Motor Control Impairments Flashcards Preview

PTRS 853 Midterm > Motor Control Impairments > Flashcards

Flashcards in Motor Control Impairments Deck (46):
1

Describe the neural and non-neural causes of muscle tone

neural: AMN more sensitive to input

non-neural: stiffness due to immobilization/atrophy

2

Motor Neuron: response to quick stretch (high velocity, low amplitude)

Type 1a

3

Efferent fiber: contracts mm spindles

gamma motor neuron

4

List the Tx options for hypertonicity (3)

- Drugs (baclofen, valium, botox)

- Surgerical (block/cut)

- PT (slow sustained stretching = short term effects)

5

Describe the theory behind prolonged stretch on tone

Thought of "Reflex Inhibiting"

Prolonged stretch activates GTOs autogenic inhibition which may allow for functional task practice but won't necessarily have long term effects

6

Describe the key features of the GTO (4)

- Stretch sensitive

- Results in inhibition

- Facilitates opposite mm 

- Must use an interneuron

7

List the neural and non neural causes of stiffness

neural: "relfex stiffness"

non-neural: effect of immob, limb inertia, heterotopic ossification, effect of aging, pain, arthritis, scoliosis 

8

List the Tx options for stiffness (6)

- stretching

- splinting

- serial casting

- joint mobilization

- heat modalities

- surgical release

9

Describe the effect of stretching in healthy individuals vs. those with neurologic pathologies

Healthly: 30 sec hold or shorter duration over 15 min increases PROM

Non-healthy: standard stretching (above) is ineffective), 20-30 minute daily positioning may be effective in preventing contracture but not in reducing contracture

10

Describe Brunnstrom Stage 1

no movement

11

Describe Brunnstrom Stage 2

Involuntary movement only 

12

Describe Brunnstrom Stage 3

abnormal synergy only 

13

Describe Brunnstrom Stage 4

isolate 1 joint

14

Describe Brunnstrom Stage 5

isolate 2 joints

15

Describe Brunnstrom Stage 6

isolate all joints

16

Describe Brunnstrom Stage 7

normal movement

17

List the Tx options for synergy (3)

- task specific training 

- varied timing demands

- varied force demands

18

List the peripheral factors of strength and power (2)

- L/T properties

- Viscoelasticity

19

List the central factors of strength and power (4)

- Motor units

- Firing rate

- Sequencing

- Postural stabilization 

20

List causes of decreased force production in those with CNS pathology (8)

- inadequate input from AMN (plegia)

- alpha-gamma coactivation 

- incoordination

- spasticity/synergy

- sensory loss

- ROM loss

- atrophy

- endurance/fatigue

21

Describe alpha gamma co-activation

- When the mm shortens, the mm spindle also shorterns

22

Describe the adverse effects if alpha-gamma coactivation doesn't occur

If this doesn't occur the loose spindle can't response to stretch which lessens the input from the mm spindle, this can result in weaker/smaller mm contraction (even when concentrating)

23

Term: weakness as a secondary impairment

deconditioning

24

List the tx options for weakness if your pt's strength is > 3+ (2)

- resisted exercise

- task specific training

25

List the tx options for weakness if you pt is unable to move (2)

- facilitation techniques (stretch reflex, tapping, vibration)

- task specific training 

26

Describe the mechanisms behind the following tx for weakness in a pt. who is unable to move:

1. stretch reflex

2. tapping

3. task specific training

1. autogenic facilitation, no activation of M1

2. autogenic facilitation w/the opportunity for the brain to make connections with the AMN

3. activate alpha and gamma motor neurons via voluntary movement pathways

27

List the tx options for weakness in your pt who has some movement (grade 2-3) (2)

- gravity eliminated

- task specific training

28

List skill acquisition strategies (4)

- immediate feedback

- manual guidance (learning + safety)

- blocked pratcie (little variation)

- MOTIVATION

29

Term: ability to carry out any motor task precisley and quickly 

coordination 

30

Term: multiple joints and muscles activated at appropriate times to work together

coordination

31

Describe the effect of weights on coordination

Weights dampen movement, may improve accuracy with or with out alteration of speed

 

However, may have extra incoordination when the weight is removed 

32

Exercise: reciprocal movements of hands/feet; trace shapes and numbers

Frenkels exercises

33

List the tx options for unilateral neglect (4)

- task specific training

- visual feedback (mirror, video)

- mental imagery 

- encourage cross midline movement

34

Describe why it is important to minimize verbal feedback in the treatment of those with left sided neglect 

The language center of the brain is located on the brain.  Verbal feedback activates the L side of the brain, thus competing with the activation of the R side of the brain to over come neglect.

 

When language centers are kept quiet, the R side of the brain is more activated than the L side

35

Describe the effec tof crossed arm activity on neglect

With arms crossed, the accuracy of the neglected side improves

 

 

36

Syndrome: leans to weak side

Pusher syndrome

37

Condition: motor planning disorder

Apraxia

38

Syndrome: grasping behavior withouth conscious awareness of pt. 

Alien hand syndrome

 

Stroke in corpus callosum

39

Syndrome: unable to communicate or move but cognitively intact

Locked in syndrome

40

Describe the STREAM and S-STREAM

Stroke Rehabilitation Assessment of Movement

STREAM = 30 items (UE, LE, Function), 15 min

S-STREAM = 15 item, 10 min

 

41

Type of PNF: pt. holds position with isometric resistance of agonists followed by antagonists

alternating isometrics

42

Type of PNF: modificaiton of AI with isometric resistance provided in rotation motion 

rhythmic stabilization

43

Treatment Strategy:

ADV: readily modifiable to allow facilitation or resists

DISADV: complex, indirection functional relevant

AFFECTS: mm strength/power, multi-mm activation, coordiantion

PNF

44

Describe the levels of the NDT approach

1st level (basis) = normalize tone

2nd level = automatic reaction (balance/trunk control)

3rd level = isolated/normal movement 

45

Treatment Strategy

ADV: readily modifiable for facilitation, manual guidance

DISADV: complex, strength not addressed, limited functional relevance

EFFECTS: multi-mm activation, coordination, tone, PROM

NDT

46

Treatment Strategy:

ADV: readily modifiable to inc/dec difficulty, based on function

DISADV: cognitive impairment

EFFECTS: mm strength/power, multi-mm activation, coordination, tone, PROM, sensation/perception/vision

Task specific training