Neuro Interventions

Question 1

Stages of Motor Learning

Answer 1

Skill acquisition stage (cognitive stage)
skill retention stage (associative stage)
Skill transfer stage (autonomous stage)

Question 2

Skill acquisition stage of motor learning

Answer 2

occurs during initial instruction and practice of skill
“what to do” stage
develops understanding of task, task demands, indemnifies stimuli and selects response
structures motor program

Question 3

Training strategies for skill acquisition stage of motor learning

Answer 3

demonstrate ideal task performance
emphasize intact sensory systems and intrinsic feedback systems
high dependence on vision
focus on success of movement outcome, don’t cue on large number of errors
feedback after every trial in various ways
break down complex tasks, then tach as a whole
used blocked practice to improve performance
use variable practice of related skills once skills are established
Closed, stable, predictable environment

Question 4

Skill Retention Stage of Motor Learning

Answer 4

involves carryover as individual is asked to demonstrate skill after initial practice
practices movements, refines motor program
increases use of proprioceptive feedback

Question 5

Training Strategies for Skill Retention Stage of Motor Learning

Answer 5

continue to utilize KP, intervene when errors are consistent
emphasize prop feedback, “feel of the movement”
Stress relevant functional outcomes with KR
encourage learner to self-assess achievement
focus on variable practice of related skills to increase retention
progress towards open, changing environment

Question 6

Skill Transfer Stage of Motor Learning

Answer 6

involves individual demonstrating skill in a new context
continues to refine motor responses
spatial and temporal highly organized

Question 7

Training strategies for Skill Transfer Stage of Motor Learning

Answer 7

learner demonstrates appropriate self-evaluation and decision making skills
provide occasional feedback when errors evident
stress consistency of performance in variable environments and skills
massed practice is appropriate
ready learner for multiple environments

Question 8

Near Transfer in Motor Learning

Answer 8

alternate form of initial task
very similar to the initial task but has a minimal number of changes in task parameters

Question 9

Intermediate Transfer in Motor Learning

Answer 9

moderate number of changes to task parameters, but still has some similarities to inital task

Question 10

Far Transfer in Motor Learning

Answer 10

introduces an activity that is conceptually the same as but physically different from the initial task

Question 11

NDT Assumptions

Answer 11

Normal tone and limb posture are needed before normal movements
Postural reactions are considered the basis for control of movement
avoid movements and activities that increase tone
Inhibition of primitive reflexes and abnormal movements

Question 12

Focus of NDT

Answer 12

improving quality of movement
integration of both sides of the body to increase functional use
establishment of the ability to wear bear and shift through the limbs
establishment of normal righting and equilibrium patterns

Question 13

PNF Assumptions

Answer 13

Response of neuromuscular mechanisms can be hastened through stimulation of proprioceptors
Techniques are superimposed on patterns of movement (diagonals) and sensory stimulation (verbal, visual and manual cues)
Development proceeds in a cervicocaudal and proximodistal direction

Question 14

PNF Techniques

Answer 14

Movements are rhythmic and reversing in character
ordered sequence of total patterns and movement
Frequency of stimulation and repetitive activity are used to promote and retain motor learning
Diagonal patterns or mass movements are used during functional activities

Question 15

PNF Diagonal patterns

Answer 15

All patterns cross midline and encourage rotary components of movement
UE patterns: D1 and D2, either flexion or extensionP

Question 16

PNF D1 Flexion

Answer 16

Scapular: abducted and upwardly rotated
Shoulder: flexed, adducted, externally rotated
Elbow: slightly flexed
Forearm: supinated
wrist: flexed towards the radial side
fingers: fisted
Functional example: combing the left side of the head with the right arm

Question 17

PNF D1Extension

Answer 17

elbow extended
forearm pronated
shoulder extended, abducted
fingers extended
Functional Example: reaching for the armrests to push up from the chair, reaching for back and butt to bathe while standing

Question 18

PNF D2 Flexion

Answer 18

shoulder flexed, abducted, externally rotated
elbow extended
supination
wrist extended
fingers extended and abducted
Functional example: raising an arm in class, reaching for a cup in the upper right cabinet with the right arm

Question 19

PNF D2 Extension

Answer 19

shoulder internally rotated, adducted
elbow in some flexion
forearm pronated
wirst flexed towards ulnar side
fingers flexed
functional: washing left though with right arm, donning a belt

Question 20

Brunnstroms principles

Answer 20

focused on facilitating recivery though sequence
promotion of movement from reflexive to volitional
seven stages including synergies

Question 21

Brunnstrom Stage 1

Answer 21

Flaccid, no voluntary movement

Question 22

Brunnstrom Stage 2

Answer 22

Synergies and spasticity are developing

Question 23

Brunnstrom Stage 3

Answer 23

Increase in spasticity and the beginning of voluntary movement in synergy

Question 24

Brunnstrom Stage 4

Answer 24

decrease in spasticity and voluntary movement begins out of synergy pattern

Question 25

Brunnstrom Stage 5

Answer 25

spasticity continues to decrease, movements become more complex without synergic patterns

Question 26

Brunnstrom Stage 6

Answer 26

Spasticity almost gone and isolated voluntary movement

Question 27

Brunnstrom Stage 7

Answer 27

normal movement

Question 28

Roods Four Phases of Motor Control

Answer 28

Reciprocal Inhibition/innervation Co-contraction Heavy work Skill

Question 29

Roods Reciprocal Inhibition/innervation Phase

Answer 29

early mobility pattern that is primarily reflexive governed

Question 30

Roods Co-contraction Phase

Answer 30

Simultaneous contraction of agonist and antagonist that provides stability in a static pattern hold a position or an object for a long period of time

Question 31

Roods Heavy Work Phase

Answer 31

mobility superimposed on stability Proximal muscles contract and move while distal segments are fixed

Question 32

Roods Skill Phase

Answer 32

The highest level of motor control combines stability and mobility stabilized proximal segment while the distal end is moving

Question 33

Roods assumptions

Answer 33

The motor response achieved is dependent on sensory stimulus provided by therapist sensorimotor control is developmentally based and must begin at persons current level

Question 34

Modified Ashworth Scale 0

Answer 34

no increase in muscle tone with stretch

Question 35

Modified Ashworth Scale 1

Answer 35

slight increase in muscle tone with catch and release or minimal resistance at end of ROM in flexion or extension

Question 36

Modified Ashworth Scale 1+

Answer 36

slight increase in muscle tone with catch, followed by minimal resistance through less than half ROM

Question 37

Modified Ashworth Scale 2

Answer 37

Marked increase in muscle tone through most of the ROM but affected parts are easily moved

Question 38

Modified Ashworth Scale 3

Answer 38

Considerable increase in tone, passive movement is difficult

Question 39

Modified Ashworth Scale 4

Answer 39

The affected part is rigid in flexion or extension

Question 40

Inclusion Criteria for CIMT

Answer 40

20 degree of wrist extension and 10 degree of finger extension or 10 degrees wrist extension, 10 degrees of thumb abduction and 10 degrees of extension of any two other digits or able to lift a washrag off a tabletop using anytype of prehension and release it

Question 41

Three major components of CIMT

Answer 41

1. Massed practice and shaping 2. Restraint of less affected UE at home and during therapy 3. Transfer package