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Flashcards in Phys Dys midterm Deck (28)
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Modified Ashworth Scale

This clinical measure of muscle spasticity uses an ordinal scale that ranges from 0 (noincrease in tone) to 5 (rigid)



Assesment of motor and process skills

Purpose:This instrument is designed to measure the quality of performance in basic and instrumental activities of daily living, to assist in planning intervention, and to compare with reevaluation results to determine the success of intervention.

Population:Children over the developmental age of 3 years, adolescents, adults, and older persons for whom ADL task performance is a concern

A trained examiner evaluates the quality of ADL/instrumental ADL (IADL)performance, which is assessed by rating effort, efficiency, safety, and independence in 16 motor (e.g.,walk, reach, lift, transport) and 20 process (e.g. choose, use, sequence, accommodate) skill items.


Box and block test

Purpose:This test assesses unilateral gross manual dexterity in adults and children to determine functional levels of the upper extremity in people with disability compared with those without disability.

Population:Adults age 20 to 75 and older, with or without disabilities;

Description:Beginning with the dominant hand, the subject is instructed to quickly move blocks from one side of the box to the other, placing them after passing over the center divider. After a 15-second trial, the subject is allowed 1 minute for transferring blocks


Nine hole peg test

Purpose:This tool is used to measure unilateral finger dexterity to determine the extent of fine motor impairment in people experiencing difficulties with functional performance.

Population:Children and adolescents age 4 to 19 (sample consisted of 406 subjects); adults age 20 to 94

Description: With pegboard in position, pegs are placed off to the side being assessed, in close proximity to the board.The subject is read standardized instructions (Mathiowetz et al., 1985) toput pegs into the board as quickly as possible and then remove them.Time is recorded in seconds.



6 domains

lowenstein occupational therapy cognitive assesment

Purpose:The LOTCA was developed to detect cognitive impairment, establish a baseline, and identify people needing a detailed assessment of cognitive functioning.The LOTCA-G is a version of the LOTCA designed for older adults.

Population:Adults with acquired brain injury including stroke and progressive neurological conditions, including dementia

6 subscales grouped into six domains: Orientation,Visual Perception, Spatial Perception, Praxis, Visual motor Organization, and Thinking Operations.


Bedside swallowing assesment

To provide data useful in diagnosis and treatment planning

Establishes if dysphagia is present: Is there likelihood that dysphagia exists?
Evaluates and determines severity: Does the patient requires referral for further swallowing assessment


Sensory testing

11 assesments

pain discrimination (sharp and dull)
2 point discrimination
light touch
temperature (hot and cold)
stereognosis test cortical sensory functions extroceptive and proprioceptive input should be intact
Grasphethesia- with eyes close identify letters and number written on the skin
Joint position in space
Double simultaneous testing
deep pressure


Finger to nose test

Used to test for cerebellar disease deficits in balance, coordination, muscle tone


Diadochokinesia test

alternating or rapid movement in both extremities to asses motor function.

Population: individuals with cerebellar lesions, used for individuals with speech disorder


Volitional movement

test to select, plan, and initiate motor movement

Population individuals with praxis defecits
apraxia, dyspraxia and difficult motor sequencing


Primary visual screening

2 main test

A visual field test is an eye examination that can detect dysfunction in central and peripheral vision which may be caused by various medical conditions such as glaucoma, stroke, brain tumours or other neurological deficits.

Visual discrimination-test of visual perceptual
accuracy can your eyes follow specific movements of fingers in shapes, number, switching eye movements from one hand to another


edema assesment

pitting edema

test indentation when finger is pressed to skin
no indentation
slight indentation
deep indentation
indentation of 30 seconds or more


The motor system is part of what system? it is involved in what? and consist of what?

The motor system is the part of the central nervous system that is involved with movement. It consists of the pyramidal and extrapyramidal system.


The sensory system is part of what system and consist of what?

The sensory system is a part of the nervous system responsible for processing sensory information. A sensory system consists of sensory receptors, neural pathways, and parts of the brain involved in sensory perception


What is the motor pathway called?
Where are the upper and lower motor neurons located?

The motor pathway also called pyramidal tract or the corticospinal tract start in the motor center of the cerebral cortex. There are upper and lower motor neurons in the corticospinal tract.


Where do motor impulses come from?
How does the origin of the motor system affect how we see movement?

The motor impulses originates in the Giant pyramidal cells or Betz cells of the motor area i.e precentral gyrus of cerebral cortex.


This system is responsible for what?
Commonly recognized sensory systems are what?

responsible for processing sensory information. A sensory system consists of sensory receptors, neural pathways, and parts of the brain involved in sensory perception


The sematomotor sensory system is what?
In general sensory systems are what

Commonly recognized sensory systems are those for vision, hearing, somatic sensation (touch), taste and olfaction (smell). In short, senses are transducers from the physical world to the realm of the mind.


Reflex theory

Reflexes work together or in sequence to achieve a common purpose

With the whole CNS intact, the reaction of various parts of that system, the simple reflexes combined into greater actions that constitute the behavior of the individuals as a whole


Hierarchial theory

Hierarchial models 4

Organizations control that is top down. That is, each successively higher level exerts control over the level below it.

Movement therapy



Assumptions and principles


Strives to appropriately and adequately stress the CNS and muscular systems such that an individual creates, maintains, and reinforces the sensorimotor pathways to enable efficient motor control in their desired environment

Assumption and principles
Normalization of postural tone (prereq for movement)
Postural reactions are considered the basis for control of movement
Normalization of movement patterns
Integration of both sides of the body
Establishment of wt-bearing and wt- shifting through the limbs
Inhibit abnormal tone

Observes of axial alignment, posture and trunk control
Evaluates of abnormal tone
Evaluates reactions to situations, balance and movements equilibrium and rightiing reactions



Believes that sensory stimuli can facilitate an adaptive motor response. Stimuli must be goal-oriented

Controlled sensory stimuli will illicit a motor response
Activity demand is purposeful and goal directed
Facilitation and inhibitory techniques can change tone

Asses muscle tone
sensory system
determine the level of motor control



A multi sensory approach that uses proprioceptive input and movement in diagonal patterns to facilitate functional movement.

Neuromuscular mechanisms can be hastened through stimulation of proprioceptors
The human system moves in diagonal patterns (D1 and D2)
Frequency of stimulation and repetitive activity is used to promote and retain motor learning

Developmental sequence
vital functions
Head and neck patterns
Developmental postures


Movement therapy

Brunnstrum theory

Believes that the recovery process post stroke involves the development of synergistic patterns. Focuses on the synergistic patterns of movement

SC and brain stem reflexes become modified and their components rearrange into purposeful movement
Reflexes and primitive movements are used to facilitate recovery of voluntary movement
Movement is elicited by use of associated reactions and tactile stimulation

Sensory evaluation
Limb classification according to levels of motor recovery
Level of voluntary motor control
Trunk movement


Motor programming theories

Examines the physiology of actions rather than reactions

If we remove the motor response from its stimulus, we are left with a concept of central motor pattern.


Motor relearning approaches


Training are based on current research and knowledge of the motor behavior
Reject assumptions of the reflex-hierarchical model
Includes remediation of client factors and environmental modifications to improve tasks


How PEO and CTO Can Work Together

and components of CTO

Occupational therapy focuses on complex dynamic relationships between people, occupations and environments

Task performance emerges from the interaction of multiple systems, including personal and performance contexts

Contemporary approaches to treating motor dysfunction incorporate principles of motor learning during intervention, and focus on remediating motor control in persons with CNS dysfunction


Systems of tactile

Protective and discriminative system

Protective Tactile System (spinothalamic system) pain, light touch, vibration, deep pressure, hot and cold
Discriminative Tactile System (medial lemniscal system) stereognosis, localization, finger identification, graphesthesia, position sense, kinesthesia (includes cortical sensory functioning)