Term
|
Definition
| Lack of blood flow by blockage (most common) |
|
|
Term
| Hemorrhagic stroke. Presentation. |
|
Definition
| Rupture that leads to swelling. Presents as worst headache ever. |
|
|
Term
| Why are TIA (transient ischemic attacks)important for PTs? |
|
Definition
| Even though symptoms resolve in 24 hours 35% of TIA have CVA within 5 years. |
|
|
Term
| When do you want to see CVA in rehab? |
|
Definition
| As soon as they are stable (first 72 hours) and rehab for first 3-6 months (most gains) |
|
|
Term
| Which has greater neuroplasticity and why? CP or CVA |
|
Definition
| CP because young children have massive cell division |
|
|
Term
|
Definition
| Muscles that work in conjunction together that produce coordinated movement |
|
|
Term
| UE flexion synergy and the strongest component |
|
Definition
GH ext rot
GH abduction to 90
Forearm supination
wrist and finger flexion
STRONG COMPONENT: ELBOW FLEXION |
|
|
Term
| UE extension synergy and strong components |
|
Definition
Shoulder girdle protraction
Elbow extension
Wrist extension or flexion
STRONG COMPONENTS:
GH internal rotation
GH adduction
Forearm pronation |
|
|
Term
| LE flexion synergy and strong component |
|
Definition
Hip external rotation
Hip abduction
Knee flexion
Ankle DF/inversion
STRONG COMPONENT: Hip flexion |
|
|
Term
| LE extension synergy and strong component |
|
Definition
Hip extension
Hip internal rotation
Hip adduction
Ankle PF/eversion
Strong component: Knee extension |
|
|
Term
| Most common UE and LE synergy patterns |
|
Definition
UE is flexor
LE is extensor |
|
|
Term
|
Definition
| Voluntary forceful movements produce involuntary movements in affected extremity |
|
|
Term
| UE associated reaction and stimulus |
|
Definition
Flexion evokes flexion
Extension evokes extension
stimulus: resisted motion (may req reps) |
|
|
Term
|
Definition
Flexion evokes extension
Extension evokes flexion |
|
|
Term
|
Definition
Home(same)lateral(limb) synchrony
Hip flexion and shoulder flexion
His favorite: Resist hip flexion to facilitate DF |
|
|
Term
|
Definition
Used overflow and helps patient psychologically.
Hip adduction resisted on one side will overflow to other side and cause hip adduction. |
|
|
Term
|
Definition
| Raise arm over head facilitates hand and finger extension |
|
|
Term
| Stage 1 recovery UE and LE |
|
Definition
| Flaccidity, no voluntary movement, no spasticity, limbs feel heavy and may be different. |
|
|
Term
| Stage 2 recovery UE and LE |
|
Definition
Weak associated reactions
Voluntary attempts to move
Spasticity developing (UE flex, LE ext) |
|
|
Term
|
Definition
| Spasticity at max (pt may not progress) |
|
|
Term
|
Definition
1. Place hand behind body
2. elevation of arm to forward horizontal
3. Pronation/supination elbow at 90 |
|
|
Term
|
Definition
Spasticity is waning
1. Arm raising to side horizontal
2. Arm raising forward and overhead
3. Pron/Sup arm at side or in front elbow straight |
|
|
Term
|
Definition
Movements well isolated and appear normal to near normal
Some awkwardness
Spasticity not demonstrated w passive movement
Active movements may show spasticity
Interference may or may not be spasticity |
|
|
Term
| Stage 7 recovery UE and LE |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Sitting with knee flexed BEYOND 90
Foot sliding backward on floor
Voluntary DF w/o lifting foot off floor |
|
|
Term
|
Definition
Standing: isolated non weight bearing knee flexion, hip extended
Standing in half step position with knee extended
Perform isolated DF (toe tapping) |
|
|
Term
|
Definition
Standing: Hip abduction (ROM beyond pelvis elevation)
sitting: reciprocal isolation of inner and outer hamstring mm's (rolling knee in and out)
Inversion and eversion |
|
|
Term
| If you saw a patient in stage 1 recovery what would you do? |
|
Definition
ANYTHING AND EVERYTHING to get patient to move without causing harm.
Associated reactions (raimestes) and attidunial reflexes (putting finger in hand to facilitate flexion) |
|
|
Term
| What would you do with patient in stage 2 recovery? |
|
Definition
| anything and everything.Try to create movement and observe synergies that develop. |
|
|
Term
| What do you do with patient in Stage 3 recovery? |
|
Definition
| Start working out of synergy |
|
|
Term
| What do you do with patient in stage 4? |
|
Definition
| Keep working out of synergy and the next stage's actions |
|
|
Term
|
Definition
| GET PATIENT TO SITTING AS SOON AS POSSIBLE |
|
|
Term
| Bernsteins 3 stages of recovery? |
|
Definition
Facilitate
Inhibit
Re-educate |
|
|
Term
| Cognitive features R vs L hemisphere |
|
Definition
Right: Holistic
Left: Process linear/sequence |
|
|
Term
| Perception feature of R vs L hemisphere |
|
Definition
Right: Visual spatial perception
Left: Produce language |
|
|
Term
| Academic features of R vs L hemisphere |
|
Definition
Right: synthesizing inferences
Left: mathematical calculations |
|
|
Term
| Motor features of R vs L hemispheres |
|
Definition
Right: Posture
Left: Perform movement |
|
|
Term
| Emotion features of R vs L hemisphere |
|
Definition
Right: Negative emotion
Left: Positive emotion |
|
|
Term
| Left hemisphere injury features |
|
Definition
R weakness/sensory loss
Speech and language loss
Apraxia
Slow cautious behavior
Difficult to express positive emotion |
|
|
Term
| R hemisphere injury features |
|
Definition
L weakness/sensory loss
Visual perception unilateral neglect agnosis
Impulsive behaviors
Poor judgement
Safety risk
Difficulty sustaining movements
Difficulty expressing negative emotion |
|
|
Term
| Lacunar type strokes (1/4 all ischemic strokes) |
|
Definition
| small infarcts (2-20mm diameter) in the deep cerebral white matter, basal ganglia, or pons presumed to result from the occlusion of a single small perforating artery supplying the subcortical areas of the brain |
|
|
Term
|
Definition
| MOST COMMMON STROKE LOCATION: in posterior limb of INTERNAL CAPSULE, which carries descending corticospinal and corticobulbar fibers |
|
|
Term
| What is pure sensory syndrome and what part of the brain does it affect? |
|
Definition
| Hemibody sensory systems that involve the face, arm, leg and trunk. THALAMUS infarct (aall sensory info except smell goes through) |
|
|
Term
| Ataxic Hemiparesis syndrome |
|
Definition
Combo of cerebellar and motor symptoms on the SAME SIDE of the body.
Cerebellar ataxia always on SAME SIDE. |
|
|
Term
| Ipsilateral pushing or Pushers syndrome |
|
Definition
Lean to affected side
Thalamus R hemisphere
18 degrees of vertical misperception
Vestibular inputs intact |
|
|
Term
|
Definition
A - Premotor area
B - Primary motor cortex
C - Prefrontal area
D - Broca's area (motor speech area)
E - Auditory association area
F - Primary auditory cortex
G - Central sulcus
H - Primary somatic sensory cortex
I - Somatic sensory association area
J - Visual association area
K - Wernicke's area (sensory speech area)
L - Visual cortex
M - Taste area |
|
|
Term
| When do stroke survivors show the most functional improvement? Further improvement? (time span) - outcomes |
|
Definition
First 3 months
Further improvement during next 3 months |
|
|
Term
| Loss of leg movement in the 1st week and no arm movement after 4 weeks has poor or good outcomes? (stage 1) |
|
Definition
|
|
Term
What are the statistics of stroke survivors?
What % are hemiparetic after 6 mos?
What % can't walk?
What % partially dependent in ADLs?
What is rate of recurrent strokes per year? |
|
Definition
48% are hemiparetic
22% can't walk
50% are dependent
3-7% have recurrent strokes |
|
|
Term
| When should t-PA (IV tissue plasminogen activator) be given to someone with symptoms of stroke? |
|
Definition
| Within 3 hours of symptom onset |
|
|
Term
| What % of patients were more likely to experience an excellent recovery at 3 mo when given t-PA? |
|
Definition
|
|
Term
| What is the associated risk with t-PA? |
|
Definition
| 6.4% incidence of intracranial hemorrhage (10-fold increase in risk) |
|
|
Term
| Is t-PA used for hemorrhagic or ischemic stroke? |
|
Definition
|
|
Term
| What serious complications should you watch for when you begin PT on post-stroke pt? (5) |
|
Definition
Cardiac arrhythmias
Dysphagia (avoid aspiration)
DVT (most common cause of death)
Uncontrolled BP
Additional strokes |
|
|
Term
| What is the most common cause of death among stroke patients and when do they happen? |
|
Definition
| DVT pulmonary embolism in the 2-4 weeks post stroke |
|
|
Term
| What are some drugs used for spasticity? (6) |
|
Definition
Diazepam
Procaine
Phenol
Botox
Dantolene
Baclofen |
|
|
Term
| How does the drug Diazepam work? |
|
Definition
| decreases spasticity but also depresses entire CNS system (drowsy) |
|
|
Term
| How does the drug Procaine work? |
|
Definition
| inhibits intrafusal muscle fibers the effect is transient |
|
|
Term
| How does the drug phenol work? ** not a good answer sorry |
|
Definition
| intramuscular. It is effective 2-12mo post stroke, but can damage tissue |
|
|
Term
| How does the drug Botox work? |
|
Definition
Temporarilty interferes with acetylcholine at motor plate
COMMON |
|
|
Term
| How does the drug dantolene work and some side effects? |
|
Definition
Sodium decreases excitation of skeletal muscles
Side effects: drowsiness and weakness |
|
|
Term
| How does the drug Baclofen work and what forms can be used? |
|
Definition
Skeletal muscle relaxer
Pill form and IV |
|
|
Term
| What are the treatment strategy categories? (4) |
|
Definition
Compensation training
Substitution training
Habituation training
Neural adaptation |
|
|
Term
| How would you use compensation training? |
|
Definition
|
|
Term
| How would you use substitution training? |
|
Definition
Use a good working muscle as a substitute for a very weak or paralyzed muscle.
Ex) Use anterior deltoid for elbow extension |
|
|
Term
| How would you use habituation training? |
|
Definition
| Getting used to weird sensations |
|
|
Term
| How would you use the neural adaptation treatment strategy? |
|
Definition
| create motor programs (nueroplasticity) with consistent practice |
|
|
Term
| What is the functional retraining strategy of treatment? |
|
Definition
| Practicing functional activities (walking, transfers, etc) |
|
|
Term
| What is impairment training strategy? |
|
Definition
Identify the impairment and work on it
Ex) identify weak quads and strengthen to perform sit to stand. |
|
|
Term
| What is the somatosensory reintegration interventions strategy? |
|
Definition
treating impaired sensory function
Ex) lean on intact side and feel the table (temp and pressure) then lean on affected side and try to imitate the feeling. Look at it for visual. Bend and straighten while looking at it. |
|
|
Term
| What is the first symptom of Parkinson? |
|
Definition
Sensory symptoms first
Loss of smell |
|
|
Term
| What tone would you find in a Parkinson's patient? |
|
Definition
| Lead pipe and cogwheel rigidity WITHOUT spasticity (velocity dependant) |
|
|
Term
| What is "phantom pillow" in Parkinson's disease? |
|
Definition
| When pt is supine they are kyphotic as if they have a pillow underneath them |
|
|
Term
| What is wrong with the motor unit in Parkinsons? (3) |
|
Definition
Delay in recruitment. (They cant recruit when they want/need to)
Pauses once unit fires (inability to increase firing and inability to sustain contraction)
They need to complete a movement before starting another |
|
|
Term
| What are the statistics of Parkinsons falls? |
|
Definition
Common - 1/3 fall
10% more than once a week |
|
|
Term
| Why do Parkinson's pt fall? (gait pattern) |
|
Definition
| Flat foot or toe heel sequence that cause them to trip on carpet |
|
|
Term
| What are some strategies to use to improve gait function in Parkinson's? (9) |
|
Definition
Integrate the 5 senses!
Random practice
Mental practice
Speed variation
Large steps and arm swings (BIG)
Start/stop activities
Chant L/R progress to singing
Scoot on mat
Evaluate devices |
|
|
Term
| What are the 15 "Bernstein tips" to use for Parkinson's pt? |
|
Definition
tapping of leg for freezing
Rocking on heels (trunk forward)
Visualize chair further
Distract mind
Rolled magazine in hand or canes (increase arm swing)
Wide turns
Ladder steps
Beach ball, balloons
Reach in pocket to decrease tremor
Facial expressions
Clapping to music
Metronome
Marching
Sit and stand
Dance waltz |
|
|
Term
| How long will Parkinson's treatment carryover? |
|
Definition
<6 mo they need to continue at home!
Medication: 5 years |
|
|
Term
| What is Guillain-Barre syndrome? |
|
Definition
| Disorder in which the bodies immune system attacks part of the peripheral nervous system with axon degeneration and demyelination. |
|
|
Term
| What usually causes Guillian barre syndrome? |
|
Definition
| they don't really know but usually occcurs within days or weeks after a repiratory or GI infection |
|
|
Term
| How does Guillian barre syndrome usually progress? |
|
Definition
Gets progressively worse for 2-3 weeks with complete recovery in 75% of cases. Only 3% mortality (when it hits repiratory function)
May start in arms and move down\
or MORE COMMONLY
may start in feet and move up |
|
|
Term
| How do you diagnose Guillian barre syndrome? (4) |
|
Definition
| Loss of reflexes (knee and ankle) Nerve conduction velocity slows Spinal tap (CSF show elevated protein) Blood and urine sample may show excess proten |
|
|
Term
| What is plasma exhange (PE)? Plasmapheresis |
|
Definition
| Involves taking blood out then removing antibodies from it and replacing blood |
|
|
Term
| How long is PE (plasma exchange) suggested for ambulatory and non ambulatory patients? |
|
Definition
| 4 weeks for nonambulatory 2 weeks for ambulatory |
|
|
Term
| What is Immunoglobin therapy? (IVIg) |
|
Definition
| Immunoglobins are added to blood which blocks the antibodies |
|
|
Term
| How long do you use IVIg for ambulatory patients? and when do you not use them? |
|
Definition
2-4 weeks for ambulatory patients
Dont administer after PE (plasma exchange) |
|
|
Term
| what is multiple sclerosis (MS)? |
|
Definition
| Disease of myelin in the CNS. Ages 16-60, but between 20-40 most common. More in women 2-3:1. |
|
|
Term
| What are the 4 conditions in the MS disease course? |
|
Definition
Progressive
Relapsing/Remitting
Secondary progressive
Progressive relapsing |
|
|
Term
| What are symptoms of MS? (9) |
|
Definition
Fatigue (most common)
weakness
Paresthesias
Spasticity
Unsteady gait
Double vision
Tremor
Neurogenic bladder/spastic bladder
Absence of bowel constipation |
|
|
Term
| What is ALS (amyotrophic lateral sclerosis)? |
|
Definition
| Loss of motor nerve cells in the anterior horns of the spinal cord and in the other motor nuclei of the brain stem |
|
|
Term
| What does lateral sclerosis refer to? |
|
Definition
| corticospinal tract degeneration |
|
|
Term
| Does ALS affect sensation? |
|
Definition
| No which makes it a characteristic important to making diagnosis |
|
|
Term
| Does ALS affect sensation? |
|
Definition
| No which makes it a characteristic important to making diagnosis |
|
|
Term
| What are the phases and stages of ALS? |
|
Definition
Phase 1 (stage I-III) Independant
Phase 2 (stage IV, V) Partially independant
Phase 3 (stage VI) Dependant |
|
|
Term
| Rehab for Phase I ALS? (5) |
|
Definition
Strengthen but dont overexert
Breathing exercises
ADs
Measure for motor chair
Energy conservation |
|
|
Term
| What do you in Phase II ALS rehab? |
|
Definition
Isometric exercises of all major muscles
Control edema in hand
Teach transfers |
|
|
Term
| What do you do in rehab of Phase 3 of ALS? |
|
Definition
|
|
Term
| What are some pt characteristics in Phase I ALS? (2) |
|
Definition
Weakness but ambulatory except for long distances
Slight increase in respiratory effect |
|
|
Term
| What are some pt characteristics in Phase 2 ALS? (2) |
|
Definition
Wheelchair dependent
Hanging arm syndrome - pain, edema, atrophy |
|
|
Term
| What are some characteristics of Phase 3 ALS pt? (5) |
|
Definition
Bedridden
Completely dependent in ADL
Need soft foods
Suction
Speech amplification |
|
|
Term
| How do you position patients with abnormal synergies? |
|
Definition
Position out of synergy.
Most common UE - flexion so position in extension
LE extension most common so position in abduction and hip flexion and knee flexion |
|
|
Term
| Does ALS affect sensory and motor? |
|
Definition
| NO it ONLY attacks motor neurons |
|
|
Term
| What is the hallmark initial sign of ALS? |
|
Definition
|
|
Term
| How does ALS progress (body)? |
|
Definition
Starts in hands and feet
Progresses to trunk muscles
Eventually affects speech, swallowing, chewing and breathing.
Ultimately a ventilator is needed |
|
|
Term
| How long does a person live after being diagnosed with ALS? |
|
Definition
| 3-5 years (few live 15-20 years) |
|
|
Term
| When does ALS usually appear? (age, gender) |
|
Definition
|
|
Term
| What are some symptoms of heat illness? (7) |
|
Definition
| dizziness or fainting heavy sweating muscle cramps cold or clammy skin headaches rapid HR nausea |
|
|
Term
| When do you call 911 with heat illness? symptoms? (8) |
|
Definition
Rapid HR
Confusion or delirium
Warm dry skin
Fever >104
Severe headaches
Seizure or muscle twitching
Unconsciousness
Death |
|
|
Term
|
Definition
| Combination of functionally based diagonal patterns of movement with techniques of facilitation to evoke motor responses, |
|
|
Term
|
Definition
| Improve neuromuscular control and function |
|
|
Term
| What can PNF techniques be used for? |
|
Definition
| Develop muscular strength and enduracne, facilitate stability, mobility, coordinated movements, and lay a foundation for functional restoration |
|
|
Term
|
Definition
| Guiding (pt won't do anything they can't) |
|
|
Term
| What are the components of NDT? |
|
Definition
Postural stability (trunk - pelvis and scapula)
Key points of control are the point of the body we cue
Proximal key points (hip)
Distal key points (knee, hand) |
|
|
Term
| What are the stages of motor control? (7) |
|
Definition
Rolling side to side
Moving from supine to sit and sit to supine
Maintain sitting posture
Transfers
Moving from sitting to standing and standing to sitting
Maintaining standing posture
Walking |
|
|
Term
| The 4 basic task requirements? |
|
Definition
Mobility
Stability
Controlled mobility
Skill |
|
|
Term
| Heavy Joint Compression: Facilitation or Inhibition? |
|
Definition
|
|
Term
| Resistance: Facilitation or Inhibition? |
|
Definition
|
|
Term
| Quick stretch: Facilitation or Inhibition? |
|
Definition
|
|
Term
| Fast vestibular stimulation (fast spinning): Facilitation or Inhibition? |
|
Definition
|
|
Term
| Slow vestibular stimulation: Facilitation or Inhibition? |
|
Definition
|
|
Term
| Tapping: Facilitation or Inhibition? |
|
Definition
| Facilitation. Quick stretch of muscle spindle. |
|
|
Term
| Therapeutic fast vibration: Facilitation or Inhibition? |
|
Definition
| Facilitation. On muscle belly (IA fibers sensitive to stretch and vibration - like tapping DTR) |
|
|
Term
| Traction: Facilitation or Inhibition? |
|
Definition
| Facilitation. Facilitates agonists to enhance contraction. |
|
|
Term
| Light moving touch: Facilitation or Inhibition? |
|
Definition
|
|
Term
| Quick Icing: Facilitation or Inhibition? |
|
Definition
|
|
Term
| Prolonged icing: Facilitation or Inhibition? |
|
Definition
|
|
Term
| Neutral warmth: Facilitation or Inhibition? |
|
Definition
|
|
Term
| Slow stroke:Facilitation or Inhibition? |
|
Definition
|
|
Term
| Rocking:Facilitation or Inhibition? |
|
Definition
|
|
Term
| Tendinous pressure: Facilitation or Inhibition? |
|
Definition
|
|
Term
| Which side is lengthened when shifted and slouched? |
|
Definition
| The side you are shifted to |
|
|
Term
| Which side is shortened when you lift leg up? |
|
Definition
| the side the leg is lifting on |
|
|
Term
| What does the quick stretch do? |
|
Definition
| lengthen muscles that are to contract during diagonal movement pattern |
|
|
Term
| What does rhythmic initiation do? |
|
Definition
| initiate a movement pattern |
|
|
Term
| contract-relax/hold-relax/autogenic inhibition |
|
Definition
| contract biceps then elongate into elbow extension |
|
|
Term
| Reciprocal inhibition/agonist contraction |
|
Definition
| contract triceps to make biceps relax. Fire triceps to increase extension. |
|
|
Term
| hold relax with agonist contraction |
|
Definition
| combination of contract relax and agonist contraction. both ways. contract biceps then triceps then elongate. |
|
|
Term
| What are repeated contractions? |
|
Definition
| repeated dynamic contraction initiated with repeated quick stretches followed by resistance are applied at any point in ROM to strengthen a weak agonist component of a diagonal pattern |
|
|
Term
|
Definition
| dynamic contraction of strong agonist pattern immediately followed by dynamic concentric contraction of weaker antagonist pattern |
|
|
Term
| what is slow reversal hold? |
|
Definition
| isometric contraction at end of range of a pattern to enhance end-range holding of weakened muscle |
|
|
Term
| what are alternating isometrics? |
|
Definition
| manual resistance applied in a single plane on one side of the body segment then on the other |
|
|
Term
| What is rhythmic stabilization? |
|
Definition
| multi-directional resistance by placing manual contacts on opposite sides of the body (rotators) |
|
|
Term
| What are the progression concepts? (4) |
|
Definition
1. Mobility
2. Stability
3. Controlled-mobility
4. Skill |
|
|
Term
| Define mobility in terms of motor control |
|
Definition
| Initial movement in a functional pattern (adequate ROM and muscle activity for movement to occur?) |
|
|
Term
| Define stability in terms of motor control |
|
Definition
| The ability to maintain a steady position in weight bearing, anti-gravity posture. (can pt maintain posture w/ min sway or instability?) |
|
|
Term
| Define controlled mobility in terms of motor control |
|
Definition
| The ability to alter a position or move into a new position while maintaining stability. (independent assumption of posture and weight shifting) |
|
|
Term
| Define skill in terms of motor control |
|
Definition
| Highly coordinated movement that allows for investigation and interaction with the physical and social environment. |
|
|
Term
| Define static-dynamic control in terms of motor control (part of controlled mobility) |
|
Definition
| ability to shift weight onto one side and free up a limb for non-weight bearing, dynamic activities. |
|
|
Term
|
Definition
palm to face
Shoulder: flex, add, ext rot
Scapula: anterior elevation
Elbow: flex or ext
Forearm: supination
Wrist: flex, radial deviation |
|
|
Term
|
Definition
knee up and in
Hip: flex, add, ext rot
Ankle: DF and inversion
Knee: flex or ext |
|
|
Term
| D1 UE extension components |
|
Definition
face to ext
Shoulder: ext, abd, int rot
Scapula: posterior depression
Elbow: flex or ext
Forearm: Pronation
Wrist: ext, ulnar deviation |
|
|
Term
| D1 LE extension components |
|
Definition
Hip: Ext, abd, int rot
Ankle: PF, eversion
Knee: flex or ext |
|
|
Term
|
Definition
Sword out
Shoulder: fl, abd, ext rot (thumb back)
Scapula: posterior elevation
Elbow: fl or ext
Forearm: supination
Wrist: ext, radial deviation |
|
|
Term
|
Definition
Fire hydrant
Hip: Flex, abd, int rot
Ankle: DF, eversion
Knee: fl or ext |
|
|
Term
| D2 UE extension components |
|
Definition
Sword in
Shoulder: Ext, add, int rot
Scapula: anterior depression
Elbow: flex or ext
Forearm: pronation
Wrist: flex, ulnar deviation |
|
|
Term
| D2 LE extension components |
|
Definition
Cross legs
Hip: Ext, add, ext rot
Ankle: PF, inversion
Knee: flex or ext |
|
|
