Unit 3 Week 10 Flashcards
when addressing pain what are the two areas of focus?
addressing peripheral/structural injury
address neurophysiological changes across the nervous system
what is the top down intervention approach? what are some examples of interventions in this approach?
cognitive based interventions. work in the brain to make neuroplastic changes and change how pain is perceived.
education about pain neuroscience, graded motor imagery, cognitive behavior therapy, mindfulness meditation
what is the bottom up intervention approach? what are some examples of interventions in this approach?
physical interventions. somatosensory inputs help influence neuroplasticity.
manual therapy, motor learning, peripheral discrimination training
what is the biomedical approach?
pathoanatomical approach
surgery, opioids, pathoanatomical education (scary words like degenerative, wear and tear, crumbling)
what is the biopsychosocial approach?
pain happens in the intersection of the biological, psychological, and social.
need to recognize threat
pain is activated whenever there is perceived threat
what four themes are central to success from the patient’s perspective?
working with the whole of me
more than just a professional
awareness
working through challenges in the therapeutic relationship
what is cognitive behavioral therapy?
thoughts, emotional responses, physiological and behavioral responses interact and influence one another
individuals actively process environmental events and internal stimuli and consequences of behaviors
what is CBT designed to do?
improve coping; develop strategies to solve current problems; changing patterns of thoughts, behavior, and emotional regulation; correct maladaptive thinking about pain; control emotional reactions to pain; cope more effectively with pain and other stressors;
what are the phases of CBT?
- assessment: conversation and self-report measures; identify degree of psychosocial impairment involved
- reconceptualization: largest portion; help pts question and challenge irrational/maladaptive thoughts
- skills acquisition: teach pts how to deal with obstacles and avoid automatic thought patterns
- skills consolidation and application training: homework that reinforces skills acquired
- generalization and maintenance: discuss the future and coping after treatment
- post-treatment assessment follow-up: monitoring of application of skills in pt’s life
what is the cartesian model?
tissue damage = pain
what is the neuromatrix view of pain?
nociception + threat = pain
need to eliminate the treat
what is mindfulness meditation?
non-elaborative, non-judgmental awareness of present moment experience
what are the two forms of mindfulness meditation?
focused attention: uses an attentional focus, for example breathing control
open monitoring: non-focused, open and non-judgmental monitoring of awareness itself
what effects does pain have on the brain?
pain can quickly influence the cortical maps
size changes: body representation grows
laterality recognition: difficulty differentiating left from right
smudge: representation blurs
what is the sequenced that should be used with graded motor imagery?
low threat to high threat
laterality recognition –> motor imagery –> mirror therapy
what is normal reaction time? how does pain effect this?
1.5-2 seconds
pain or expectation of pain slows reaction time
how long/often should someone practice laterality recognition?
15 minute sessions 2x/day
what is motor imagery? how often should it be done?
imagining the body part and remapping the brain without movement
frequently; 2x/day
what is mirror therapy?
using a mirror to trick the brain
replacing the injured part
what is the progression for graded motor imagery interventions?
observation (watching actions)
L/R judgements
imagining movements
mirror
physical movements/activities
when working with a patient with pain what should you use to gauge the intensity of the exercise?
not numerical pain scale
is the exercise tolerable or not tolerable. if tolerable keep going
what is sensory discrimination?
bottom up approach using tactile discrimination and sensorimotor training
aims to reverse cortical reorganization
