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NM 2 > lecture 3: tradtional treatment approahes and evidence based practive > Flashcards

lecture 3: tradtional treatment approahes and evidence based practive Flashcards

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1
Q

what are movements synergies

A

group of mm that work together as a bound unit in a primitive/automatic way

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2
Q

where are movements synergies present at

A

spinal cord level

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3
Q

what is the resting LE synergy

A

 Pelvis: elevation and retraction

 Hip: flexion and adduction

 Knee: extension

 Ankle/foot: PF with inversion

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4
Q

what are the UE resting synergy

A

 Scapula: Scapular depression & retraction

 Shoulder: Extension, adduction, & internal rotation

 Elbow: Flexion

 Forearm: Pronation

 Wrist/Hand: Wrist & finger flexion

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5
Q

who are postural/ attitudinal reflexes present in

A

adults with/wtihout brain damage

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6
Q

what are associated reactions of the brunnstrom approach

A

automatic movements that change the position of a body part

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7
Q

an associated reaction is an automatic movement that changed tha position of body part when …. (5 things)

A
  • another body part moves voluntarily
    -increased effort is used
    -patient sneezes , coughs
    -artificially simulated
  • can include raimiste’s phenomenon (1st lab)
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8
Q

When we sneeze our arm moves but when a pateint sneezes their arm doesn’t move this is an example of what reaction

A

associated

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9
Q

do you use brunnstroms stages of recovery for stroke or TBI patients

A

stroke

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10
Q

pertaining to Brunnstroms stages of recovery for strokes …. what are the 5 rules

A
  • recovery can stop at any stage
  • stages are never skilled
  • may see aspects of more primitive stages when patients under stress
  • motor recovery reflects CNS
  • UE and LE staged SEPARATE
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11
Q

• Flaccidity
• No voluntary or reflexive activity is present
• No associated reactions elicited
• No DTRs

this describes what stage for Brunnstrom Approach

A

stage 1

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12
Q
  • Spasticity is developing.
  • DTRs present
  • Min voluntary movement, all within synergy
  • Partial limb synergies elicited reflexively

this represents what stage for the Brunnstrom Approach

A

2

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13
Q

are DTR’s presents for stage 1 for the Brunnstroms Approach

A

no

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14
Q
  • Can perform basic movement synergies voluntarily
  • May not be able to complete within full PROM
  • Spasticity increases to maximum/peak levels

what stage of the Brunnstrom Approach does this represent

A

stage 3

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15
Q

what stage of the Brunnstroms Approach does spasticity increase to maximum levels

A

stage 3

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16
Q

what stage is basic movement shown for the Brunnstrom Approach

A

3

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17
Q
  • Spasticity starts to decrease.
  • Can voluntarily perform min movements out of synergy

this describes what stage of the Brunnstroms Approach

A

stage 4

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18
Q

what happens during stage 4 of the Brunnstrom Approach

A

spasticity starts to decrease and performed voluntary movements out of synergy

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19
Q
  • Spasticity continues to decrease.
  • Basic synergies losing their dominance over movement
  • Can perform some movement combinations outside of synergies

this describes what stage of the Brunnstrom Approach

A

stage 5

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20
Q

what stage of the Brunnstroms APproach is there 2 joints doing differen things at 2 different times and spasticity and synergies is decrease

A

stage 5

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21
Q
  • Slight remnants of spasticity
  • Isolated muscle action with variety of movement patterns
  • Slow speed/coordination

what stage of the Brunnstrom Approach does this describe

A

stage 6

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22
Q

what happens during stage 6 of the brunnstrom approach

A

-decreased spasticity
-isolated mm action w variety of movement patterns
-slow speed/coordination

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23
Q

what happens during stage 7 of the Brunnstrom Approach

A

-no spasticity
- restoration of normal movemtn and function

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24
Q

what is the definition of PNF

A

the activation of the neuromuscular system through stimulation of proprioceptors

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25
patients need ___ for motor learning
reps
26
what are the 4 main purposes of PNF
- mm strength - develop increased mobility -promote motor learning -improve functional movement
27
what is the agonists mm
most hat are shortengin while contracting it is the direction of the movements desired
28
ex: shoulder flexion … what is the agonist and antagonist mm
agonist is the anterior delt and antagonist is the lats
29
what is the antagonists mm
mms that are lengthening within the diagonal opposite to the desires direction of movement
30
what is **reciprocal innervation/inhibiton**
facilitation of alpha motor neurons of agonist will inhibit antagonist
31
what id **autogenic inhibiton**
contraction of antagonist will allow immediate relaxation of same mm
32
what is **successive induction**
max effort of antagonist will overflow into agonists if reversal of direction is quick
33
what is max effort of **stronger** muscles within a pattern facilitate or overflow into **weaker** muscles.
irradiation
34
what are the 7 commandments of PNF
1. manual contacts 2. commands/communcations 3.stretch 4. traction/approximation 5.maximal resistance 6. normal timing 7. reinforcement
35
what is the 1. manual contact used to stimulate for PNF
stimulate specific groups of mm and to direct the line of movement
36
what is 2. commands/communcation of PNF
-tone of voice -preparatory instruction -action commands
37
for teh Stretch commandment of PNF what is **activated** to **stimulate** the **agonist**
mm spindles
38
for teh Stretch commandment of PNF how is the body part positioned before starting the pattern
in a lengthened range
39
for teh Stretch commandment of PNF what kind of stretch is applied to elongate mms to add reflexive components to movement initiation
quick
40
for the 4. traction/approximation commandments of PNF what does **traction** and **approximation** facilitate
traction facilitates movement approximation facilitates stability
41
6. normal timing of the commandments of PNF .. how is the movement and when do u allow rotation to occur
distal to proximal movemtn and allow rotation to occur earliest in patttern
42
7. reinforcement commandments for PNF .. we can use what to **increase the strength** of a response
“timing for emphasis”
43
what are the stages of **motor control** in PNF
1. mobility 2. stability/ static postural control 3. controlled mobility/ dynamic postural control 4. skill / skilled mobility
44
what are the 3 PNF techniques to **enchance mobility**
1. strengthening 2. lengthening shortened mm 3. getting the full motion going
45
what are the 4 **strengthening** PNF technihgues to **enhance mobility**
* Repeated contractions * Hold-relax-active-motion * Reversal of antagonists/slow reversals * Timing for emphasis
46
what are the 2 **lengthening shortened mm** PNF technihgues to** enhance mobility**
* Hold/contract-relax (with passive repositioning) * Hold/contract-relax active contraction
47
what PNF technique to enhance mobility is used for **getting the full motion going**
rhythmic initiation
48
what are the 2 PNF TECHNIQUES TO **ENHANCE STABILITY**
* Reversals of isometrics/alternating isometrics * Rhythmic stabilization
49
what PNF techniques are used for **controlled mobility / dynamic** postural control
slow reversals / reversals of isotonic
50
what are techniques for **skilled/skilled mobility** for stags of motor control in PNF
normla timing agonist reversals
51
are developmental activities just for babies
nooooo
52
what are developmental activities
movemtn that progressively challenges the patient to control more body weight aginast gravity
53
what is **plantigrade**
bear walking basically
54
for the application of developmental concepts ___ control needs to happen before ___ skill movements
proximal distal
55
for the application of developmental concepts , once th movement is mature then the timing will be ___ to ___
distal to proximal
56
what is the goal for **NDT conceptual framework**
to minimize activity limitation and impairments with in the context of a patients environment and participation goals
57
based on the NDT conceptual framework clinical practice is based upon what understanding
the understanding that sensation , action , perception , cognition and emotion are interlinked and interactive
58
what is viewed as the range of motor behavior available to people without a CNS lesion.
typical motor behavior
59
what does **NDT** allow the person to do and not to do
alllows the person to be an active co participant in therapy and does not just do it for the patient as a passive participant
60
t/f: you can superimpose efficient movement on abnormal postural alignment
FALSE u cant
61
when do u consider alignment
at the beginning of movement during execution of movement after completion of movement
62
what are the 5 elements of **postural control**
1. trunk 2. midline orientation 3. weight shift over the base of support 4. head control 5. limb function
63
for the elements of postural control what control is required in order to have controle elewhere
trunk control
64
does lower or upper trunk control happen first
lower
65
what is midline orientation and what is it needed f
point of reference from movement over the base need to be able to - stabilize in midline -move away from and back to it -cross midline
66
for the elements of postural control , for weight shift over the BOS does smaller increments precede larger ?
yes
67
what control evolves out of trunk control
head control
68
Postural control in a position precedes ability to move ____ with control.
transitionally
69
what movements are easier to harder ?
isometric > eccentric > concentric

NM 2 (17 decks)

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