Week 2 - Primary Sensori-Motor Impairments

Question 1

What are the Primary Sensori-Motor Deficits?

Answer 1

CSSS

Co-odination
Spasticity
Strength
Sensation

Question 2

Compare the Ashworth and Tardeiu Scales

Answer 2

Ashworth measures response to passive movement, not velocity dependant.

Question 3

What are the NSF interventions for spasticity?

Answer 3

p. 5

Question 4

What are the features of loss of strength in stroke?

Answer 4

Difficulty producing force rapidly
Inner range
Sustained contraction

Question 5

What is the NSF evidence for strength training?

Answer 5

Progressive resistance training - B
ES -B
Electromygraphic biofeedback plus conventional therapy - C

Question 6

What are the three characteristics of effective ways to train strength in v. weak?

Answer 6

1. Goal directed
2. High repetitions
3. Own efforts at activating muscle

Question 7

How can you make exercises easier or harder?

Answer 7

• Shorten level arm
• Limit degrees of freedom
• Minimise gravity
• ## Remove load

Question 8

What are the characteristics of loss of co-ordination?

Answer 8

• Loss of spatial accuracy
• Loss of temporal accuracy
• Jerky movement trajectories
• Excessive muscle activity/co-contraction

Question 9

What are the ASF guidelines for co-ordination?

Answer 9

Task specific training - A or B recommendation

Question 10

What are the types of loss of sensation?

Answer 10

Tactile sensation

Proprioception

Question 11

What is meant by shoulder pain after stroke? Examples.

Answer 11

Adhesive capsulitis
CRPS
RC tear 
Subluxation
Spasticity
Impingment

Question 12

Discuss the evidence for neural plasticity and the number of reps needed to alter cortical representation.

Answer 12

Kleim (1998) 400 reps per day in rats
Kleim (1998) 400-600 reps per day in monkeys
Zhang (2012) found that treadmill training within 24 hours of stroke reduced infarct damage, BBB volume and inflamm. response (on rats)
Carey (2002) did 1200 reps of a finger task

Question 13

How much extra training on average did the successful intensity of practice groups get?

Answer 13

Verbeek (2011) 37 mins per day for 5.7 weeks.

Question 14

How can we increase intesity of practice? 3 ways

Answer 14

• Enrich the rehab/gym environment (make it motivating, set it up for lots of independent practice)
• Encourage active patient participation - empower patients with a central LoC, record their progression and let them compete against themself
• Therapist behaviour - expect high reps, communicate to encourage self efficacy.