Evidence For Rehab Interventions For TBI

Question 1

What are the 4 parts of the brain’s motor system

Answer 1

Posterior cortex, prefrontal cortex, Premotor cortex, motor cortex

Question 2

What does the posterior cortex do

Answer 2

Provides sensory info to the frontal cortex

Question 3

What does the prefrontal cortex do

Answer 3

Plans movement

Question 4

What does the premotor cortex do

Answer 4

Organizes movement sequences

Question 5

What does the motor cortex do

Answer 5

Executes actions

Question 6

What is the final common pathway

Answer 6

Corticospinal tract

Question 7

What is the posterior parietal cortex

Answer 7

Sensory assoc. area and intermodal integration of incoming sensory info to the
-area of planned movement**

Question 8

What 3 structures are involved with planned movements

Answer 8

-vision from occipital to frontal eye fields
-auditory cortex
-somatosensory cortex

Question 9

4 benefits of tilt table

Answer 9

-prevent contractures
-verticality** (engages vestibular, somato, postural responses)
-wt bearing
-increased load for bone density

Question 10

What is the superior collicus function? Found where?

Answer 10

Helps brain respond to environment stimuli; brain stem

Question 11

What is first thing to tx in severe TBI

Answer 11

Visual attention

Question 12

3 ways DAI affects visual attention in severe TBI

Answer 12

-difficult scanning scene
-slow rxt to stimuli
-spatialize orientation head and eyes

Question 13

What to advance to after visual attention. Examples

Answer 13

Automatic/subconscious
Sit pt up (endurance, head/trunk righting response, visual tracking)

Question 14

What to advance to after automatic/subconcious. Ex?

Answer 14

Planned/purposeful
Vision and objective recall, 2-3 step command

Question 15

What to advance to after visual attention? Purpose/fxn?

Answer 15

Adding posterior parietal cortex
Ability to attend relevant stimuli and ignore others

Question 16

What is visuospatial attention

Answer 16

Selects relevant input in environment for motor planning

Question 17

Key to movement is processed where

Answer 17

Sensory cortex

Question 18

What is after adding posterior parietal cortex in tx

Answer 18

Prefrontal cortex and planned movements

Question 19

Examples of prefrontal cortex/planned movement tx

Answer 19

STS for acts
Transfers on various heights and surfaces

Question 20

What are mirror neurons

Answer 20

See a person perform action is the same as performing the action (premotor neurons fire)

Question 21

Plans do what to movement

Answer 21

Correct it

Question 22

What can help improve movement outcomes

Answer 22

Watching others practice

Question 23

How does premotor cortex activate (from study)

Answer 23

At sight of cue

Question 24

What do neurons do when they see a cue of action

Answer 24

Encode intention to perform movement

Selection of movements based on external cues

Question 25

The premotor cortex _______ to select specific motions based on _____________

Answer 25

Learns, external events

Question 26

What is the key to increasing neuroplasticity

Answer 26

Gradual progression

Question 27

How to gradually progress task based interventions

Answer 27

Progressively challenging -change environment -add resistance -complex movements

Question 28

What is the supplemental motor area

Answer 28

Where 10% of corticospinal tracts originate from Connected to primary motor cortex Complex sequence of movements

Question 29

When does primary motor cortex activate

Answer 29

5-100 ms before initiation of movement

Question 30

What does primary motor cortex encode

Answer 30

Force, direction, speed and extent of movement

Question 31

What parts of the brain does the primary motor cortex engage

Answer 31

SMA, BG, cerebellum, thalamus

Question 32

Describe the task demand circuitry

Answer 32

-Activated premotor cortex -primary motor cortex -corticospinal tracts originate -motor program achieved via mus spindle to cerebellum -motor behavior = goal