Primary Impairments - Lecture 11 Flashcards
motor recovery is initially
flaccid
motor recovery: there is a development of
spasticity
hyperreflexia
mass patterns of movement
as recovery continues –> motor recovery
spasticity and synergies decline
advanced motor patterns are possible
Brunnstrom Stages of recovery
6 stages
stage 1
flaccidity
no mvt
stage 2
minimal voluntary mvt
associated rxns
spasticity begins to develop
stage 3
voluntary control of mvt synergies
spasticity peaks in severity
stage 4
mastery of some mvt synergies
spasticity peaks in severity
stage 5
difficult mvt combos are learned
synergies lose their dominance
stage 6
spasticity disappears
isolated joint movement and coordination achieved
flexion synergy components UE strongest component
elbow flexion
strongest component of flexion synergy components LE
hip flexion
strongest component of extension synergy components
shoulder ADD
forearm pronation
strongest component of extension synergy component
hip ADD
knee extension
why do we experience paresis
decrease # of fxning agonist motor units
recruitment order may be altered
decreased firing rates
denervation changes in corticospinal tract
why do we experience paresis (2)
atrophy of mm fibers
contraction time increases with increased fatigability
inappropriate co-contract of mm
mechanical changes in soft tissue
incoordination is the result of
cerebellar or BG involvement
proprioceptive losses
motor weakness
ataxia (esp w/ cerebellar disorders)
impaired stretch reflex response)
impaired stretch reflex response
normally allows automatic adaptation of mm to postural movement changes
aphasia
brocas
wernikes
global
conduction
dysarthria
impairment of speech production secondary to damage to the CNS or PNS
what does dysarthria cause
oral motor weakness, paralysis or incoordination of the motor speech system
what does dysarthria affect
respiration
phonation
articulation
resonance
dysarthria has deficits in
swallowing
dysarthria has lesions affecting
CN 9 & 10
CN lesions cause
delayed triggering of swallow reflex
decreased pharyngeal peristalsis
decreased lingual control
cognitive/behavioral deficits
in orientation
attention
processing speed
conceptual abilities
executive fxn
memory
cognitive/behavioral deficits cause
emotional liability
(R) CVA
(L) CVA
generalizations
emotional liability
unstable or changeable emotional state
emotional liability is characterized by
pathological rapid change from laughing to weeping w/ only slight provocation
(R) cva
difficulty grasping the whole idea or the overall organization of a pattern or activity
what is R cva described as
indifferent, quick, impulsive, euphoric
pt overestimates their ability while minimizing the problem
R CVA major issue
safety
L cva
difficulty with processing ingo in sequential/linear manner