Week 1: overview of neurological conditions Flashcards
What is the difference between an UMNL and LMNL?
- UMNL: means that the motor n. has been damaged in either the brain or SC (e.g. stroke)
- LMNL: damage is to motor n. in periphery
What are symptoms for lack of blood through ant. cerebral a.?
- m. weakness
- loss of sensation
- Broca’s aphasia
- cog./behavioural
What are symptoms for lack of blood through middle cerebral a.?
- aphasia
- weakness (arm > leg)
- loss of sensation (face and arm)
- inattention/neglect
What are symptoms for lack of blood through post. cerebral a.?
- loss of vision
* weakness and/or loss of sensation
What are some examples of conditions with recovery potential?
- stroke
- TBI
- CP
- GB
What are the aims for rehab in Pt.’s w/recovery potential?
- Address underlying impairments
- intensive task-related training of activities
- limit adaptive strategies
What is a condition which requires adaptation for rehab?
SCI
what are the aims for rehab in Pt.’s who require adaptation?
- address underlying impairment where possible
- train adaptive strategies to promote activity and participation
- prescription of aids
(incomplete SCI has recovery potential)
What are some examples of degenerative conditions?
- PD
- MND
- MS
- m. dystrophy
What are the aims for rehab in Pt.’s w/degenerative diseases?
- early-slow decline
- maintenance
- train adaptive strategies to promote activity and participation
- prescription of aids
What is weakness in neurological conditions?
- loss of max. force generating capacity caused by decreased neural drive
What are some physiological changes of weakness in UMNL?
- disruption to descending input to lower motor neurons, which leads to:
- decreased no. of motor units activated
- decreased motor unit discharge rate
What are some strategies to decrease weakness in paralysed Pt.’s?
- high mental effort and high reps (daily)
- EMG biofeedback
- Provide mechanical advantage to m.
- mental practice++
What are some strategies to decrease weakness in very weak Pt.’s?
- high mental effort and high reps (daily)
- continue strategies for paralysed Pt.’s and incl. exercises that:
- work through full range
- sustained contractions
- increase movement speed
- add resistance to mid range
What are some strategies to decrease weakness in weak Pt.’s?
- high physical effort (i.e. progressive resistive training)
- mod-high intensity - low reps to fatigue (3 sets, 3/7)
- functional strengthening tasks
what is the difference in training parameters for paralysed/v/weak Pt.’s and weak/strong Pt.’s?
- paralysed/v/weak:
- high reps
- low intensity
- high mental effort
- weak/strong:
- low reps
- high physical intensity
what are the 3 main interventions to increase coordination?
- task-related training (part or modified)
- task training (whole)
- task training
what are the 2 common sensory impairments?
- Kinaesthetic
* Tactile (more common)
what are components of kinaesthetic sensibility?
- sense of position
- sense of movement
- sense of heaviness
what are components of tactile sensation?
- light touch
- temp.
- pressure
- pin-prick
- two-point discrimination
- point localisation
what are some adaptive behaviours caused by tactile and kinaesthetic impairments?
- decrease ability to manipulate objects
- inability to sustain appropriate level of force during grasp w/out vision
- poor ability to balance in standing
decrease walking velocity, inability to walk - less safe
- decreased ability to learn new motor skills
What does Nottingham Sensory Assessment involve?
Measurement of sensation that assesses different aspects of sensation
What are examples of sensory retraining?
- texture discrimination
- Limb position sense
- tactile object recognition
What is spasticity?
A motor disorder characterised by a velocity-dependent increase in tonic stretch reflexes (‘m. tone’) w/exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex as one component of the upper motor neuron syndrome
