Neuro peds UE training and strengthening

Question 1

what is the difference btwn learned non-use and developmental disregard?

Answer 1

learned non-use we see a lot in the adult population after stroke

Developmental disregard: peds patients because they haven’t even had the chance to develop it yet

Question 2

throughout development connections are pruned off, what happens when you have a lesion?

Answer 2

your brain has to rewire the existing synapses, this wont happen if you wont use it!

Question 3

what is the difference btwn forced use and CIT (constraint induced therapy)?

Answer 3

forced is is they just go home with a cast and they go throughout their day, its not therapeutic in nature.

CIT: intense therapy

Question 4

true or false: all models of CIT have shown improvement in UE function

Answer 4

true!

Question 5

what is the big pro of HABIT?

Answer 5

younger kids being able to learn to use both hands together, its the PRACTICE that matters

Question 6

did CIT or HABIT have improved grasp?

Answer 6

CIT

Question 7

what are the four key components to neuromotor recovery?

Answer 7

repetition

shaping

functional practice

behavior change

Question 8

what is shaping

Answer 8

individualized tasks to work on specific movements

Question 9

signature CIT how much % of waking hours is it worn

intense training for how many hours a day for 2 weeks

Answer 9

90%

intense training for 3 hours EVERYDAY for at least 2 weeks

Question 10

how many hours a day and days a week is the restraint worn for modified CIT?

Answer 10

5 hours a day
5 days a week

intense training 2 hours a day 3x a week

Question 11

brushing teeth and opening baggies vs. stacking blocks or placing push pins

Answer 11

functional practice

vs.

shaping

Question 12

critical piece of UE training she said

Answer 12

behavior change!! can make a behavior contract

Question 13

what creates gains 2.4 x higher than if you don’t use it

Answer 13

behavior contracts/going through life everyday as practice

Question 14

Saeboflex would be used for what population

Answer 14

someone who has a lot of spasticity impeding function

Question 15

reoGO is what kind of device

Answer 15

robotic: can give different things depending on what they need

Question 16

what does physiological flexion allow infants

Answer 16

mechanically stable base; they constantly practice active movement which builds trunk and proximal limb strength which you need before distal mobility

Question 17

in atypical development what does an infants posturing normally look like

Answer 17

hips, knees, elbows extended

Question 18

in atypical development when children are extended what does this do to the proximal muscles?

Answer 18

they are at a mechanical disadvantage to initiate movement.

Question 19

which is normal development: repetitive movement or no movement?

Answer 19

repetitive: leads to increased strength and better control

Question 20

which is normal development: more movement patterns or less?

Answer 20

more! atypically developing kids have.a limited number of movement patterns they can use

Question 21

large arcs of motion vs. ballistic patterns, which is normal development?

Answer 21

large arcs of motion: allows strengthening with more degrees of freedom

Question 22

which is normal development: practice of components or no practice?

Answer 22

practice of components: they go through smaller trials of movements

Question 23

reciprocal inhibition is normal or not?

Answer 23

it is normal, you need to be able to shut off muscles to do certain movements

atypically developing children have decreased reciprocal inhibition therefore increased co-contraction

Question 24

what 2 things are normally weak in the trunk area and what are the issues with these things

Answer 24

spinal extensors: can’t move against gravity and creates hypermobility at joint junctions

abdominals; impacts breathing!

Question 25

what are the three common problem muscles in the hip and what is the impact of this

Answer 25

extensors: not enough strength to gain full range flexors: shortened hip ABD; moment arm disadvantage due to muscle size

Question 26

Match the following distal proximal elongation shortening talking about the patella and rectus

Answer 26

distal elongation of patella tendon proximal shortening of the rectus

Question 27

match the following distal proximal elongation shortening talking bout the hamstrings

Answer 27

distal shortening: med

Question 28

no foot to mouth play due to extended posturing and no supported bouncing lead to what weaknesss?

Answer 28

DF and PF

Question 29

true or false: strength training was previously thought to be contraindicated for children with neurologic conditions

Answer 29

true! especially those with hypertonicity they believed that poor motor control precluded performance of strength training exercises

Question 30

true or false: isolated motor control is a prerequisite for participation in strength training programs

Answer 30

false! we now kids with CP we can strengthen

Question 31

is strength training a new idea in neurologic population!

Answer 31

nope we know its going to work for a long time now

Question 32

how do you chose which muscles to target?

Answer 32

base it on your examination, interview the patient and family and find out what is the most important for them!

Question 33

Name the four muscles typically strengthened for CP

Answer 33

quads glutes abdominals extensors

Question 34

``` whats the deal with strengthening gastroc hamstrings hip ABD DF ```

Answer 34

theyre difficult to isolate for desired motion may require NMES or FES intervention

Question 35

what is the ideal % for OC exercise what about CC exercise

Answer 35

65% 50 to 100% more

Question 36

how do you progress the training load?

Answer 36

retest MVIC every 2 weeks

Question 37

whats the rule if you don't have a HHD for OC exercises how do you check if you're right

Answer 37

double or triple what you're thinking with this weight strapped on see if they can ACTIVELY move through 50% of their ROM

Question 38

what are some things to think about when doing CC exersises

Answer 38

maximize technique and alignment first, move through shorter ROM if needed

Question 39

what is the dosage for these kids. reps sets rest

Answer 39

5-8 reps 5-6 sets 90-120 sec rest: THINK FIVE SETS OF FIVE they need a lot more rest! can be just the other side working

Question 40

what is the deal with frequency for these kids

Answer 40

3-5days a week 2 days rest between is optimal! Back to back days is seen to be just as effective as training once a week

Question 41

open chain non functional exercises use distal or proximal load placement?

Answer 41

distal!

Question 42

open chain functional exercises use distal or proximal load?

Answer 42

proximal! their bodies are already heavy enough, put it on their proximal muscles

Question 43

what does the theraband provide that cuff weight does not

Answer 43

graded resistance

Question 44

any closed chain exercise where do you want the load, distal or proximal?

Answer 44

Proximal

Question 45

for closed chain exercise you are trying to maintain sagittal plane alignment, who is this super important for?

Answer 45

super important for skeletally immature population

Question 46

what is super important for these kids HEP

Answer 46

one exercises a week, work up to 6-8