Types of Neuro Rehab

Question 1

Brunnstrom

Answer 1

synergy pattern approach that isnt used as much.
Key guidelines:
encourage synergies as part of milestones for recovery
encourage overflow to recruit active movement of weak side
introduce movements that are not synergies once spasticity decreases
Incorporate only tasks that patient can master or almost master
repetition and positive reinforcement

Question 2

NDT

Answer 2

Functional movements
No compensations
Utilize manual contact
Emphasize rotation
Provide orientation to midline by moving in and out of midline dynamically

Question 3

PNF

Answer 3

verbal commands=short and concise
resistance during movement for stability and not for mobility
Increase balance between agonists and antagonists
Increase strength or improve relaxation by enhancing overflow
Functional patterns

Question 4

Rood

Answer 4

Based on sensorimotor learning
uses a developmental sequence seen as key patterns.
Utilize sensory stimulation to achieve motor output
focus on homeostasis of all systems
Neutral warmth, maintained pressure and slow rhythmical stroking to calm patient.
Tactile stimulation to facilitate normal movement
exercise must provide proper sensory feedback to be therapeutic

Question 5

Plasticity

Answer 5

high intensity and high volume training required for plastic changes to occur.
early rehab is important but too aggressive too early can have a negative impact.
Plastic changes can occur months or years after
Rehab should not focus on compensatory movements early on since it might stimulate compensatory movements instead of plastic changes in the paretic limb.

Question 6

Carr and Shepherd: Motor relearning programme

Answer 6

techniques for handling, facilitation, inhibitive casting and use of therapeutic ball
practice includes breaking the task into discrete components, followed by practice of the task as a whole.
self-correction and self-awareness incorporated using mirror, verbal feedback and biofeedback.
application of ice, brushing, tapping for facilitation.
biofeedback used for decreasing hypertonicity with movement or for targeting facilitation of a muscle group.

Question 7

Constrained-Induced Movement Therapy

Answer 7

forced use of paretic limb for task-oriented training several hours a day.
Intensity should challenge pt.
When not in training, unaffected limb is still constrained.
Avoid forced overuse in acute stages of healing.
Use adherence logs and diaries to improve compliance.
Treatment also used with TBI, Parkinson’s, hemiplegic cerebral palsy

Question 8

Locomotor training

Answer 8

manual facilitation by therapist should focus on normalizing gait kinematics.
Level of assist is 30-40% and decreases as pt improves.
Gait speed is gradually increased over time.
Typical dosage is 30-60 min, 3-5 days for 6-12 weeks.
Goal is to transition from treadmill training to overground training.