week 2

Question 1

when is neuroplasticity used to promote rehabilitation

Answer 1

post neurological event
MS relapse
stroke
TBI

Question 2

what are the two ways neuroplasticity occurs

Answer 2

unmasking of dormant pathways
collateral sprouting

Question 3

what are the 10 principles of neuroplasticity

Answer 3

use it or lose it
use it and improve it
specificity
repetition matters
intensity matters
salience matters
age matters
transference
interference
time matters

Question 4

where in the nervous system does neuroplasticity occur

Answer 4

the brain

Question 5

what 3 systems need to be intact for optimum balance within the individual

Answer 5

sensory, motor and cognitive

Question 6

what are the 3 typical postures patients with hemiparesis might adopt

Answer 6

fix
fall
push

Question 7

what is falling (hemiparesis patient)

Answer 7

this happens when a patient falls towards their affected side due to weakness (limb and trunk)

Question 8

how do you treat falling?

Answer 8

strengthen trunk (in sitting and in lying)
sitting practice with facilitation
reaching within BOS with unaffected upper limb
reaching out of BOS with unaffected upper limb
progress to reaching with affected upper limb
bilateral upper limb tasks
functional tasks in sitting
moving lower limbs in sitting

Question 9

when does fixing happen (hemiparesis patient)

Answer 9

when a patient leans towards their unaffected side to compensate for weakness (limb and trunk)

Question 10

how do you treat fixing

Answer 10

increased BOS
strengthen trunk (in sitting and in lying)
reaching within BOS with unaffected upper limb
reaching out of BOS with unaffected upper limb
bilateral upper limb tasks
functional tasks

Question 11

when does pushing happen (hemiparesis patient)

Answer 11

when a patient pushes with their unaffected side towards their affected side due to disturbance in midline perception

Question 12

how do you treat pushing

Answer 12

increase BOS (the smaller the BOS the more they will push)
use head of bed/other environmental tools
use vision to orientate (visual vertical appears to be unaffected in pushers)
as someone improves then reduce BOS
weightbearing through unaffected side (in sitting and lying)

Question 13

what do you have to be careful with with pushers

Answer 13

be careful not to fatigue this patient group - this will increase the push
don’t push a pusher

Question 14

before working on sit to stand with a patient what do you need to think about

Answer 14

patients sitting balance
patients lower limb strength
patients engagement in physio
patients ability to follow instructions
patients weight
your positioning
your ability and experience
environment
equipment available

Question 15

what do you need to consider when facilitating sit to stand

Answer 15

side of weakness
balance
anxiety/fear of falling

Question 16

how can you adapt sit to stand

Answer 16

height of surface
foot position
speed
alignment
upper limb involvement
half task (mini-squat)

Question 17

who is a tilt table useful for

Answer 17

people who don’t have the muscle strength to sit to stand even with facilitation
people who are unable to maintain standing even with facilitation
low consciousness level
are struggling with postural hypotension