Week 9 (parts 1 and 2)

Question 1

part 1

Answer 1

introduction to reflexes

Question 2

what is a reflex

Answer 2

instinctive/ involuntary reaction to danger

Question 3

why do we need reflexes

Answer 3

protect areas of your body

Question 4

what types of reflexes are there

Answer 4

involuntary, deep tendon reflex

Question 5

why do we test reflexes

Answer 5

to differentiate between the CNS and PNS

Question 6

what is the deep tendon reflex

Answer 6

 The myotatic or muscle stretch reflexes (sometimes known as deep tendon reflexes) provide information on the integrity of the central nervous system and peripheral nervous system. This information can be detected using electromyography (EMG).[8] Generally, decreased reflexes indicate a peripheral problem, and lively or exaggerated reflexes a central one.[8] A stretch reflex is the contraction of a muscle in response to its lengthwise stretch.
* Biceps reflex (C5, C6)
* Brachioradialis reflex (C5, C6, C7)
* Triceps reflex (C6, C7, C8)
* Patellar reflex or knee-jerk reflex (L2, L3, L4)
* Ankle jerk reflex (Achilles reflex) (S1, S2)

Question 7

what are examples of superficial reflexes

Answer 7

Corneal reflex, Conjuctival reflex, Pharyngeal reflex, Scapular reflex, Abdominal reflex, Cremasteric reflex, Bulbocavernous reflex, Anal reflex, Plantar reflex

Question 8

what are some reflexes involving the cranial nerves

Answer 8

Pupillary light reflex, Accommodation reflex, Jaw jerk reflex, Corneal (blink) reflex, Glabellar reflex, Vestibulo-ocular reflex, Gag reflex

Question 9

what are primitive reflexes (+examples)

Answer 9

 Newborn babies have a number of other reflexes which are not seen in adults, referred to as primitive reflexes. These automatic reactions to stimuli enable infants to respond to the environment before any learning has taken place. They include:
* Asymmetrical tonic neck reflex
* Palmomental reflex
* Moro reflex, also known as the startle reflex
* Palmar grasp reflex
* Rooting reflex
* Sucking reflex
* Symmetrical tonic neck reflex
* Tonic labyrinthine reflex

Question 10

why do we test reflexes in neuro physiotherapy

Answer 10

 We primarily test reflexes in neurology to help differentiate between lesions of the CNS and Peripheral.
 Therefore they help us to see if there is an UMN lesion or LMN lesion.
Please remember that a patient may have several pathologies happening simultaneously though, so reflexes are looked at with the patients history and other physical signs/symptoms along with any specific diagnostic tests

Question 11

part 2

Answer 11

outcome measure (Neuro)

Question 12

what is an outcome measures

Answer 12

 “An outcome measure is a measure of change, the difference from one point in time (usually before intervention) to another point in time (usually after an intervention)” (Kendall 1997)”

 A physical therapy outcome measure is “a test or scale administered and interpreted by physical therapists that has been shown to measure accurately a particular attribute of interest to patients and therapists and is expected to be influenced by intervention” (Cole 1994, based on Mayo 1994)”
 Outcome Measures are part of your wider patient assessment. They do not replace assessment. These tools contribute to ‘aspects of practice’ (Lennon, 2018)

Question 13

why do we use outcome measures

Answer 13

 Tools can support and inform clinical judgement
 Enables a clinician to be clear regarding a patient’s problem, plan appropriate goals and treatment
 Measures can support team communication
 Can monitor a patient’s progress (objectively)
 Can support planning and decision making

Question 14

what is the WHO ICF

Answer 14

 International Classification of Functioning, Disability and Health.
 Dysfunction of body functions or structure (impairment)
 Activity limitations
 Participation

Question 15

what can you treat/ improve in neuro rehabilitation for body structures and functions

Answer 15

Body Functions & Structure:
- Balance
-Tone
-Weakness/ strength
-Pain
-Range of movement
-Fatigue
-Ataxia
-subluxation
-walking - step length etc

Question 16

what can you treat/ improve in neuro rehabilitation for activities

Answer 16

• Reaching and grasping
• on/ off the toilet
• transferring, standing, rolling
• outdoor mobility

Question 17

what can you treat/ improve in neuro rehabilitation for participation

Answer 17

• Hobbies
• employment

Question 18

how is reliability defined

Answer 18

are the results consistent when used in consistent conditions?

Question 19

what is test-retest reliability (Intrarater reliability)

Answer 19

Test-retest reliability provides information about the extent to which the same results are gained on repeated use of the outcome instrument over time, when no change is expected (Beatie 2001, Simmons et al 1999).

Question 20

what interrater reliability

Answer 20

where the same patient is measured over time, by two different physiotherapists

Question 21

what is validity

Answer 21

Validity provides evidence that an outcome instrument measures what it is supposed to measure (Andresen 2000, Bowling 1997).

Question 22

what should you consider about the process of performing an outcome measure

Answer 22

 Equipment Required
 Preparation of the clinical environment
 Instructions for the therapist / Instructions for the Patient
 How do you score the results
 Evaluate