AOTA Neurodegenerative Diseases

Question 1

define neurodegenerative disease

Answer 1

progressive and usually chronic conditions resulting from damange to peripheral nervous system, central nervous system, or both

Question 2

define akinesia

Answer 2

impairment of voluntary and spontaneous movement initiation resuling in feeding, especially during gait activitites

Question 3

define bradykinesia

Answer 3

slowed motor movements

Question 4

define dysmetria

Answer 4

decreased coordination of movment

Question 5

define rigidity

Answer 5

muscle stiffness that impairs movement

Question 6

define fasciculation

Answer 6

involuintary muscle contraction and relaxation; observed as muscle twitch

Question 7

define festinating gait

Answer 7

small rapid steps resulting from forward-tilted head and trunk posture

Question 8

define paresthesia

Answer 8

numbness and tingling because of sensory nerve changes

Question 9

how do you perform the eval for neurodegenerative diseases

Answer 9

occupational profile
standardized and nonstandardized testing,
observation and inteview
skills assessments

Question 10

what are some cognitive compensatory strats used with neurodegenerative diseaes

Answer 10

minimize distractions and interruptions during task completion
use problem solving techniques
use memory aids and written instructions
minimize multitasking
allow increased time to comlete task

Question 11

what are some interventions used with neurodegenerative diseaes

Answer 11

cognitive starts, activity strats, role delegation, environmental mods, exercise programs

Question 12

define MS and its signs and symptoms

Answer 12

chronic, priogressive demyelinating disease of CNS that interferes with axons’ abilty to conduct impulses resulting in impaired nerve conduction and inflammation which causes neurological dysfunction

symptoms - impaired balance and coordination, partial or complete paralysis of a part of the body, muscle weakness, fatigue, intention tremors, dysphagia; paresthesia, vertigo, pain, diplopia, slurred speech, scannig speech, bladder and bowel problems, cognitive issues, emotional symptoms

Question 13

what is the goal of rehab for MS

Answer 13

minimize severity, amount and length of exaverbations in order to improve funciton.

Question 14

what are the types of MS

Answer 14

relape-remitting - fluctuating course of relapse with associated neurologic dificits
secondary progress - cessation of fluctations with slow deterioration
secondary progressive with relapses - flucuation with relapses and deterioration
primary progressive - deterioration from beginning
progressive relapsing - progressive with relapses

Question 15

what are some ot interventions used with MS

Answer 15

vision compensation, sensory compensation, bathroom schedules, body mechanics and yoga, resting splints, activity level diary, ergonomic positioning, cooling techniques, eneregy conservation.

Question 16

define parkinsons and its signs/symptoms

Answer 16

progressive, variable condition that causes degneration in basal ganglia and substantia nigra with decreased dopamine production.

symptoms - tremor, muscle ridigity or stiffness, bradykinesia, postural instabilty, gait dysfunction, fine motor and bimanual impairments, freezing, cognitive deficits, communication difficulties.

Question 17

what are the 5 stages of parkinsons disease

Answer 17

1 - unilateral symptoms
2- bilateral symptoms
3 - impaired balance secondary to postural instabilty resulting in mild to moderate impairments inf unction
4 - decrease in postural stability, decrease in function,impaired mobility need tfor assistance with ADLs
5 - total dependence

Question 18

describe ot interventions used with parkinsons disease

Answer 18

energy conservation
caregiver training
support and advocacy groups
safety considerations
feeding and adl adaptations
communication adpatations
bathroom schedule
cognitive adaptations

Question 19

define ALS and its symptoms

Answer 19

progressive, degenerative disease in which motor neurons in brain, spinal cord and peripheral system are destroyed and replaced by scar tissue

symptoms - moves distal to proximal, lower to upper extremities, spasticity, dysphagia. NOT AFFECTED: cognition, sensation, vision, and hearing and bowels.

Question 20

what are the six stages of ALS

Answer 20

1 - can walk, some weaknes, indepenedent with ADLs
2 - person can walk and has moderate wekaness
3 - person can walk but has severe weakness
4 - person requires wheelchair for mobilty, needs some assistance with ADls and has severe weakness in legs
5 - person requires wheelchair for mobilty, depenedent for ADls and has severe weakness in extremities
6 - person is confinsed to bed and depednent for ADLs and most self-care task

Question 21

what are some OT interventions used for ALS

Answer 21

compensatory activities
home safety eval
exercise
dysphagia education and techniques
decrease physical demands
work with client during stage and what they need

Question 22

define gillian barre syndrome and its symtpoms

Answer 22

inflammatory disease that causes demyelination of axons in pheriphal nerves.

symptoms - pain, fatigue, edema, absence of deep tendon relfex, mild sensory less in hands/legs, bladder dysfunction

Question 23

what are the three phases of GBS

Answer 23

onset and acute stage - acute weakness in at least 2 extremities that advances and reaches max in 2-4 weeks
plateau - most dibiltating symptoms. no change in symptoms
recovery - remyelination and axonal regeneration occurs over long period.

Question 24

describe the eval process in the three phases

Answer 24

in acute, occupational profile, interest and roles.
plateau phase, screen and eval occur in ICU. assesments cover communication, control of physical engironment, comfort, and positioning and anxiety managmgene.t
in recoery phase, eval focuses on mobility, self care and ADLs, communication, leisure, and workplace and community reintergration.

Question 25

what is the internvetion plan for plateau phae of GBS

Answer 25

modifications are deemed tempoeray
develop and train client in use of communcatio tools
environmental modifications
adjustment of supione and sitting positions
positioning
educations

Question 26

what is the intervention for recovery phase of GBS

Answer 26

splinting, mobilty with assist, modified techniques for self care, commucbnation, AE education, energy conservation, home assessment.

Question 27

define huntingtons disease and its symptoms

Answer 27

hereditary neurological disorder that leads to severe physical and mental disabilities. progressuive lslowing of nerve cells in brain that affet movement, cognition, emotions and behavior

symptoms - motor difficulties, cognitive and behavioral abilities,

Question 28

what are the different ypes of involuntary movement patterns found in huntingtons disease

Answer 28

choreiform
chorea - rapid, unvoluntary iurregular movements
akathsiai - motor restlessness
dystonia - abnormal, sustained posturing

Question 29

what are the different voluntary movement patterns found in huntington’s disease

Answer 29

bradykinesia
akinesia - delayed initiation of movement
incoordinations

Question 30

what are some ot interventions for the early stages of huntingtons disease

Answer 30

cognitive and emotinal disability strats, includuing word associations, sequencing, and daily routines.
motor disability modifications
safety modifications

Question 31

what are some ot interventions for the middle stages of huntingtons disease

Answer 31

engagement in purpoiseful activities
caregiver education
simple cues
assistive tech
positioning

Question 32

what are some ot intervenntions for the final stages of huntingtons disease

Answer 32

splinting
environmental contorls
daily schedules
smooth transtitions

Question 33

what are the different types of dementia?

Answer 33

alzheimers - progressive impairment of memory, executive function, attention, language, visual processing and praxis

vascular - cognitive decline similar to alzeimers with less memory involvement, gait disturbances, abrupt of stpewise decline.

frontotemporal - progressive aphasia, corticobasal syndrome, or symptoms similiar to AD or parkinsons disease

lewy body - progressive deficits in attention and executive function, meory impairment, fluctuating cognition, visual halluciations, parkinsonism, autonomic dysfunction, and falls.

Question 34

what are the primary signs and symptoms of dementia

Answer 34

memory impairment
cognitive deficits
poor judgement
anxiety
psychotic symptoms
motor deficits
symptom severity

Question 35

describe the early stage of dementia

Answer 35

adls remain intact
first signs of memory loss
affects orientation to place
IADLs are impaired.
withdraw from social participation

Question 36

describe the middle stage of dementia

Answer 36

impairments in all occupations
simple home management task can be done with assistance
safety is major concern
limited social participation

Question 37

describe the late stags of dementia

Answer 37

all area of occupation are lost
person is depednent in all ADLs
can no longer ambulate safely

Question 38

what are the 6 levles of allens cognitive disabilities theory

Answer 38

1 - automatic actions; requires total cognitive assistance. constant 24 hour supervision.
2 - postural actions; requires maximum cognitive assitance. one step, imiated, near reflexive and familiar actions. requires aroudn the clock supervision
3 - manual actions; requires moderative cognitive assisstance. tactile cueing. one step familiar and action orientated motor actions. avoid sensory overload; requires 24 hour supervision.
4 - goal directed activity; requires minimum cognitive assist. 2 or three step activities. simple, concerete, and supportive activities. needs 24 hour supervision.
5 - exploratory actions. caregiver standby or supervision needed for cognitive asist. learns through visibilem, concrete and meanigniful stimuli. follow fourto five step process and learn new concerete ideas.
6 - planned actions; normally independent.