Week 1 Exam Questions Flashcards

1
Q

what is salience

A

the brain will pay attention to what is important!

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2
Q

can we say things are weak after a stroke

A

no, because there is nothing wrong with the muscles, it is really an issue with activation and initiation and coordination, meaning that there is an issue in the network. We must increase motor firing rates

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3
Q

why does a decrease in torque production after stroke matter

A

the decrease in torque is from with a decreased speed of production, or because the muscle is at a shortened length. We must train people at that shortened length and train speed and power after a stroke

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4
Q

what is spasticity

A

velocity dependent hypertonicity. We have it when it is on one side of the joint, and there is resistance to externally imposed moments.

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5
Q

what is the controversy around spasticity

A

spasticity is often described as a movement disorder, but we test this is a static resting position. so how can we assume there is disordered movement if we do not test it while moving

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6
Q

after a stroke what must we manipulate to get normal movement

A

task, environment or the person ( we can make the environment more or less challenging, we can decrease the DOF, we can also increase their capacity to move by strengthening or practice)

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7
Q

what is recovery

A

permanent changes in organizations and structure and getting back what was lost

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8
Q

is the goal recovery or compensation

A

recovery: restore the function of tissue, and get them back to premorbid levels

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9
Q

what is compensation

A

something we self teach, and something we did not have before the injury. doing something old in a new way and using alternative parts

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10
Q

what is learned non use

A

comenation! we learn to not use one side, and figure out a way to do the task in a different way

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11
Q

what may be the primary reason that a motor deficit still remains

A

compensation, they have learned to not use it.

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12
Q

what is positive and what is negative neuroplasticity

A

positive: recovery
negative: compensation

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13
Q

what category does restoration, recruitment and retraining fall under, compensation or recovery

A

restoration is recovery

recruitment and retraining are compensation

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14
Q

what is a reversal of diaschisis

A

the spontaneous recovery, think about spinal shock. we get a sudden loss of function, and then we get it back with or without treatment

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15
Q

how do we get neuroanatomical reorganization

A

changing neural networks, altering NT levels, branching, sprouting, neurogenesis

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16
Q

neuroplasticity definition

A

brain can adapt, but changes function and structure of neurons, an growing new neurons, and reorganizing them. reorganize networks, and representations, and access latent circuits

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17
Q

for a therapist, what does neuroplasticity mean

A

that there is a way to train the brain to perform old functions

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18
Q

what are the structural and functional mechanisms of neuroplasticity

A

functional: increasing activity, excitability, and postsynaptic potential.
structural: more connections, axon growth, receptor density

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19
Q

what are some examples of non synaptic neuroplasticity

A

changing the number of ion channels, increasing responsiveness of synaptic inputs.

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20
Q

what happens when we rely on the less-affected limb, to reorganization

A

there is growth in the non-affected hemisphere, which we do not want. this is maladaptive, and can hurt our chances of changing the affected hemisphere.

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21
Q

with learning dependent plasticity, what leads to the rewiring of the motor cortex

A

skill learning!

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22
Q

what is an important stimulant for neuroplastic change

A

task specific motor learning

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23
Q

what is our best hope for brain remodeling.

A

learning

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24
Q

when someone has many concussions, and learning is impaired what does this mean for neuroplasticity

A

there is a decrease in plasticity. bottom line, brain injury interferes with learning

25
Q

recovery is a ___ process

A

relearning

26
Q

which leads to increased number of synapses in motor cortex? motor learning or activity

A

learning.

27
Q

TF: the brain does not rely on the same neurobiological processes it used to acquire a skill initially

A

false, it does rely on the same

28
Q

what should our first therapeutic effort be

A

to recover those specific behaviors that were disrupted by the brain injury

29
Q

in cat and rat experiments, what can we say is good for recovery

A

task specific and high reps, and a good intensity.

30
Q

what two things make therapy effective

A

intensive therapy and task specificity

31
Q

what are some characteristics of a task that are important for plasticity

A

complexity, intensity, specificity, sensory experience (like an enriched environment)

32
Q

what are the 10 principles of experience dependent plasticity

A
  1. use it or lose it
  2. use and improve
  3. specificity
  4. repetition matters
  5. intensity matters
  6. time matters
  7. salience
  8. age matters
  9. transferene
  10. interference.
33
Q

what kind of environment do we want

A

a complex one, and an enriched one

34
Q

is CIMT therapy beneficial to motor learning

A

yes, constraining the good limb and focusing attention on the bad one is a good way to treat and get results

35
Q

TF: exercise dose in the first matters after a stroke

A

true

36
Q

TF: speed of the exercise matters

A

true

37
Q

what are some components of intensity

A

reps, sets, time, RPE, environments, distractions, load, cardio response, challenge

38
Q

what is the FITT principle

A

frequency is the number of days a week

intensity: lets say the weight to do 8-10 reps
time: lets say each set takes 30 seconds, do it in a 30 minute timeframe
type: the gym equipment we use

39
Q

TF: we can continue to improve patients if they have reached a plateau with changing the intensity

A

true, the more intense, we can still see results

40
Q

TF: the study with walking and steps, by changing the dose and increasing the number of steps a lot shows a larger response

A

true

41
Q

what are some important things for practice

A

challenging, motivating,

42
Q

what are some characteristics of a skilled clinician

A
listen will 
patient centered
always changing hypothesis 
thinking about what the patient is saying 
hypothesis early on
43
Q

what does skilled decision making incorporate

A
goals 
prevention and optimizing health 
patient centered
holistic 
evidence based 
carryover to Home
44
Q

what are the 5 conditions we look at before we get to the outcomes

A
initial conditions (posture, enviro)
preparation (what do they do before?)
initiation (timing, direction and smooth)
execution (amplitude, speed, smooth)
and termination (timing, stability)
45
Q

what did animal models show us

A

that high reps are great

46
Q

what do the AHA/ASA guidelines say about stroke rehab

A

it takes a big team and communication

47
Q

TF: dose and duration and intensity matters

A

true

48
Q

what two things make therapy effective

A

intensity and task specific

49
Q

if patients plateau, is there anything we can do

A

yes! change the dose, have them walk more, and get them going!

50
Q

what does an enhanced environment do for people

A

motivates them more, and lies likely to be alone and inactive

51
Q

TF: 50% of patients stay in bed

A

true

52
Q

TF: people are alone 60% of the day, and 30% stay in bed with no activity

A

true

53
Q

TF: functional capacity appears to affect therapeutic activity

A

false, there is no correlation between mild, moderate or severe in jury with activity levels

54
Q

what was the average treatment time for treatment in a 60 minute session

A

averaged 36 minutes

55
Q

how many reps were patents getting in UE and LE? steps?

A

12 and 8

less than 300 steps

56
Q

TF: functional UE movements happened in all sessions

A

false, only in 50%

57
Q

TF: differences in the amount of practice were correlated to age, patient level of function and therapist experience

A

false

58
Q

how many minutes were patients at their target HR zone

A

2.8 minutes

59
Q

are we doing enough for neuroplasticity

A

no