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Neuroscience > Week 6 - Upper limb Ax and Rx > Flashcards

Week 6 - Upper limb Ax and Rx Flashcards

1
Q

Should Rx strategies for the upper limb post stroke be remedial or compensatory?

A

Mainly remedial, as improvements are possible. However compensatory strategies can be in-corperated when working on specific skills and enable function.

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2
Q

What are some factors that may cause increase in tone?

A
  • Temperature (particularly cold)
  • Time of day
  • A sneeze or yawn
  • Fatigue
  • Increased effort in lower limb function
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3
Q

What are physical signs that a client is experiencing difficulty during an upper-limb task?

A
  • Elevating the affected shoulder excessively during an activity
  • Fixing the affected UL against the body
  • Abducting the shoulder before flexing the shoulder when reaching
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4
Q

What does the Brunnstrom scale do?

A

It measures the recovery of voluntary movement in the upper extremity and hand.

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5
Q

Describe stage I (1) of the Brunnstrom scale of the upper extremity.

A

Flaccidity - there is no voluntary movement

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6
Q

Describe stage II (2) of the Brunnstrom scale of the upper extremity.

A
  • Spasticity developing
  • Reflex movements in synergy
  • Flexion developing before extension
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7
Q

Describe stage III (3) of the Brunnstrom scale of the upper extremity.

A
  • Spasticity increasing
  • Developing voluntary movement in synergy
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8
Q

Describe stage IV (4) of the Brunnstrom scale of the upper extremity.

A
  • Some movements deviating from synergy
    a. hand behind back
    b. arm to forward horizontal
    c. pronation/supination of forearm when elbow flexed in 90 degrees
  • Spasticity decreasing
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9
Q

Describe stage V (5) of the Brunnstrom scale of the upper extremity.

A
  • Independence from basic synergies
    a. arm to side horizontal position
    b. arm forward and overhead
    c. pronation/supination of forarm when elbow fully extended
  • Spasticity waning
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10
Q

Describe stage VI (6) of the Brunnstrom scale of the upper extremity.

A
  • Isolated joint movements freely performed with near normal coordination
  • Spasticity minimal
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11
Q

What is synergy?

A

Instances of associated reactions. When movement is initiated at a joint, all muscles that are linked in synergy with that movement will automatically contract

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12
Q

Describe what happens with UL flexor synergy

A
  • Scapular retraction and/or elevation
  • Shoulder abduction
  • Elbow flexion (strongest component)
  • Forearm supination
  • Position of the wrist and fingers are variable
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13
Q

Describe stage I (1) of the Brunnstrom scale of the hand.

A

Flaccidity

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14
Q

Describe stage II (2) of the Brunnstrom scale of the hand.

A

Little or no finger action

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15
Q

Describe stage III (3) of the Brunnstrom scale of the hand.

A
  • Mass grasp or hook grasp with no voluntary finger extension or release
  • MCP joints in extension
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16
Q

Describe stage IV (4) of the Brunnstrom scale of the hand.

A
  • Semi-voluntary finger extension in a small ROM
  • Lateral prehension with release by thumb movement
17
Q

Describe stage V (5) of the Brunnstrom scale of the hand.

A
  • Palmar prehension
  • Cylindrical grasp (emerging)
  • Spherical grasp (emerging)
  • Voluntary mass finger extension (variable ROM)
18
Q

Describe stage VI (6) of the Brunstromm scale of the hand.

A
  • All types of prehension with improved skill
  • Voluntary finger extension (full ROM)
  • Individual finger movements
19
Q

What is mass flexion of the hand?

A

Making a fist

20
Q

What is a hook grasp?

A

MCP extension, PIP and DIP flexion. Like holding a shopping bag

21
Q

What is lateral prehension?

A

Grasping an item (like paper) between the thumb and the side of the index finger

22
Q

What is palmar prehension?

A

The tip of the thumb, index finger and middle finger come together to grasp an item (like holding a pencil)

23
Q

What is cylindrical grasp?

A

Taking hold of a cup

24
Q

What is spherical grasp

A

Taking hold of a tennis ball (fingers abducted)

25
Q

What do clients need to be taught how to self-regulate their tone?

A

A good level of cognition and sensation

26
Q

What might UL function be impacted by?

A
  • Scapula movement
  • If movement is possible at the shoulder joint
  • ROM of UL joints (both active and passive)
  • Muscle tone (high or low?)
27
Q

What are benefits of maintaining ROM?

A
  • Maintenance of joint lubrication
  • Prevention of impingement
  • Maintenance of soft tissue length
  • Reduction in tone
  • Prevention of contractures

Neuroscience (7 decks)

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