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NPTAE Neuro > Neuromuscular Theories of Rehabilitation > Flashcards

Neuromuscular Theories of Rehabilitation Flashcards

1
Q

Bobath: Neuromusclular Developmental Treatment (NDT)

A

based on hierarchical model of disfunction
abnormal postural reflex activity/ muscle tone caused by loss of CNS control @ brainstem/spinal cord
recognizes abnormal function of CNS = slowing/cessation of motor development, inhibited righting/equilibrium reactions, automatic movements
**pts should learn to control movement via normal movement patterns that integrate functionality

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2
Q

NDT Postural Control Assupmptions

A

Can be learned/modified w/ experience
Uses both feedback & feed-forward mechanisms to perform tasks
Initiated from pt’s base of support
Required for skill development
Develops by assuming progressive positions that increase distance b/w CoG and BoS (BoS should also decrease)

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3
Q

NDT Intervention Constructs

A

Inhibit abnormal patterns w/ simultaneous facilitation of normal patterns
Alter abnormal tone & influence isolated active movement
Use manual contact/handing through key points of control for facilitation/inhibition
Achieve balance b/w muscle groups during interventions
Use developmental sequence, dynamic reflex inhibiting patterns, functional activities w/ varying difficulties
Emphasize rotation
Provide sensation of normal movement by inhibiting abnormal postural reflexes
Tx should be active/dynamic w/emphasis on function
Orient pt to midline control by moving in/out of midline w/dynamic activity
Belief that compensation techniques are unnecessary/should be avoided

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4
Q

Brunnstrom Movement Therapy in Hemiplegia

A

created/defined “synergy,” encouraged use of synergistic patterns during rehab immediately, then develop combos of patterns outside of syngery
synergies = primitive patterns occurring @ spinal level as result of hierarchical organization of CNS
**research now says synergies are very hard to change, use discouraged in therapy

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5
Q

Brunnstrom’s 7 Stages of Recovery

A

1: no lateral movement
2: appearance of basic limb synergies, beginning of spasticity
3: synergies performed voluntarily, spasticity increases
4: spasticity begins to decrease, movement patterns not dictated solely by limb synergies
5: further decrease in spasticity w/ independence from synergistic patterns
6: isolated joint movement performed w/ coordination
7: normal motor function restored

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6
Q

Homolateral Synkinesis

A

flexion pattern of involved UE facilitates flexion in involved LE

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7
Q

Limb Synergies

A

group of muscles that produce predictable pattern of movement in flex/ext patterns

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8
Q

Raimiste’s Phenomenon

A

involved LE AB/ADDucts w/applied resistance to uninvolved LE in same direction

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9
Q

Souque’s Phenomenon

A

raising involved UE above 100˚ w/ elbow ext produces ext and ABduction of fingers

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10
Q

Proprioceptive Neuromuscular Facilitation (PNF)

A

based on idea that stronger body parts are used to stimulate/strengthen weaker ones
Normal posture= balancing agonist and antagonist muscle groups, development follow normal sequence
places great emphasis on correct manual contacts/handling w/ short verbal commands+resistance through full movement of pattern
should promote response of neuro mechanism through stimulation of proprioceptors
movement follows diagonal/spirals (flex/ext/rotation) directed towards/away from midline

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11
Q

PNF Constructs

A

pt learns diagonal patterns of movement
must have accurate timing/ specific commands/ correct hand placement
verbal cues must be concise
repetition is important for motor learning
resistance given is greater to develop stability, less to develop mobility
techniques should use isometric/isotonic contractions
Tx objective dictate use of techniques through either full movement/ @points w/in range
used in conjunction w/ developmental sequence to increase balance between agonists/antagonists
implemented to progress pt through stages of motor control
functional patterns used to increase control
should increase strength/relaxation by enhancing overflow from stronger muscles to weaker ones

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12
Q

PNF Pattern: Scapula

A

D1 Flex: elevation, ABduction, Upward rotation
D1 Ext: ext, ADDuction, downward rotation

D2Flex: elevation, ADduction, upward rotation
D2 Ext: depression, ABduction, down rotation

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13
Q

PNF Pattern: Shoulder

A

D1 Flex: flex, ADduction, LAT rotation
D1 Ext: ext, ABduction, MED rotation

D2Flex: flex, ABduct, LAT rotation
D2Ext: ext, Adduct, MED rotation

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14
Q

PNF Pattern: Elbow

A

D1 Flex: flex/ext
D1 Ext: flex/ext

D2 Flex: flex/ext
D2 Ext: flex/ext

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15
Q

PNF Pattern: RadioUlnar

A

D1 Flex: supination
D1 Ext: pronation

D2 Flex: supination
D2 Ext: pronation

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16
Q

PNF Pattern: Wrist

A

D1 Flex: flex, RAD deviation
D1 Ext: ext, ULN deviation

D2 Flex: ext, RAD deviation
D2 Ext: flex, ULN deviation

17
Q

PNF Pattern: Thumb

A

D1 Flex: ADduct
D1 Ext: ABduct

D2 Flex: extension
D2 Ext: opposition

18
Q

PNF Pattern: Pelvis

A

D1 Flex: protraction
D1 Ext: retraction

D2 Flex: elevation
D2 Ext: depression

19
Q

PNF Pattern: Hip

A

D1 Flex: flex, ADduct, LAT rotation
D1 Ext: ext, ABduct, MED rotation

D2 Flex: flex, ABduct, MED rotation
D2 Ext: ext, ADduct, LAT rotation

20
Q

PNF Pattern: Knee

A

D1 Flex: flex/ext
D1 Ext: flex/ext

D2 Flex: flex/ext
D2 Ext: flex/ext

21
Q

PNF Pattern: Ankle and Toes

A

D1 Flex: dorsiflex, inversion
D1 Ext: plantarflex, eversion

D2 Flex: dorsiflex, eversion
D2 Ext: plantarflex, inversion

22
Q

Rood

A

introduced use of sensorimotor stim to facilitate/inhibit responses
all motor output is result of both past and present sensory input. Tx based on sensorimotor learning. uses developmental sequence of “key patterns” to enhance motor control. Goal = obtain homeostasis in motor output & activate muscles to perform tasks independent of stimuli
Once response is obtained curing Tx, stimulus should be widthdrawn

23
Q

Sensory Stimulation Techniques: Facilitation

A 
Approximation
Joint compression
Icing
Light Touch
Quick Stretch
Resistance
Tapping
Traction
24
Q

Sensory Stimulation Techniques: Inhibition

A

Deep Pressure
Prologued Stretch
Warmth
Prologued Cold

25
Q

Rood Constructs

A

use sensorimotor stim to achieve motor output during Tx
movement considered autonomic, not cognitive
homeostasis is essential
use neutral warmth, maintained pressure, slow rhythmic stroking to calm patient
tactile stim/ environment can influence effects of Tx
exercise must provide proper sensory feedback in order to be therapeutic
belief in stimulation of proprioceptive/ exteroceptive/ vestibular channels of CNS

NPTAE Neuro (21 decks)

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