Dykinesias

Question 1

Dystonia

Answer 1

Sustained muscle contractors that cause twisting and repetitive movements and/or abnormal postures
May be triggered by voluntary movement and may overflow into other muscles

Question 2

Athetosis

Answer 2

Slow, involuntary, convoluted, writhing movements of the fingers, hands, toes and feet
Often due to damage of the basal ganglia

Question 3

Chorea

Answer 3

Quick involuntary movements of the feet or hands

May occur with athetosis - choreoathetosis

Question 4

Aims of post-DBS Physio

Answer 4

Posture and balance
Functional mobility
Functional UL use
ADLs/cares

Question 5

Treatment of post DBS Physio

Answer 5

Strength, stability
Selective motor control
Sensory modulation

Question 6

PT treatment aims - postural control

Answer 6

Moving to midline
Reduction in internal perturbations
Functional Orientation

Question 7

PT treatment aims - Gross motor

Answer 7

Functional mobility
Transfers
Mobility equipment selection and training

Question 8

PT treatment aims - fine motor/UL

Answer 8

ADLs/cares
Education/learning
Recreation/sports

Question 9

Postural stability treatment

Answer 9

Postural awareness (visual - mirrors, tactile, proprioception)
Task orientation
Graded contraction
Muscle groups for posture, holding, orientation

Question 10

Selective motor control treatment

Answer 10

Isolated contraction
Purposeful movement
Plastic rings in hands to keep hands in midline
Ladder to stabilise and control movement

Question 11

Range of motion treatment

Answer 11

Increase and preserve ROM and mobility needed for function

Question 12

Sensory integration/modulation

Answer 12

Awareness of triggers - strategies to minimise incidence and impact
Teach use of sensory cueing to stabilise posture and movement

Question 13

Dyskinesia - Motion

Answer 13

Dystonia - may have less movement - stuck in postures

Choreoathetosis - excessive movement, involuntary/unwanted

Question 14

Dyskinesia - Orientation

Answer 14

Poor antigravity, speed of responses vary, may be absent, difficulty sustaining postures, may use fixation for stability

Question 15

Dyskinesia - Variety

Answer 15

Poor repertoire of voluntary movement due to interference from unwanted movement and/or fluctuations in tone

Question 16

Dyskinesia - Ease

Answer 16

CA - tend to have free movement - no contractors

Dystonia - if repeatedly fixating may develop stiffness or pain

Question 17

Dyskinesia - Modulation

Answer 17

range, speed and effort are poorly controlled

Question 18

Dyskinesia - Effective

Answer 18

Variable even if can problem solve, due to volume, nature and timing of involuntary/unwanted movement/tone

Question 19

Dyskinesia - Normal

Answer 19

Most cases show slow acquisition and lower quality for age

Severe cases can show significant and permanent delays

Question 20

Dyskinesia - Timing

Answer 20

all aspects of movement timing can be interrupted by unwanted posture/movement, even if child can plan

Question 21

Dyskinesia - safe

Answer 21

Difficulty protecting self

Accidental injury to others due to unwanted movement

Question 22

Dyskinesia - Senses

Answer 22

Low registration of certain sensory stimuli e.g. vision, hearing, tactile

Question 23

Dyskinesia - Engages

Answer 23

Avoidance or over-seeking - not common unless concomitant autism

Question 24

Dyskinesia - Nominates

Answer 24

Poor perception common

Question 25

Dyskinesia - Symmetry

Answer 25

Depending on area of brain impairment, may experience hemisensory loss, hemianopia, extinction

Question 26

Dyskinesia - Adjusts

Answer 26

Very poor position adjustments and maintenance due to excessive involuntary movement, limited control of alignment

Question 27

Dyskinesia - Tunes

Answer 27

Over or under responses to stimuli (e.g. exaggerated parachute reaction or absent postural response)

Question 28

Dyskinesia - Integrates

Answer 28

Overuse of certain sensory information; over use as well

Question 29

Dyskinesia - Overrides

Answer 29

Likely problems with unresolved sensory conflict/mismatch due to poor system function and integration, sensory bias

Question 30

Dyskinesia - Normal

Answer 30

Unsafe - yes, involuntary movement can cause injury to others because of poor control