Term
| what are the general considerations of the carr and shepherd approach? |
|
Definition
| context-specificity of muscle action; maintenance of balanced alignment of body segments; cognitive effort and active participation by the patient; consistency of practice |
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|
Term
| what are the 4 steps in assessment and treatment according to carr and shepherd? |
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Definition
| analysis of the task, practice of missing components, practice of the task, transference of training |
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Term
| what to look for in task analysis |
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Definition
| what components are missing. What compensations are being used |
|
|
Term
| what are the essential components of being able to reach and grasp according to carr and shepherd? |
|
Definition
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Term
| considerations for practice to improve UE function according to Carr & Shepherd |
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Definition
| begin early working with patient in supine with arm elevated for reaching. Shift from concentric to eccentric in different parts of range and at various speeds. Have patient consciously try to eliminate unnecessary muscle activity. If patient is unable to achieve control, use orthoses and/or biofeedback. introduce tasks using both arms as soon as possible. avoid compensatory strategies and learnednon-use; manage shoulder dysfunction |
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Term
|
Definition
| proprioceptive neuromuscular facilitation |
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Term
|
Definition
| a philosophy of treatment with utilization of sensory and neuromuscular channels to facilitate movement and control. Utilization of manual contacts to facilitate motor responses in positions of function - for stability, movement, skilled control |
|
|
Term
| what are good patient populatinos for PNF |
|
Definition
| any patient with a movement dysfunction |
|
|
Term
| are musculoskeletal issues good for PNF? |
|
Definition
|
|
Term
| are neuromuscular issues good for PNF |
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Definition
|
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Term
|
Definition
|
|
Term
| what is one issue that might not be good for PNF |
|
Definition
| some movement patterns require cognitive ability to understand commands |
|
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Term
|
Definition
| diagonal movement patterns applied to extremities and trunk |
|
|
Term
| what are the functional demands of positions |
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Definition
| initial mobility, stability, controlled mobility, skilled movement |
|
|
Term
| what is initial mobility? |
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Definition
|
|
Term
|
Definition
| once in a position, ability to hold and stabilize |
|
|
Term
| what is controlled mobility |
|
Definition
| movement within a position over a fixed base of support |
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Term
|
Definition
| movement to investigate or manipulate the environment |
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|
Term
| what to consider in manual contacts |
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Definition
| location should be specific and directed. Lumbrical grip is more comfortable for the patient |
|
|
Term
| what to consider in therapist position |
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Definition
| appropriate surface height, face the diagonal, use bodyweight to transmit resistance |
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|
Term
| what is the point of resistance in PNF |
|
Definition
| appropriate grading and timing of resistance can facilitate contraction of muscles. |
|
|
Term
| what is the effect of resistance |
|
Definition
|
|
Term
|
Definition
| spread of response to nearby or contralateral muscle groups |
|
|
Term
| what does the quick stretch do |
|
Definition
| reflexively stimulate muscle contractions |
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|
Term
| what is meant by appropriate grading of resistance |
|
Definition
| different resistance is needed for athlete vs little old lady who's had a stroke |
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|
Term
| what happens in quick strecth |
|
Definition
| stretch the main muscle that will do the motion, the muscle spindle will increase activation of that muscle |
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|
Term
| what are isotonic contractions? |
|
Definition
| contractions in which the patient moves |
|
|
Term
| what are the 2 types of isotonic contractions |
|
Definition
|
|
Term
| what are isometric contractions and when are they used |
|
Definition
| contractions in which the patient doesn't move. Used in rhythmic stabilization |
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|
Term
| what is the point of joint traction |
|
Definition
| increase mobility, decrease pain |
|
|
Term
| is traction more commonly used in flexion or extension |
|
Definition
|
|
Term
|
Definition
| increased input during weightbearing activities to increase stability |
|
|
Term
| what could you do for someone who has had a stroke and has pain? |
|
Definition
| do a little distraction to separate the joint surfaces just a little bit to help deal with the pain |
|
|
Term
| what to consider with verbal inputs |
|
Definition
| voice volume to be alerting or relaxing as needed |
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|
Term
| what to consider with visual inputs |
|
Definition
| encourage head/trunk and eye movement |
|
|
Term
| describe rhythmic initiation |
|
Definition
| this is the beginning of PNF: start with passive movement, then active assist, then add resistance as appropriate |
|
|
Term
| what are indications for rhythmic initiation |
|
Definition
| difficulty relaxing, hypertonicity, motor learning deficits, apraxia, aphasia, or to learn the pattern for the first time |
|
|
Term
| describe repeated quick stretch contractions |
|
Definition
| therapist applies repeated quick stretches throughout the movement range to encourage muscle response |
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|
Term
| indications for quick stretch |
|
Definition
| weakness, incoordination, muscle imbalance, reduced endurance |
|
|
Term
| when to do careful quick stretches |
|
Definition
| to initiate movement if needed, when response wimps out |
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|
Term
| describe how to do careful quick stretches |
|
Definition
| gentle taps then wait for a response |
|
|
Term
| what are the diagonals on a clock for scapular patterns |
|
Definition
|
|
Term
| what are the scapular patterns |
|
Definition
| anterior elevation, posterior depression and posterior elevation, anterior depression |
|
|
Term
| what are the manual contacts for resisting anterior elevation? |
|
Definition
|
|
Term
| what are manual contacts for resisting posterior depression |
|
Definition
| heels of hands on inferior angle and medial border of scapula |
|
|
Term
| how many quick stretches could you use in scapular motion? |
|
Definition
|
|
Term
| what to consider when doing PNF with patient who has had a stroke |
|
Definition
| comfort, positioninng, need to assist with bed mobility |
|
|
Term
| describe combination of isotonics |
|
Definition
| therapist uses hold, concentric and eccentric contractions during a movement pattern to improve control |
|
|
Term
| indications for isotonics |
|
Definition
| weakness, incoordination, muscle imbalance, functional implications |
|
|
Term
| what are 3 types of combination of isotonics |
|
Definition
| reversal of antagonists, agonist reversals, dynamic reversals |
|
|
Term
| what is reversal of antagonists |
|
Definition
| resist one side then the other |
|
|
Term
| what are agonist reversals |
|
Definition
| concentric contraction of the agonist followed by eccentric contraction of the agonist |
|
|
Term
| what are dynamic reversals? |
|
Definition
| a type of antagonist reversals |
|
|
Term
|
Definition
|
|
Term
| what is a slow reversal hold |
|
Definition
| a hold contraction integrated into the reversal at some point during the range, such as a point of weakness |
|
|
Term
| what are indications for dynamic reversals |
|
Definition
| difficulty performing reciprocal movements, muscle imbalance, weakness, incoordinatoin, decreased endurance |
|
|
Term
| what are hand placements to resist scapular posterior elevation |
|
Definition
|
|
Term
| what are hands placements to resist scapular anterior depression |
|
Definition
|
|
Term
| what are stabilizing reversals |
|
Definition
| isometric contractions that are alternated with a pause between contractions, such as alternating trunk flexion/extension with a pause as you switch hands from flex to ext |
|
|
Term
| what is rhythmic stabilization |
|
Definition
| resistance is applied continuously, moving only one hand at a time so that there is always a point of resistance |
|
|
Term
| what are indicationd for stabilizing reversals and rhythmic stbailization |
|
Definition
| instability in weightbearing or holding, static postural control, weakness, ataxia |
|
|
Term
| what are the diagonals on a clock for extermity patterns |
|
Definition
|
|
Term
| describe timing for emphasiss |
|
Definition
| use of greater resistance to increase overflow from stronger to weaker muscles. Stop motion proximally to work the distal part of an extremity. Use with repeated contractions |
|
|
Term
| what are indications for timing for emphasis |
|
Definition
|
|
Term
|
Definition
| start with whole arm/wrist/elbow extended, then flex up. End with everything flexed, shoulder ER and adducted. |
|
|
Term
| which scapular pattern goes with D1 flexion. |
|
Definition
|
|
Term
| what are the 2 theoretical mechanisms of contract-relax and hold-relax |
|
Definition
| Direct relaxation of tight muscle through GTOs; reciprocal inhibition of the tight muscle by antagonist contraction |
|
|
Term
| what is indirect treatment |
|
Definition
| reciprocal inhibition of the tight muscle by antagonist contraction |
|
|
Term
| if someone's pecs are tight, how can you use direct treatment to solve this |
|
Definition
| do D2 flexion/abduction movement. Resist extension isometrically, have them relax, then flex the pec |
|
|
Term
| what is the difference between contract relax and hold relax |
|
Definition
| contract relax allows some movement; hold must hold contraction for 5-8 seconds with no movement |
|
|
Term
| when are contract relax and hold relax both indicated |
|
Definition
|
|
Term
| when is contract relax indicated |
|
Definition
|
|
Term
| when is hold relax indicated |
|
Definition
| for pain or muscle psasms |
|
|
Term
| how to do contract relax direct treatment |
|
Definition
| resist contraction of the synergist, allowing slight movement. Then relax and actively assist the limb into a greater range |
|
|
Term
| how to do contract relax indirect treatment |
|
Definition
| resist contraction of the antagonist, allowing slight movement. Then relax and passively or active assistly move the move the limb into a greater range |
|
|
Term
| when to do hold relax instead of contract relax |
|
Definition
| do hold relax if painful, if contractions are too strong for PT to control |
|
|
Term
| when to do indirect vs direct contractions |
|
Definition
| do indirect if contraction of restricted muscle is too painful or weak for an effective contraction |
|
|
Term
| what verbal cues could you give to someone to resist you in D2 extension |
|
Definition
| squeeze my hand and pull down across toward your opposite hip |
|
|
Term
| what verbal cues could you give to someone to resist you in D2 flexion |
|
Definition
| open up your hand and push back toward me |
|
|
Term
| what movement does chopping faciliate in the trunk and cervical spine? |
|
Definition
|
|
Term
| what movement does lifting faciliate in the trunk and cervical spine |
|
Definition
|
|
Term
| what can chopping/lifting do for function |
|
Definition
|
|
Term
| what goes with pelvic anterior rotation |
|
Definition
|
|
Term
| what is the hand position to resist pelvic posterior depression |
|
Definition
|
|
Term
| what is the hand position to resist pelvic anterior elevation |
|
Definition
|
|
Term
| what pelvic motion is used to scoot forward |
|
Definition
|
|
Term
| what is the hand position to resist pelvic anterior depression |
|
Definition
| hands on GT or one hand on GT, one hand on knee |
|
|
Term
| what is the hand position to resist pelvic posterior elevation |
|
Definition
| hands on posterior iliac crest |
|
|
Term
| what are the two mass trunk patterns |
|
Definition
|
|
Term
| what is the scapular movement for trunk elongation |
|
Definition
|
|
Term
| what is the movement of the pelvis in mass trunk elongation |
|
Definition
|
|
Term
| which LE PNF pattern is the hacky sack move of abduction and internal rotation? |
|
Definition
|
|
Term
| where should PT stand to do scapular anterior elevation and posterior depression |
|
Definition
| behind patient, facing up toward patient's head |
|
|
Term
| where should PT stand to do scapular anterior depression and posterior elevation |
|
Definition
| behind patient, facing toward patient's bottom hip |
|
|
Term
| should the trunk roll or rotate with scapular patterns? |
|
Definition
|
|
Term
| should the humerus move with scapular patterns? |
|
Definition
|
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