibit
ineffective alignment/movement
what do manual cues do
stretching of tight structures
4 primary uses of NDT
establish the BOS
align body segments
activate the muscle activity
assist w/ weight shift
what does therapeutic handling influence –> NDT
quality of motor response
carefully matched to the pt’s ability
key points of control –> NDT
proximal
distal key points
proximal points of control –> NDT
shoulder and pelvis
influence proximal segments and trunk
distal key points of control –> NDt
hands and feet
key points of control can be used to
facilitate
inhibit
what should everything be related back to –> NDT
fxnal tasks
