Term
What Score on the GCS?
Opens eyes spontaneously |
|
Definition
|
|
Term
What Score on the GCS?
Does not open eyes in response to any stimulation |
|
Definition
|
|
Term
What Score on the GCS?
Opens eyes in response to speech |
|
Definition
|
|
Term
What Score on the GCS?
Opens eyes in response to painful stim |
|
Definition
|
|
Term
What Score on the GCS?
Makes non purposeful movement in response to noxious stim |
|
Definition
|
|
Term
What Score on the GCS?
Extends all extremities in response to pain |
|
Definition
|
|
Term
What Score on the GCS?
flexes UE or LE in response to pain |
|
Definition
|
|
Term
What Score on the GCS?
Follows Commands to move body |
|
Definition
|
|
Term
What Score on the GCS?
Makes localized movement in response to painful stim |
|
Definition
|
|
Term
What Score on the GCS?
Makes no response to noxious stim |
|
Definition
|
|
Term
What Score on the GCS?
Makes incomprehensible sounds |
|
Definition
|
|
Term
What Score on the GCS?
Replies with inappropriate words when spoken to |
|
Definition
|
|
Term
What Score on the GCS?
Converses may be confused |
|
Definition
|
|
Term
What Score on the GCS?
Verbaly is oriented to person, place, and time |
|
Definition
|
|
Term
What Score on the GCS?
Makes No Verbal Response |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| difficultly in articulating a word |
|
|
Term
|
Definition
| unable to follow verbal commands |
|
|
Term
|
Definition
| direct damage at the site of impact |
|
|
Term
|
Definition
| damage where the brain hits the skull on the opposite side |
|
|
Term
|
Definition
| no skull fracture, no laceration |
|
|
Term
|
Definition
| meninges have been breached |
|
|
Term
|
Definition
|
|
Term
| ICP levels to defer therapy |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Hemorrhage or rupture of vessels in the white matter |
|
|
Term
|
Definition
|
|
Term
What state of consciousness is this?
unresponsive and requires vigorus stimulation to bring to arousal, is known as |
|
Definition
|
|
Term
What state of consciousness is this?
The pt is in a confused state |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| define anterograde amnesia |
|
Definition
| inability to form new memory |
|
|
Term
| define retrograde amnesia |
|
Definition
| inability to recall events just before the injury |
|
|
Term
| define declarative deficits |
|
Definition
| not able to recall the facts |
|
|
Term
| what are 4 symptoms associated with concussion |
|
Definition
| dizziness, disorientation, nausea, HA |
|
|
Term
| minor head injury that can result in LOC that lasts a short time and is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull. |
|
Definition
|
|
Term
| injury caused by a blow or violent shaking that results in temporary loss of function |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What 7 deficits might you see in a patient with TBI? |
|
Definition
Cognitive deficits
Neuromuscular deficits
Visual deficits
Perceptual deficits
Swallowing deficits
Communication deficits
Behavioral deficits |
|
|
Term
| What deficits are the most enduring and socially disabling of the impairments. |
|
Definition
|
|
Term
| What 5 problems might you see in a TBI patient with a behavioral deficit? |
|
Definition
Disinhibition: emotional, sexual
Apathy
Aggression
Low tolerance for frustration
Depression |
|
|
Term
| What 5 problems might you see in a TBI patient with a Neuromuscular deficits? |
|
Definition
Abnormal tone
Sensory deficits
Motor control deficits
Impaired balance/ataxia/nystagmus
Paresis/paralysis |
|
|
Term
| What are 4 Factors Influencing Outcome of a TBI |
|
Definition
Premorbid status:
previous brain injury, personality, age, existing physical deficits, morphology, intelligence
Duration of coma and PTA
Primary injury: amount of immediate damage from the impact of the brain injury
Secondary injury: damage from systemic and intracranial mechanisms that occur after the initial injury |
|
|
Term
| What are treatment strategies for TBI patients based on? |
|
Definition
| Treatment Strategies are Based on Levels of Cognitive Function |
|
|
Term
What level on RLAS?
No response to any stimulation |
|
Definition
|
|
Term
| Non-purposeful & inconsistent response to any stimulus |
|
Definition
| Level II: Generalized Response |
|
|
Term
| Responses the same regardless of type or location of stimulation |
|
Definition
| Level II: Generalized Response |
|
|
Term
| Reflexive in nature to pain stimulus |
|
Definition
| Level II: Generalized Response |
|
|
Term
Response directly related to type of stimulus but inconsistent
Examples: blinks when strong light crosses visual field; pulls at tubes & restraints that are uncomfortable |
|
Definition
| Level III: Localized Response |
|
|
Term
| What 5 interventions should you focus on when working with a TBI patient with a level 1 - 3 on RLAS? |
|
Definition
maintaining functional ROM – includes managing tone positioning to prevent indirect impairments
facilitating any kind of active movement & response (sensory stimulation): movement may not be purposeful at this point
family education: teach to assist with ROM, positioning, and sensory stimulation
upright positioning – sitting, tilt table |
|
|
Term
Increased level of activity
Non-purposeful behaviors
Inappropriate or incoherent speaking |
|
Definition
| Level IV: Confused – Agitated |
|
|
Term
Cries out or screams out of proportion to a stimulus
May be aggressive or exhibit flight behavior
No short term or long term memory
May display disinhibited behavior |
|
Definition
| Level IV: Confused – Agitated |
|
|
Term
| What 2 interventions should you focus on when working with a TBI patient with a level 4 on RLAS? |
|
Definition
maintaining any functional abilities: usually more automatic, previously acquired abilities
may try to add functional tasks depending on physical ability of the patient |
|
|
Term
| Should you expect new learning or much carryover with a level 4 on RLAS |
|
Definition
No!
Don’t expect new learning or much carryover |
|
|
Term
| What are the 4 interventions with a Confused – Agitated TBI? |
|
Definition
maintaining any functional abilities: usually more automatic, previously acquired abilities
add functional tasks depending on physical ability of the patient
May still attend to maintaining range & positioning if patient needs attention
Don’t expect new learning or much carryover
add highly structured, closed environment: build in success.
-Expect egocentricity.
-Be prepared with a variety of activities/tx options and be prepared to modify
Family education:
Reassure the family that the patient is not intentionally trying to hurt others but that the patient cannot control the behaviors.
Teach behavior management strategies |
|
|
Term
Gross attention to environment but easily distracted without a structured environment
Responds to simple commands & performs previously learned tasks with external cues and a structured environment |
|
Definition
| Level V: Confused – Inappropriate |
|
|
Term
Difficulty with complex tasks; responses non-purposeful & random; may inappropriately use objects with external direction
May confabulate (replacing fact with fantasy)
May display disinhibited behavior
Memory impaired |
|
Definition
| Level V: Confused – Inappropriate |
|
|
Term
Past memory shows more depth & detail
Goal directed behavior but needs structure and direction |
|
Definition
| Level VI: Confused – Appropriate |
|
|
Term
Consistently appropriate response to simple directions but may be incorrect due to memory problems
Shows carryover for relearned tasks |
|
Definition
| Level VI: Confused – Appropriate |
|
|
Term
| What are the 5 Intervention for Levels V-VI |
|
Definition
- More treatment for motor deficits that interfere with mobility,
-maintain structure and decrease stress
- help the patient remember events, people, and skills.
-Emphasize safety with patient and family
-Teach family to assist with functional mobility. |
|
|
Term
| What is the order of Developmental Sequence for developing Posture |
|
Definition
Prone on elbows
quadraped
bridging
sitting
kneeling and half kneeling
modified plantigrade
standing |
|
|
Term
Appears appropriate and oriented in hospital & home situations
Can learn new tasks but learning is slow
Judgment impaired: overestimates abilities; unrealistic; does not recognize unsafe situations |
|
Definition
| Level VII: Automatic – Appropriate |
|
|
Term
Robotlike: can go through daily routine automatically as long as there are no changes
Egocentric
Oppositional |
|
Definition
| Level VII: Automatic – Appropriate |
|
|
Term
May continue to show decreased abstract thinking but can learn new tasks
Decreased tolerance for stress and decreased judgment in unusual circumstances |
|
Definition
| Level VIII: Purposeful – Appropriate |
|
|
Term
| What are the 3 Intervention for Levels VII-VIII |
|
Definition
Focus in on maintaining performance level while decreasing structure.
Increase strength and endurance to allow for community activities.
Safety, ADL’s, social skills, and community/work reentry: judgment, problem solving, and planning emphasized. |
|
|
Term
| What are 3 Interaction guidelines for a Level I and Level II on RLAS? |
|
Definition
Talk to the patient in a normal conversational manner.
Provide appropriate stimulation for the patient.
Change the patient’s position frequently. |
|
|
Term
| What are 4 Interaction guidelines for a Level III on RLAS? |
|
Definition
Use simple 1-part directions. Allow delay for the patient to respond.
Realize that level of awareness fluctuates and attention span is very diminished.
Do not expect patient to remember or recall recent events.
Provide the patient with visual orientation cues (family pictures, calendar) |
|
|
Term
| What are 4 Interaction guidelines for a Level IV on RLAS? |
|
Definition
Family members must realize that agitation is due to the patient’s confusion, fear, & disorientation not anger with the family or staff.
A primary concern now is patient safety.
Avoid contacts to which the patient responds negatively (physical contact, loud noise).
Do not react to outbursts of anger.
Do not stay with the patient alone if your are uncomfortable or fearful.
Be aware that the patient will respond to the emotional level of others.
Use short simple commands and repeat them frequently. Simplify & slow down your rate of speech. |
|
|
Term
| What are 7 Interaction guidelines for a Level V on RLAS? |
|
Definition
Don’t expect the patient to have the ability to learn new information.
Provide orientation information without quizzing the patient.
Provide ways to support memory and reinforce these methods.
Use 1-step commands with concrete simple vocabulary.
The patient will not recognize or understand subtle humor or voice inflection.
Attention span for one task may only be about 2-3 minutes. Therefore, be prepared with a variety of tasks.
Agitated behavior is usually caused by demands or pressures that exceed the patient’s tolerance. |
|
|
Term
| What are 4 Interaction guidelines for a Level VI on RLAS? |
|
Definition
You can reduce cueing to elicit information.
You can use more complex directions (2-step) and normal vocabulary.
The patient may need a great deal of emotional support.
Expect performance of brief tasks without supervision (If the patient is physically impaired, you may have to assist.) |
|
|
Term
| What are 3 Interaction guidelines for a Level VII on RLAS? |
|
Definition
Use normal conversation with the patient.
Expect literal interpretation of what is said.
No subtle humor
No recognition of underlying tone and gestures.
Patient may deny future implications of disabilities. |
|
|
Term
| Do physical recovery and cognitive recovery occur at the same rate? |
|
Definition
No!
A patient may be ambulatory and have minimal physical impairment but be at a Level IV, or the patient may have few cognitive/behavioral deficits but be severely physically impaired. |
|
|
Term
| What does confudable mean and what level of the RLAS is it associated with? |
|
Definition
"replacing fact with fantasy"
Confused Inappropriate |
|
|
Term
Name this disease
Chronic and disabling demyelinating disease of the CNS
Characterized by periods of exacerbation and remission |
|
Definition
|
|
Term
| MS is a Chronic and disabling demyelinating disease of what part of the nervous system |
|
Definition
|
|
Term
Name this disease
Demyelinating process and subsequent gliosis (replacement of tissue in myelinated areas with nonneuronal tissue or “plaques”) |
|
Definition
|
|
Term
| What type of MS makes up 80 percent of patients. Attacks last up to 24 hours with a full recovery. Attacks are variable and take place usually a month apart |
|
Definition
|
|
Term
| What type of MS makes up 15 to 30 percent of patients. Has a gradual progression with some plateaus |
|
Definition
|
|
Term
| What type of ms has a full recovery from attacks but a progressive neurological decline. Periods of minor remissions or plateaus |
|
Definition
|
|
Term
| What type of MS has patterns of increasing progression, but with periods of relapse. May or may not have full recovery from relapses |
|
Definition
|
|
Term
| What are 4 things that can exacerbate or bring on a MS attack? |
|
Definition
-fever, increased temperature following prolonged exercise)
-Viral & bacterial infections and diseases of major organs
-Major life stress events
-Hyperventilation, malnutrition, exhaustion, dehydration, sleep deprivation |
|
|
Term
| What are 5 somatosensory impairments in MS |
|
Definition
Paresthesias – pins & needles (foots asleep)
Dysesthesias – abnormal burning or aching (affects mostly lower extremity)
Hyperpathia – hypersensitivity to minor stimuli (light touch and preassure)
Trigeminal Neuralgia
Lhermitte’s sign – flexion of neck results in “electric shock” sensation along the spine |
|
|
Term
| What is a Lhermitte’s sign |
|
Definition
| flexion of neck results in “electric shock” sensation along the spine |
|
|
Term
| What are 5 Interventions for MS Sensory Impairments |
|
Definition
Substitute with other sensory systems
Increase sensation with weights, resistance, approximation
Teach skin care and precautions to prevent breakdown
Manage pain |
|
|
Term
| What are 6 ways to manage musculoskeletal pain for a MS patient? |
|
Definition
selective stretching or exercise,
splinting,
ultrasound/modalities
massage, or other soft tissue techniques
Pressure garments (or wrapping)
neutral warmth |
|
|
Term
| What type of MS impairment is found in 80% of all patients |
|
Definition
|
|
Term
| What type of visual impairment is common with cerebellar or vestibular involvement in MS patients |
|
Definition
|
|
Term
| What visual problem occurs with uncoordinated muscle activity in MS patients Because muscles of the eye are not well coordinated |
|
Definition
|
|
Term
| What type of impairment May lead to significant balance deficits in a MS patient |
|
Definition
| Visual impairments... Diplopia |
|
|
Term
| What are two Interventions for Visual Impairments in an MS pt |
|
Definition
Patching for diplopia (only during therapy)
Compensatory measures to increase safety during movement activities |
|
|
Term
| what are the 7 Motor Impairments for a MS pt |
|
Definition
Weakness or Paralysis
Fatigue
Spasticity
Eye Hand In-coordination
Intention Tremor
Impaired Balance
Gate Disturbance |
|
|
Term
| What type of movement does Poor motor unit recruitment result in? |
|
Definition
| Poor motor unit recruitment results in slow, stiff, & weak movement |
|
|
Term
| What spinal cord tract is damaged when an MS pt has muscle Weakness? |
|
Definition
| damage to the corticospinal tracts or motor cortex |
|
|
Term
| For a MS patient what can Prolonged muscle inactivity result in? |
|
Definition
|
|
Term
| What are 6 Interventions for Motor Impairments for a MS pt |
|
Definition
Muscle Strengthening
Compensatory strategies
Assistive devices
Functional training (ambulation/mobility, transfers)
Cardio-respiratory muscle strengthening
Aquatics |
|
|
Term
| What are 2 ways aquatics helps a MS patient? |
|
Definition
requires proximal muscles to work and can help slow the onset of fatigue
provides support and helps slow ataxic movements |
|
|
Term
| In MS where is Spasticity Typically more pronounced? |
|
Definition
|
|
Term
T or F
With advanced MS, spasticity can be very difficult to manage |
|
Definition
|
|
Term
| What type of tone seems to predominate in patients with MS dealing with spasticity impairments |
|
Definition
| Extensor tone seems to predominate |
|
|
Term
| What are 4 interventions to reduce spasticity in a MS patient |
|
Definition
Stretching
Rotation, especially trunk and shoulder girdle
Reciprocal inhibition with active exercise that requires contraction of the antagonistic muscles (antagonists to the spastic muscles)
Positioning – splints, orthoses, inhibitory casts |
|
|
Term
| What do over half of patients suffering from MS report as the most serious symptom? |
|
Definition
|
|
Term
| What 2 things aggravate fatigue in a pt with MS? |
|
Definition
| heat and emotional stress |
|
|
Term
| What are 4 interventions when dealing with fatigue in a MS patient? |
|
Definition
Energy conservation techniques
Careful application and monitoring of exercise
Assistive devices
Home modifications |
|
|
Term
T or F
Intention tremors and postural tremors can be present in patients with MS |
|
Definition
|
|
Term
| what are 5 intervention for coordination and balance with a MS patient |
|
Definition
Improve static control in a variety of weight bearing positions (rhythmic stabilization and joint approximation; strengthening of proximal muscles)
Progress to dynamic control (PNF; functional training; Frenkel’s; weight shifts, etc. etc.)
Aquatics: provides support but helps slow ataxic movements
Apply variety of facilitation or inhibition techniques to promote controlled movement
May treat central vestibular dysfunction |
|
|
Term
| What are three Oromotor impairments seen in a MS patient |
|
Definition
Dysarthria (slurring and poor articulation)
Dysphagia (difficulty swallowing)
Scanning Speech |
|
|
Term
| What is one respiratory impairment seen with MS patients |
|
Definition
|
|
Term
| What is the primary role of physical therapy for Oromotor and respiratory impairments with ms patients? |
|
Definition
| Primary role of physical therapy is improving upright posture and head control (positioning and/or improving control) to support oromotor and respiratory function |
|
|
Term
| What are 8 Cognitive and behavioral problems seen in MS patients? |
|
Definition
Memory
attention
concentration
reasoning
reaction time
executive functions
Emotional dysregulation
Depression |
|
|
Term
| What are the 8 general impairments seen in MS |
|
Definition
Somatosensory
Visual
Motor
Spasticity
Fatigue
Coordination and Balance
Oro Motor and Respiratory
Cognitive and Behavioral |
|
|
Term
name this disease
Chronic and progressive disease of the central nervous system characterized by these cardinal manifestations
Rigidity
Bradykinesia (or akinesia)
Tremor
Postural instability |
|
Definition
|
|
Term
|
Definition
| group of disorders that produce abnormalities of basal ganglia function |
|
|
Term
| What 3 ways is Parkinson's diagnosed? |
|
Definition
Based on history and clinical examination
Based on at least 2 of 4 cardinal signs being present
Secondary and Parkinson-plus syndromes are ruled out |
|
|
Term
| What is the Medical management for PD? |
|
Definition
| Medical management: control symptoms & slow progression |
|
|
Term
|
Definition
|
|
Term
| What is used to decrease bradykinesia and rigidity in PD patients? |
|
Definition
| Dopamine replacement (L-dopa) |
|
|
Term
| What are 6 side affects of L-Dopa? |
|
Definition
Anorexia, nausea, vomiting, constipation
Mental restlessness, over activity, anxiety
Orthostatic hypotension
Dysuria
Dyskinesia ****
Sleep disturbances |
|
|
Term
| What can Long term use of L-Dopa and increased dosage result in with a PD patient |
|
Definition
| decreased effectiveness of the drug |
|
|
Term
| What are 3 drugs used in PD ? |
|
Definition
MAOs to improve dopamine metabolism
Dopamine inhibitors to combine with
L-dopa to improve effectiveness: reduce rigidity, bradykinesia, & motor fluctuations
Anticholinergic agents: moderate tremor, rigidity, and motor fluctuations |
|
|
Term
| High protein diets can do what to the effectiveness of dopamine replacement and why? |
|
Definition
| Block them because amino acids compete with L-dopa absorption |
|
|
Term
| What are 4 types of surgical managements are used with PD? |
|
Definition
Pallidotomy
Thalamotomy
Deep Brain Stim
Stem cell replacement |
|
|
Term
| What 2 types of rigidity is seen in PD? |
|
Definition
lead-pipe
cogwheel (cogwheel is probably a combination of lead-pipe rigidity superimposed on tremor) |
|
|
Term
| How is rigidity distributed and how does it progress in a PD patient? |
|
Definition
| Typically unequal in distribution and progresses proximal to distal |
|
|
Term
| What side of the body does Rigidity start on and where does it progress to? |
|
Definition
| Initially unilateral, eventually progressing to whole body |
|
|
Term
| What are 5 Secondary complications of rigidity |
|
Definition
decreased ROM,
postural deformity, such as kyphosis,
decreased respiratory capacity
inability to express postural adjustments necessary for balance
loss of reciprocal gait movements |
|
|
Term
| What can be exacerbated by mental concentration, emotional tension, or active movements in PD patients |
|
Definition
|
|
Term
|
Definition
Absence of movement
Responsible for moments of “freezing” often seen with PD |
|
|
Term
| What is Directly influenced by degree of rigidity, stage of disease, and drug actions in PD patients? |
|
Definition
|
|
Term
| What is the most disabling sign of PD, leading to increased dependence in ADL |
|
Definition
|
|
Term
| What 2 ways does Bradykinesia present itself in a PD patient |
|
Definition
Slowness and difficulty maintaining movement, changing speed, and changing direction
prolonged movement times during functional activities and loss of automatic movements |
|
|
Term
| When is a tremor less sever in a PD patient? |
|
Definition
| when person is rested and/or when unoccupied |
|
|
Term
| How are tremors aggravated in a PD patient? |
|
Definition
| Aggravated by emotional stress and fatigue |
|
|
Term
| Why do One-third of PD patients experience falls: 1in10 fall more than once per week |
|
Definition
| because they have Postural Instability |
|
|
Term
| Postural Instability in PD patients make it more difficult for them to perform what type of activities? |
|
Definition
| dynamic destabilizing activities |
|
|
Term
| What causes a PD patient to have Poor cocontraction of trunk muscles during periods of instability |
|
Definition
| (bradykinesia/akinesia, weakness, fatigue) |
|
|
Term
| What causes a PD patient to have an Inability to use normal postural balance strategies or delayed manifestation of strategies |
|
Definition
| rigidity, weakness, fatigue bradykinesia/akinesia, or hypokinesia) |
|
|
Term
| what causes a PD patient to have Reduced feed-forward adjustments: anticipatory or proactive strategies |
|
Definition
| rigidity, weakness, bradykinesia/akinesia, or hypokinesia) |
|
|
Term
| what causes a PD patient to have an Inability to adapt movement strategies to a changing sensory environment |
|
Definition
| difficulty processing visual, vestibular, and somatosensory information) |
|
|
Term
| A PD patient has Difficulty integrating what two types of plans at the same time |
|
Definition
| two types of motor plans at the same time |
|
|
Term
| What triggers freezing in a PD patient |
|
Definition
| triggered by competing stimuli |
|
|
Term
| what type of patient has a masked face? |
|
Definition
|
|
Term
| What may have a significant impact on success of therapy due to increased time for thought processing with PD |
|
Definition
|
|
Term
|
Definition
|
|
Term
T or F
PD patients do not have Difficulty with sequential tasks |
|
Definition
|
|
Term
|
Definition
| abnormally small, cramped handwriting and/or the progression to continually smaller handwriting. |
|
|
Term
| What disease is micrographia commonly associated with? |
|
Definition
|
|
Term
| Why might a PD patient be depressed? |
|
Definition
| due to chemical changes in the brain |
|
|
Term
T or F
Swallowing & communication disorders are common in PD patients |
|
Definition
|
|
Term
| What are 4 Autonomic dysfunction seen in PD |
|
Definition
| excessive sweating, increased salivation, bladder dysfunction, impotence …. |
|
|
Term
| What are 2 Musculoskeletal changes seen in PD |
|
Definition
| decreased flexibility, malalignments |
|
|
Term
| What are 4 Visual & sensorimotor changes seen in PD |
|
Definition
| decreased blinking, decreased eye pursuit, decreased visual reflex responses |
|
|
Term
| What are 3 Cardiopulmonary dysfunctions seen in PD? |
|
Definition
Bradykinetic disorganization of respiratory movements
Decreased chest expansion (rigidity, kyphotic posture, decreased flexibility
Deconditioning |
|
|
Term
| What are 5 PD Interventions for Rigidity, Loss of Flexibility, & Loss of Mobility |
|
Definition
Slow, rhythmic vestibular input and rotation for overall relaxation
Respiratory exercises and techniques to maintain chest wall mobility, muscle strength, and vital capacity
PNF – rhythmic initiation to improve movement initiation
Strengthening to counteract flexed posture |
|
|
Term
| when working with PD patients on interventions for Rigidity, Loss of Flexibility, & Loss of Mobility use should use PNF patters that promote what? |
|
Definition
| Use PNF patterns that promote trunk extension, expansion of the chest, and pelvic mobility |
|
|
Term
| Why should you be cautious when applying resistance in PNF with a PD patient? |
|
Definition
| Be cautious when applying resistance so as not to increase tremor and muscle tension |
|
|
Term
| what are 4 ways to use ROM to counteract flexed posture in a PD patient |
|
Definition
Positioning – low load, long duration stretch
PNF to increase ROM: contract-relax to decrease specific joint limitations
Joint mobilization
head, trunk, and pelvic rotation |
|
|
Term
| when working with a PD patient, what are the Interventions for Bed Mobility & Transfers |
|
Definition
safe performance
and the break the movement sequence into its components that can be performed in a quick and/or reflexive manner |
|
|
Term
| when working with a PD patient, What 5 things should you Pay attention to in regards to the mechanics of a task and the equipment used |
|
Definition
Bed or chair height
Armrests and rails
Using lightweight bed covers
Using visual, auditory, and proprioceptive cues; lighting; and other strategies to provide a safe environment
Smooth bottom shoes to assist in sliding |
|
|
Term
| What are 3 gait interventions you can use with a PD patient in the early stage? |
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Definition
Conscious attention to the gait pattern
Using video equipment, cameras, and mirrors to increase patient self awareness of problems and alignment
Emphasize increasing gait velocity, step length, and arm swing with focus on heel strike
Use music or a pacing partner to facilitate velocity and reciprocation |
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Term
| What are 6 things to work on freezing and motor blocks in the Later stage PD: |
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Definition
Identify what may trigger the episode
Observe which leg/foot has a greater tendency to freeze
Use visual cues
Rhythmic Cues
Retropulsion: Identify triggers & compensate
Propulsion (festination): identify triggers & compensate |
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Term
| What is another name for Trigeminal Neuralgia |
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Definition
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Term
| MS pts with cortical spinal lesions demonstrate signs and symptoms of what type of neuronal involvement? |
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Definition
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Term
| What are the 5 prognostic indicators for MS |
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Definition
Symptoms
Course of disease
Age
Neurological Findings at 5yrs
MRI Findings |
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Term
| What are the 4 disorders and impairments of the cerebellar |
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Definition
Ataxia
Dysmetira
Dysynergia
Dysdiadochokinesia |
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Term
| Define Dysdiadochokinesia |
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Definition
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Term
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Definition
| Disturbance in muscle coordination |
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Term
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Definition
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Term
With Somatosensory impairment you might experience chronic neuropathic pain?
What is chronic neuropathic pain? |
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Definition
| demylinating lesions in the spinothalamic tracts or in the sensory root. |
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Term
| What 3 things are used to diagnoses MS? |
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Definition
Pt history
Clinical Findings
Lab work |
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Term
| What is the hallmark of MS |
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Definition
| Sclerotic plaques found throughout the CNS |
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Term
| How can you help a PD patient maintain control when coming to sit? |
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Definition
| have him to lower his hands down his thighs toward his knees , causing him to lean forward and bend at the hips. |
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Term
| when working on freezing in a PD patient you should have the pt Always initiate stepping with the which leg? |
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Definition
| Always initiate stepping with the “sticky” leg |
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Term
| When working with PD patients an Exaggerate step length and increasing step length tends to increase what? |
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Definition
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Term
| What is the best way to show a PD pt how to turn? |
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Definition
| Try to have the patient establish turning in a consistent and controlled pattern in ONE direction |
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Term
These are examples of what type of trigger compensation for a PD pt?
Side step or march to turn vs. making a sharp pivot
Counterbalance with one hand while reaching to pen doors inward |
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Definition
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Term
These are examples of what type of trigger compensation for a PD pt?
Use grab bars in confined areas when turning is involved
Pay attention to keeping center of gravity over base of support when transitioning (such as strategy for sitting down)
Avoid movements that involve backing up, such as preparing to sit in a chair – turn directly in front of the chair rather than backing up |
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Definition
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Term
These are examples of what type of trigger compensation for a PD pt?
When patient or caregiver notices steps shortening and patient leaning forward, patient should stop and take a long deliberate stride to break the pattern
Minimize multi-tasking to increase concentration on the task of walking |
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Definition
| Propulsion (festination): |
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Term
| What is a PTA and what does it stand for in regards to TBI |
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Definition
The time between the injury and the time when the patient is again able to remember ongoing events
Post Traumatic Amnesia
Post Traumatic Amnesia |
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Term
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Definition
| Diffuse Axonal Injuries (DAI) |
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Term
| What does the Glasgow Coma Scale Assess? |
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Definition
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