Overview of PT Interventions for People w/ Neurological Dysfxn

Question 1

what is any approach to tx based on

Answer 1

assumptions as to how the CNS works

Question 2

who’re these assumptions explained by

Answer 2

originators of the techniques

Question 3

change in philosophy occurs b/c

Answer 3

interventions are not adequate enough

knowledge of CNS workings change

Question 4

it is best to not be

Answer 4

purist about anything

Question 5

before the 1950s there was

Answer 5

poliomyelitis

Question 6

poliomyelitis was a

Answer 6

LMN dz

Question 7

dominant intervention for poliomyelitis

Answer 7

muscular re-education

w/ the focus on individual muscles

Question 8

why was MMT developed

Answer 8

identify weak muscles and pts were taught specific exercises to strengthen these muscles

Question 9

what was the focus on w/ poliomyelitis

Answer 9

isolating muscles and working on them

Question 10

in the 1950s, hemiplegia and CP were treated as

Answer 10

orthopedic problems w/ bracing and surgery

Question 11

how was polio eliminated

Answer 11

Salk vaccine

Question 12

what didnt work for CNS dysfxns

Answer 12

muscle re-education

since the CNS controls movements through complex integrations and not individual muscles

Question 13

what did PT’s change

Answer 13

their outlook

to focus on the CNS

Question 14

what developed through the 1950s and 1960s

Answer 14

several “neurophysiological” approaches

Question 15

“neurophysiological” approaches

Answer 15

Brunnstrom

Bobath (NDT)

Rood

Question 16

what did John Hughlings Jackson say

Answer 16

the brain controls movements not muscles

Question 17

what did what John Hughlings say imply

Answer 17

that there should be more emphasis on movements patterns

not individual muscles

Question 18

what did all approaches assume

Answer 18

that lesions of particular areas of the CNS will lead to disordered movement patterns

rather than paralysis or weakness

Question 19

all approaches focused on

Answer 19

movement patterns

Question 20

one technique would…while another would…

Answer 20

suppress any kind of pathological response

use that response to facilitate movement

Question 21

what did all the approaches commonly assume

Answer 21

an abnormal movements pattern resulted from the lesion itself

rather than the pt’s attempt to compensate for the lesion

Question 22

how is the CNS organized

Answer 22

hierarchical manner

Question 23

CNS hierarchy

Answer 23

higher center normally in command of lower centers

lower centers in command of primitive and more automatic behaviors

Question 24

what does the CNS hierarchy imply

Answer 24

damage to higher centers (cerebral cortex) leads to release of lower centers from higher control

Question 25

what is the result of this hierarchy

Answer 25

pt fxns at a more primitive level and cannot suppress the automatic movement patterns d/t lack of inhibition by the higher centers

Question 26

pts are...

Answer 26

"locked" into stereotypical movement patterns

Question 27

what should tx be aimed towards

Answer 27

re-establishing inhibitory control by higher centers

Question 28

recovery from brain damage

Answer 28

follows a predictable sequence that mimics normal development of movement during infancy hierarchal organization

Question 29

how were developmental and recovery viewed

Answer 29

progressive control of higher centers over lower centers

Question 30

what has the hierarchal organization led to

Answer 30

idea of developmental sequence to progression of interventions

Question 31

what was overriding the assumption of the neurophysiological approaches

Answer 31

all motor phenomena associated w/ brain damage have a neurophysiological basis

Question 32

what doesnt the overriding assumptions account for

Answer 32

biomechanics mucsle biology behavioral science