Week 1 Exam Questions

Question 1

what is salience

Answer 1

the brain will pay attention to what is important!

Question 2

can we say things are weak after a stroke

Answer 2

no, because there is nothing wrong with the muscles, it is really an issue with activation and initiation and coordination, meaning that there is an issue in the network. We must increase motor firing rates

Question 3

why does a decrease in torque production after stroke matter

Answer 3

the decrease in torque is from with a decreased speed of production, or because the muscle is at a shortened length. We must train people at that shortened length and train speed and power after a stroke

Question 4

what is spasticity

Answer 4

velocity dependent hypertonicity. We have it when it is on one side of the joint, and there is resistance to externally imposed moments.

Question 5

what is the controversy around spasticity

Answer 5

spasticity is often described as a movement disorder, but we test this is a static resting position. so how can we assume there is disordered movement if we do not test it while moving

Question 6

after a stroke what must we manipulate to get normal movement

Answer 6

task, environment or the person ( we can make the environment more or less challenging, we can decrease the DOF, we can also increase their capacity to move by strengthening or practice)

Question 7

what is recovery

Answer 7

permanent changes in organizations and structure and getting back what was lost

Question 8

is the goal recovery or compensation

Answer 8

recovery: restore the function of tissue, and get them back to premorbid levels

Question 9

what is compensation

Answer 9

something we self teach, and something we did not have before the injury. doing something old in a new way and using alternative parts

Question 10

what is learned non use

Answer 10

comenation! we learn to not use one side, and figure out a way to do the task in a different way

Question 11

what may be the primary reason that a motor deficit still remains

Answer 11

compensation, they have learned to not use it.

Question 12

what is positive and what is negative neuroplasticity

Answer 12

positive: recovery
negative: compensation

Question 13

what category does restoration, recruitment and retraining fall under, compensation or recovery

Answer 13

restoration is recovery

recruitment and retraining are compensation

Question 14

what is a reversal of diaschisis

Answer 14

the spontaneous recovery, think about spinal shock. we get a sudden loss of function, and then we get it back with or without treatment

Question 15

how do we get neuroanatomical reorganization

Answer 15

changing neural networks, altering NT levels, branching, sprouting, neurogenesis

Question 16

neuroplasticity definition

Answer 16

brain can adapt, but changes function and structure of neurons, an growing new neurons, and reorganizing them. reorganize networks, and representations, and access latent circuits

Question 17

for a therapist, what does neuroplasticity mean

Answer 17

that there is a way to train the brain to perform old functions

Question 18

what are the structural and functional mechanisms of neuroplasticity

Answer 18

functional: increasing activity, excitability, and postsynaptic potential.
structural: more connections, axon growth, receptor density

Question 19

what are some examples of non synaptic neuroplasticity

Answer 19

changing the number of ion channels, increasing responsiveness of synaptic inputs.

Question 20

what happens when we rely on the less-affected limb, to reorganization

Answer 20

there is growth in the non-affected hemisphere, which we do not want. this is maladaptive, and can hurt our chances of changing the affected hemisphere.

Question 21

with learning dependent plasticity, what leads to the rewiring of the motor cortex

Answer 21

skill learning!

Question 22

what is an important stimulant for neuroplastic change

Answer 22

task specific motor learning

Question 23

what is our best hope for brain remodeling.

Answer 23

learning

Question 24

when someone has many concussions, and learning is impaired what does this mean for neuroplasticity

Answer 24

there is a decrease in plasticity. bottom line, brain injury interferes with learning

Question 25

recovery is a ___ process

Answer 25

relearning

Question 26

which leads to increased number of synapses in motor cortex? motor learning or activity

Answer 26

learning.

Question 27

TF: the brain does not rely on the same neurobiological processes it used to acquire a skill initially

Answer 27

false, it does rely on the same

Question 28

what should our first therapeutic effort be

Answer 28

to recover those specific behaviors that were disrupted by the brain injury

Question 29

in cat and rat experiments, what can we say is good for recovery

Answer 29

task specific and high reps, and a good intensity.

Question 30

what two things make therapy effective

Answer 30

intensive therapy and task specificity

Question 31

what are some characteristics of a task that are important for plasticity

Answer 31

complexity, intensity, specificity, sensory experience (like an enriched environment)

Question 32

what are the 10 principles of experience dependent plasticity

Answer 32

1. use it or lose it 2. use and improve 3. specificity 4. repetition matters 5. intensity matters 6. time matters 7. salience 8. age matters 9. transferene 10. interference.

Question 33

what kind of environment do we want

Answer 33

a complex one, and an enriched one

Question 34

is CIMT therapy beneficial to motor learning

Answer 34

yes, constraining the good limb and focusing attention on the bad one is a good way to treat and get results

Question 35

TF: exercise dose in the first matters after a stroke

Answer 35

true

Question 36

TF: speed of the exercise matters

Answer 36

true

Question 37

what are some components of intensity

Answer 37

reps, sets, time, RPE, environments, distractions, load, cardio response, challenge

Question 38

what is the FITT principle

Answer 38

frequency is the number of days a week intensity: lets say the weight to do 8-10 reps time: lets say each set takes 30 seconds, do it in a 30 minute timeframe type: the gym equipment we use

Question 39

TF: we can continue to improve patients if they have reached a plateau with changing the intensity

Answer 39

true, the more intense, we can still see results

Question 40

TF: the study with walking and steps, by changing the dose and increasing the number of steps a lot shows a larger response

Answer 40

true

Question 41

what are some important things for practice

Answer 41

challenging, motivating,

Question 42

what are some characteristics of a skilled clinician

Answer 42

``` listen will patient centered always changing hypothesis thinking about what the patient is saying hypothesis early on ```

Question 43

what does skilled decision making incorporate

Answer 43

``` goals prevention and optimizing health patient centered holistic evidence based carryover to Home ```

Question 44

what are the 5 conditions we look at before we get to the outcomes

Answer 44

``` initial conditions (posture, enviro) preparation (what do they do before?) initiation (timing, direction and smooth) execution (amplitude, speed, smooth) and termination (timing, stability) ```

Question 45

what did animal models show us

Answer 45

that high reps are great

Question 46

what do the AHA/ASA guidelines say about stroke rehab

Answer 46

it takes a big team and communication

Question 47

TF: dose and duration and intensity matters

Answer 47

true

Question 48

what two things make therapy effective

Answer 48

intensity and task specific

Question 49

if patients plateau, is there anything we can do

Answer 49

yes! change the dose, have them walk more, and get them going!

Question 50

what does an enhanced environment do for people

Answer 50

motivates them more, and lies likely to be alone and inactive

Question 51

TF: 50% of patients stay in bed

Answer 51

true

Question 52

TF: people are alone 60% of the day, and 30% stay in bed with no activity

Answer 52

true

Question 53

TF: functional capacity appears to affect therapeutic activity

Answer 53

false, there is no correlation between mild, moderate or severe in jury with activity levels

Question 54

what was the average treatment time for treatment in a 60 minute session

Answer 54

averaged 36 minutes

Question 55

how many reps were patents getting in UE and LE? steps?

Answer 55

12 and 8 | less than 300 steps

Question 56

TF: functional UE movements happened in all sessions

Answer 56

false, only in 50%

Question 57

TF: differences in the amount of practice were correlated to age, patient level of function and therapist experience

Answer 57

false

Question 58

how many minutes were patients at their target HR zone

Answer 58

2.8 minutes

Question 59

are we doing enough for neuroplasticity

Answer 59

no