Neuro Assessment

Question 1

What are common signs and symptoms that neurological patients might present with that will guide a therapist towards a specific exercise plan?

Answer 1

• Changes in sensation
• Muscle weakness
• Spasticity
• Fatigue
• Changes in cognition

Question 2

What are some common difficulties when rolling a patient following a neurological event?

Answer 2

• Weakness
• Lack of initiation-processing delay
• Trunk restriction
• Weight-bearing asymmetry
• Asymmetrical lower limb placement
• Arm position (high/low tone, splints/casts)
• Pain
• Neglectful head orientation

Question 3

What are some contextual factors that influence rolling & sitting-lying?

Answer 3

• Base of support (hospital bed, plinth, mat)
• Strength
• Vision & Hearing
• Drips/drains (reduced space)
• Tone
• Sensation
• Activity/task
• ROM
• Pain, anxiety, mood
• Age
• Body weight/nutritional
• Cognitive status (planning ability, problem solving, distraction)

Question 4

What are some common difficulties with lying-sitting & sitting-lying?

Answer 4

• Weakness
• Lack of initiation (processing delay)
• Trunk restriction
• Weight-bearing asymmetry
• Asymmetrical foot placement
• Arm position (high/low tone, scapular stability)
• Pain
• Neglectful

Question 5

What is tone (spasticity)?

Answer 5

The internal state of muscle-fibre tension within individual muscles and muscle groups.
- Normal resting state of the muscles
- Continuum from low (floppy or flaccid) to high (hypertonus or spasticity)

(Tone can increase over time and the patient presents with spasticity which can lead to pain, loss of function and contracture as well as interfering with return of active movement)

Question 6

What is the best way to treat a neurological condition?

Answer 6

use repeated, intensive, task-specific & functional activities

Question 7

Why do we splint?

Answer 7

• prevent contracture
• improve function

Question 8

What are the (2) main treatment strategies to prevent spasticity & manage soft tissue changes?

Answer 8

Stretching:
- Manual
- Splints
- Orthotics

Position & Postural Management:
- Chairs
- Beds
- 24hrs

Question 9

Describe how to complete stretches to improve mobility.

Answer 9

• Isometric contraction of antagonistic muscle group (6s)
• Relaxation (2-3s)
• Passive stretching of antagonistic muscle group (15-18s)
• Isometric contraction of agonist muscle group (6s)

Question 10

What are the aims of positioning?

Answer 10

• Encouragingcomfort andavoidance of pain
• Maintenance ofsoft tissue lengthand avoid contractures
• Promote hydration and nutrition
• Promote orientationfor the patient
• Avoidaspiration(aspiration pneumonia)
• Avoidsubluxationor pain ofthe UL (e.g. shoulder pain in stroke)
• Maintain appropriateskin integrity

Question 11

What does therapeutic handling allow?

Answer 11

• Facilitated normal movement
• Provide de-weighting support

Question 12

What are assessment tips to look for in terms of cranial nerves?

Answer 12

• Eye movement
• Pupil size
• Facial sensation
• Facial movements
• Tongue movements
• Listen to voice
• Check cough

Question 13

True or False…
Lateral sitting balance is more dependent on trunk muscles than leg muscles

Answer 13

True

Question 14

What is the average weight of the human head in kg?

Answer 14

5 kg

Question 15

What is the approx. total % of whole body weight made up by the trunk?

Answer 15

55%

Question 16

With neck flexion at 30 degrees, the translated weight of the head onto the trunk is how many pounds?

Answer 16

40

Question 17

How many key spinal components make up the trunk support system?

Answer 17

4