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Neuromuscular (KK) > Motor screen & PNF interventions > Flashcards

Motor screen & PNF interventions Flashcards

1
Q

when performing a gross screen of strength and ROM, what are you really looking for?

A

are they able to perform other aspects of examination activites

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2
Q

in a pt who demonstrates weakness, what is the primary impairment and what is the secondary impairment?

A

primary: paresis (partial weakness) / plegia (absence of muscle strength)
secondary: muscle atrophy due to neurologic injury

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3
Q

stroke patients demonstrate significant changes in ______ _______ due to altered _______ ______ and decreased motor unit firing rates

A

muscle performance
recruitment patterns

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4
Q

what is the protocol/flow for the motor screen?

A
  1. stabilize trunk w/ body supported in supine or sitting w/ assist
  2. AROM
  3. AAROM - pt w/ paresis may require gravity eliminated position or facilitation
  4. perform at all joints UE and LE
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5
Q

what is active restraint (insufficiency)?

A

presence of abnormal co-activation, spasticity, and abnormal posturing may alter the patient’s ability to perform isolated joint movements

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6
Q

what is passive restraint (insufficiency)?

A

muscle and soft tissue changes due to contracture

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7
Q

what are PT considerations when performing a motor screen?

A

consider movement capabilities
muscle substitutions/compensations
use functional activities

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8
Q

make sure to include these 5 things when documenting that you performed a motor screen on your patient:

A
  1. laterality & objective MMT grade
  2. position
  3. quality of movement or need for facilitation
  4. any observed synergy or muscle substitution
  5. functional movements tested
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9
Q

qualitative documentation will also include: (6)

A
  1. type and degree of changes present
  2. symmetrical or asymmetrical
  3. distal or proximal
  4. description of effects of muscle weakness on active movements, posture, and function
  5. UMN or LMN
  6. presence of atrophy
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10
Q

PNF technique has an emphasis on patterns of movement to promote _________ vs. __________

A

recovery of function (restoration) vs. compensation

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11
Q

which element of PNF matches the following descriptions:
- enhances contraction and motor control, increases strength, and aids motor learning
- response to stimulation spreads to adjacent muscles working in synergistic patterns
- increases responses and guides movements
- important for control of motion
- promote normal timing and activation of muscles to assist in the facilitation of synergistic movement

A
  • resistance
  • irradiation and reinforcement
  • manual contact
  • body position and body mechanics
  • timing
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12
Q

which element of PNF matches the following descriptions:
- provide direction for movements and play a role in motor learning
- use of ____ guides movement and plays a role in motor learning
- compression force applied to joints stimulates nerves and facilitates extensor muscles and stabilizing patterns
- distraction force applied to joints stimulates nerves and facilitates flexor muscle mobilizing patterns

A
  • verbal cues
  • vision
  • approximation
  • traction
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13
Q

what is the optimal patient position for PNF?

A

neutral alignment
maximal postural stability
enhance muscle contraction

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14
Q

what is the optimal therapist position for PNF?

A

directly in line with desired motion
use body to resist - enhance therapist control, reduces fatigue, protects against injury

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15
Q

what are manual contacts used for with PNF?

A

guiding movement
provide resistance
use lumbrical grip
enhance kinesthetic awareness and muscle contraction

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16
Q

how should you use verbal cueing with PNF?

A

clear, concise, well timed
preparatory, action, corrective cueing
improves motor learnin

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17
Q

what is a D2 pattern?

A

UE
flex/abd/ER
ext/add/IR

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17
Q

what is a D1 pattern?

A

UE
flexion/add/ER
ext/abd/IR

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17
Q

what is normal timing for:
- trunk?
- extremities?

A

proximal to distal
distal to proximal

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18
Q

optimal resistance with PNF facilitates _____

A

muscle contraction

19
Q

what approximation?
what does it ensure?

A

compression of joints
ensure all joints are properly aligned

20
Q

what is traction?
what does it facilitate?

A

elongation of joint
facilitate muscle response

21
Q

what is irradiation?
- facilitation?
- inhibition?

A

spread of response to stimulation
- contraction
- relaxation

22
Q

what is reinforcement?

A

to strengthen

23
Q

irradiation and reinforcement is a result of ______

response increases as the stimuli increase ______ and ______

A

properly applied resistance

duration and intensity

24
Q

what is a quick stretch associated with PNF?

A

facilitate existing contractions through increased motor unit recruitment –> lengthened position of muscles

25
Q

what is a contraindication for using quick stretch technique?

A

complete flaccidity

26
Q

what is rhythmic initiation?

A

voluntary relaxation followed by passive movements through increasing ROM followed by AAROM, progressing to resisted movements

27
Q

what are indications to use rhythmic initiation?

A

inability to initiate movement
uncoordinated motion
general tension or muscle tone
motor learning deficits due to comprehension

28
Q

what is the 4 part technique used for rhythmic initiation?

A

PROM - “relax, let me move you”
AAROM - “now, help me move you”
AROM - “now, move on your own”
resisted - “now, push up”

29
Q

what is combination of isotonics aka agonist reversals?

A

combines concentric and eccentric contractions of one muscle group

30
Q

what are indications to use combination of isotonics technique?

A

weak postural muscles
inability to eccentrically control body weight during movement transitions
decreased active ROM
poor control and weakness

31
Q

what is the 3 part technique for combination of isotonics?

A

concentric
isometric
eccentric

32
Q

what is stabilizing reversals aka alternating isometrics?

A

isometric holding is facilitated first on one side of the joint, followed by alternate holding of the antagonist muscle groups
- applied in multiple directions

33
Q

what are indications of using stabilizing reversals?

A

decreased stability
poor control
weakness

34
Q

what is rhythmic stabilization?
- emphasis on?

A

simultaneous isometric contractions of both agonist and antagonist muscles (co-contraction) performed without relaxation using careful grading of resistance

emphasis on rotational stability control

35
Q

what are indications to use rhythmic stabilization?

A

decreased stability in WB and holding
poor antigravity control
weakness
ataxia

36
Q

what are dynamic (slow) reversals?

A

slow concentric contractions of first agonist, then antagonist patterns using careful grading of resistance and optimal facilitation

37
Q

what are indications to perform dynamic reversals?

A

improve intra- and intermuscular coordination, strength, AROM, endurance, decrease muscle tone

38
Q

what is repeated stretch (repeated contractions) technique?

A

repeated stretch linked to voluntary effort to contract stretched muscles, may be repeated without stopping, as soon as the contraction weakens or stops

39
Q

what is the goal of repeated stretch technique?

A

enhance initiation of motion and motor learning, increase strength, endurance, improve intra and intermuscular coordination, ROM, reduce fatigue, guide desired motion

40
Q

what are indications to perform repeated stretch technique?

A

weakness
fatigue
decreased ability to perform desired pattern

41
Q

what is contraindication of repeated stretch technique?

A

do not apply in presence of joint instability, pain or injured muscle

42
Q

describe how you would perform contract-relax/hold relax?

A

actively move limb into end range (agonist contraction)
apply strong resisted isometric/isotonic contraction of the antagonists 5-8 sec (autogenic inhibition)
voluntary relaxation and passive movement into new range of agonist pattern

43
Q

what are indications to perform CR/HR?

A

limitations in ROM caused by muscle tightness or pain
spasticity

44
Q

what is the autogenic inhibition reflex?

A

sudden relaxation of muscle upon development of high tension to prevent injury of tissue
–> turn off

45
Q

what is myotatic reflex (stretch reflex)?

A

muscle contraction in response to stretching within the muscle tissue secondary to muscle spindle reaction
–> fire on

46
Q

process of muscles on one side of a joint relaxing to accommodate the “reciprocal” contraction of the muscles on the other side of the joint to improve synchrony and smoothness of the movement

A

reciprocal inhibition

47
Q
A

Neuromuscular (KK) (21 decks)

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