W14: Interventions for Patients with Parkinson’s Disease Flashcards
What are the CARDINAL SIGNS of PD ?
- Postural instability
- Tremor
- Bradykinesia
- Rigidity
What are some interventions you can use to address Postural Instability with PD patients ?
- Balance
- Righting reactions
- Teaching strategies
- Capitalizing on reflexes
- Prescribing AD’s
- Home modifications for safety.
What are some things you should know in regard to TREMORS ?
-The t TYPE of tremor is very important.
What is something that may help can suggest to help with TREMORS ?
-Gets better when you move in a focused way
Weighting may help
What is BRADYKINESIA ?
- Moving smaller amplitude
-Small and slow movement
-The Inability to perceive intrinsic deviations from the norm with movement
What is the main goal of Neuroplasticity ?
Main goal of PD intervention is to drive amplitude of movement.
In other words, make movement bigger.
What are the main goals of the principles of Neuroplasticity ?
-Intensity matters
-Repetition matters
-Salience
-Use it or lose it
-Use it and improve it
Principle 1:
Intensity matters :
-To drive amplitude.
-You need to train your patients at HIGH intensity (8/10 effort)
[MAX EFFORT]
Principle 2:
Repetition matters:
-Patients should be doing as many reps as possible daily to drive neuroplastic change.
Principle 3:
Salience:
-You are training tasks that matter to the patient. Pick relevant interventions.
-No 3 sets of 10 of a non-functional exercise like hamstring curls.
Principle 4:
Use it or lose it:
-In a progressive disease this is even more pronounced.
Principle 5:
Use it and improve it:
- Patients with PD can functionally improve, treat them like they can
What does an ideal LSVT BIG dosage look like ?
LSVT BIG is dosed:
- 4x/week
-1 hr. for 4 weeks straight.
Daily homework of about - 1 hour on treatment days.
- 2x/day on non-treatment days.
-SO MANY REPS!!!
What are some TOOLS used for BRADYKINESIA ?
Need to recalibrate them to normal.
How can you recalibrate BRADYKINESIA this in someone who cannot tell that they have bradykinesia?
Drive amplitude by:
SHOW THEM :
- You must use your own body to show them what big amplitude movement is.
- They will mirror you.
SHAPE THEM :
- Use your tactile cues position they body in bigger movements
TELL THEM:
Use your voice to drive intensity and motivation, exaggerate.
Art Of Calibration:
Changes are not _____ or ________ unless you achieve calibration.
Changes are not lasting or meaningful unless you achieve calibration.
Art Of Calibration:
Calibration would be transitioning the patient from requiring ______ cues to move with normal amplitude to depending on _________ feedback for what is normal.
Calibration would be transitioning the patient from requiring external cues to move with normal amplitude to depending on their own intrinsic feedback for what is normal.
Art Of Calibration:
We must retrain their normal to be _______ than they think it should be and then make that automatic.
We must retrain their normal to be LARGER than they think it should be and then make that automatic
Art Of Calibration:
The more a patient cues themselves, even when you are not there watching, the more you know they are getting ________.
The more a patient cues themselves, even when you are not there watching, the more you know they are getting CALIBRATED.
Art Of Calibration:
If their presentation is very different when they are working with you in clinic to when they walk back to their car, they are NOT calibrated.
[TRUE OR FALSE]
TRUE :
If their presentation is very different when they are working with you in clinic to when they walk back to their car, they are NOT calibrated.
