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Neuromuscular PT 1 > Neuroplasticity (lab) > Flashcards

Neuroplasticity (lab) Flashcards

1
Q

cognitive reserve

A

strucutral changes that support cognitive functioning

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2
Q

Positive neuroplasticity

A
  • structural changes in the brain that occur during novel and challenging stimuli
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3
Q

Negative neuroplasticity

A

changes in the brain that occur if one experiences a lack of novel, challenging stimuli and diminished health

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4
Q

Recovery after brain injury

types

A
  • spontaneous: results from repair processes post lesion
  • function-induced: occurs due to increase use of involved body segments in behaviorally relevant tasks
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5
Q

Recovery vs compensation approaches to treatment

A
  • bottom up approach emphasizes practice of desired skills to drive motor recovery of walking and UE functional use for ADLs
  • top-down approach involved teaching new compensatory strategies, requiring development of new skills
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6
Q

What are the 10 principles of experience-dependent plasticity

A
  1. Use it or lose it
  2. use it and improve it
  3. specificity
  4. repetition matters
  5. intensity matters
  6. time matters best neuroplasticity is right after event
  7. salience matters
  8. age matters
  9. transference: transfer skills from one activity to another
  10. interference: tauhg something in one context and no transfered in another
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7
Q

mechanism accounting for superior plasticicty in children

A
  • persistence of neurogenesis in certain parts of brain during postnatal period
  • elimination of neurons through apoptosis
  • proliferation and runing of synpases
  • activity dependent refinement of synpatic connections
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8
Q

types of pediatric brain plasticity

A
  • impaired plasticity
  • excessive plasticity
  • brain’s achilles hell plasticity
  • adaptive plasticity
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9
Q

Imparied plasticity

A
  • genetic or acquired disorders disrupt plasticity pathways (changes in structures, synpases, NTs) and cause cognitive developmental disorders
  • fragile X syndrome
  • neurofibromatoisis 1
  • tuberous sclerosis
  • lead poisioning
  • rett syndrome
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10
Q

excessive plasticity

A
  • leads to maladaptive brain circuits
  • dystonia and rigidity following perinatal injury is related to an imbalance in NT systems that occurs with cortical reorganization in infants
  • temporal lobe epilespy: too musch activity in temporal lobe
  • Mesial temporal sclerosis: scarring within temporal lobe may be cause or result to TLE
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11
Q

Plasticity as the brains achilles tendon

A
  • areas of the brain that are rich in excitatory synpases
  • including thalamus
  • basal ganlia
  • cortex
  • are vulnerable to acute near total asphyxia in term infants
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12
Q

adaptive plasticity

A
  • activity-dependent changes in synpases and neuronal connections
  • assoicated with acquisition of new motor skills
  • learning a language or playing an instrument or sport
  • also occurs during recovery from an injury or sensory loss

ex:

  • eye patching for amblyopia(lazy eye)
  • cochlear implants for hearing loss
  • hemispherectomy for intractable seziures
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13
Q

Neuroplasticity- based training and technologies

A
  • CIMT and mCIMT
  • microchips
  • robotics
  • virtual reality
  • functional UE orthoses
  • AFOs and LE FES
  • locomotor training
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14
Q

CIMT: constraint induced movement therapy

A
  • functionally oriented task practice of affected UE and long periods of restraint of unaffected UE
  • goal of treatment is pt based no therapist driven
  • patients with excessive spasticity or pain in involved UE are exlcuded
  • wear the mit for 23 hr/day
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15
Q

CIMT: inclusion criteria

A
  • ≥10º of active finger extension and ≥20ºof active wrist extension
  • ≥3 months p/CVA nad ambulate without a device
  • score ≥ 69 on modified mini mental status examination
  • score < 2.5 on motor activity log
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16
Q

CIMT: contraindications

A
  • any indication that treatment approach would adversely affect safety
  • fractures, significant musculoskeletal deformities or bursn in involved UE
  • cognitive deficits that would compromise safety or interfere with HEP compliance
17
Q

modified CIMT (mCIMT)

A
  • this protocol decreases wearing of constraints device frm 23 hours/da 7 days/week to 6 hours/5days a week during active times of day while at home
  • patients also participate in outpatient therapy 3days/week for 1hr/day
  • therapy consists of therapeutic activities, provided 1:1 and in group setting, designed to improve use of more involved arm and hand
18
Q

AFO: ankle foot orthosis

A
  • address foot drop and stance-phase stability
  • limit ankle excursion, may decrease muscle activation and dynamic balance
  • may limit transfers and be uncomfortable
19
Q

functional electrical stimulation (FES)

A
  • alternative to AFO for foot drop due to UMN damage
  • orthotic effect uring use; potential therapeutic effects after withdrawn
  • pain may limit ability to achieve adequate DF for swing
  • may be less effective if medial/lateral ankle instability is present
  • set up complex, reimbursement limited
20
Q

CPG for use of AFO and FES post stroke

A
  • strong evidence that AFO and FES can increase gait speend, mobility and dynamic balance
  • moderate evidence that AFO and FES increase QOL, endurance and muscles activiation
  • weak evidence for improving kinematics
  • AFO may lead to more compensatory effects while FES may lead to more therapeutic effects
21
Q

body weight support treadmill training

A
  • BSW harness allows a progressive increase in demands for postural control
  • treadmill enables systematic control and progression of gait speed
  • repetitive training of a complete gait cycle enables a more appropriate pattern of sensory input assoicated with the difference pahses of gait to stimulate the locomotor pattern
22
Q

Locomotor training CPG

A

clinicians SHOULD preform

  • walking training at moderate to high aerobic intensity
  • walking training with virtual realtiy

Clinicians MAY consider:

  • strength training at ≥ 70% 1 rep max
  • circuit training cycling or recumbent stepping at 75085% HRmax
  • balance training with virtual realtiy

clinicians SHOULD NOT preform:

  • static or dynamic balance activities including pre-gait
  • BWST with emphasis on kinematics
  • robot-assisted gait training
23
Q

locomotor training and neuroplasticity

A
  • use it or lose it
  • use it or improve it
  • specificity
  • repetition matters
  • intensity matters
  • salience matters
  • transference
24
Q

other uses for harness systems

A
  • pre-gait
  • ball exercises
  • balance activityes
  • transfers
  • UE activities in standing
  • sidestepping and backward amb.
  • crawling

Neuromuscular PT 1 (32 decks)

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