Neurodegenerative Flashcards by Kaitlyn LaGrow

Akinesia

impairment in voluntary movement and initiation that causes “freezing” especially during gait activities

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Bradykinesia

slowed motor movement

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Dysmetria

decreased coordination of movement

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Fasciculation

observed as a muscle twitch; involuntary muscle contraction and relaxaiton

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Festinating gait

small rapid steps that result in forward tilted head an trunk

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Multiple Sclerosis (MS)

demyelinating disease, own body attacks myelin sheath of brain and spinal cord

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Motor symptoms of MS

ataxia, paralysis, weakness, fatigue, tremors, dysphagia

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Sensory symptoms of MS

paresthesia, vertigo, pain

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Visual symptoms of MS

diplopia, optic neuritis (sudden loss of vision), blurred vision

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Communication symptoms of MS

dysarthria, scanning speech

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Bladder/Bowel symptoms of MS

incontinence, urgency/frequency

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Cognitive symptoms of MS

ST memory, attention, decreased processing, executive functioning, visuospatial ability

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OT eval for MS

pain, medication review, ask questions about dizziness, sensaiton, fine motor skills, fatigue, balance, sleep, etc

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Standardized eval tools for MS

COPM
mod fatigue impact scale
beck depression
9 hole peg/purdue pegboard
semmes weinstein

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PAMs for MS

focal heat to trigger points

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Fatigue management for MS

diary card to monitor activity level
reduce standing
cooling techniques (cooling vest, ice packs)
energy conservation techniques

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Ataxia management for MS

proximal stabilization to improve distal movement
hand over hand techniques (using non-affected UE over hand with tremor when dialing phone)

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T/F: maintaining hip flexion for MS reduces extensor spasms

TRUE
- you can provide stools to reach during LB dressing or bathing

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Parkinson’s Disease

affects production of dopamine, influences speed and accuracy of movement, psoture, cognition, affect, and expression

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Stage 1 PD

unilateral symptoms, no/minimal loss of function

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Stage 2 PD

BL symptoms, balance not affected

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Stage 3 PD

impaired balance/posture, mild-mod ADL impairment

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Stage 4 PD

needs assistance with ADLs

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Stage 5 PD

total dependence for ADLs/mobility

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What type of cues should be used with a pt with PD?

single auditory cues - produce quicker and smoother movement - rhythm also helps

ALS

destroys motor neurons in the brain, spinal cord, and PNS

Initial signs of ALS

weakness of small muscles of the hand or foot drop causing tripping/stumbling

LMN symptoms

muscle atrophy, cramping, twitching

T/F: cognition, sensation, vision, and bladder/bowel are affected with ALS

FALSE

How many stages of ALS are there?

Stage IV ALS

requires WC, some assistance with ADL

Stage V ALS

WC, dependent in ADL

Stage VI ALS

confined to bed, dependent in ADL

Stage I ALS

some weakness, independent in ADLs

Stage II ALS

can walk, moderate weakness

Stage II ALS

can walk, severe weakness

Life expectancy for ALS

1-5 years

OT treatment for ALS

- compensatory - keeping person active and independent for as long as possible

Ideal WC for ALS

high back, recliner, lightweight - power WC as ALS advances

Guillain Barre Syndrome (GBS)

demyelination of axons in peripheral nerves

What phase of GBS is most disabling?

Plateau phase - little or no change in days/weeks

What phase of GBS indicates a significant, if not complete, return to function?

Progressive recovery

T/F: individuals with GBS may experience postural hypotension?

True

Sensory deficits in GBS

hands and legs "glove and stocking" distribution

What is the most frequently reported symptom of GBS?

fatigue

OT role in plateau phase of GBS

- TEMPORARY modifications ex) communication tools, hands-free telephone, positioning

OT role in recovery phase of GBS

resumption of occupations and roles ex) safe mobility, dynamic splinting for ROM, modified techniques for self-care, energy conservation/fatigue management, home assessments

Huntington's Disease (HD)

severe physical and mental disabilities characterized by loss of nerve cells in the brain

HD involuntary movement pattersn

Chorea (rapid, involuntary), akathisia (restlessness), dystonia (abnormal posturing)

HD voluntary movement patterns

Bradykinesia, akinesia (delayed initiation), incoordination

T/F: HD causes difficulty with smaller movements and hand-eye coordination

TRUE

T/F: At the later stages of HD, pt's are unable to talk, walk, and perform BADLs

TRUE

OT Eval tool for HD

Unified HD Rating Scale, assesses motor, cognitive function and functional capacity

OT intervention for early stage of HD

- address memory and concentration (checklists, routines, use of open ended questions) - work sit evals - home mods/safety (reminders to turn off appliances, unbreakable dinner-wear, covered mugs for hot liquid) - support groups

OT intervention in middle stage of HD

- engagement in leisure activity - pt/family education (use simple written cues/words for self care completion, positioning, adaptive equipment) - fatigue management - oral-motor exercises

OT intervention in final stages of HD

- positioning - environmental controls - consistent schedules/routines - smooth transition to tube feeding

Procedural memory

info on how to perform a task (e.g., how to ride a bike) - stays intact with Alzheimer's/Dementia

Topographic orientation

orientation to self within the environment, gets lost easily

Cognitive assistance level: ACL 1 (automatic actions)

totalA

Cognitive assistance level: ACL 2 (postural actions)

maxA

Cognitive assistance level: ACL 3 (manual actions)

modA

Cognitive assistance level: ACL 4 (goal-directed)

minA

Cognitive assistance level: ACL 5 (exploratory actions)

stand-byA

Cognitive assistance level: ACL 6 (planned actions)

independent

At what ACL does a patient: wander, pace, eat finger foods, performs one-step motor patterns, and requires 24hr supervision?

ACL 2 (postural reactions)

At what ACL does a patient: require tactile cues, cannot learn new behaviors, and should perform activities that reinforce predictable tactile effects on the environment (e.g., walking, washing/drying dishes, wiping countertops)

ACL 3 (manual actions)

At what ACL does a patient: no longer problem solve, participate in simple, concrete activities, require visual/tactile cues?

ACL 4 (goal-directed)

At what ACL does a patient: participate in self-initiated motor actions, have difficulty with judgement, reasoning, and planning, and use trial-error learning?

ACL 5 (exploratory actions)