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OTP 541 Exam 1
| Question | Answer |
|---|---|
| What is attention? | Focus Function of higher cerebral cortex- frontal, parietal lobe |
| What is arousal? | Asleep/awake Function of brain stem, reticular formation |
| Levels of hypoarousal | 1. Drowsy/lethargic 2.Stupor- capable of reaching arousal, but takes vigorous stimulation 3. Coma- indicates brain stem damage/ hemisphere damage |
| Frontal lobe functions | Highest level of cognitive functioning - personality, judgment |
| Deficits of frontal lobe functioning lead to... | Personality changes Lack of reasoning or inhibition Irritable Poor judgment |
| Right hemisphere functions.. | Art, music, emotion, colors, creativity, imagination |
| Left hemisphere functions... | Logic, verbal, symbolic, linear, direction, math, rational |
| Right hemisphere syndrome | Inability to orient body in space and execute proper motor actions: emotional lability, hemi-neglect , decreased perspective, spatial disorientation |
| Emotional lability | Out of control emotions Roller coaster emotions Right hemisphere syndrome |
| Decreased perspective | unable to perceive 3D Right hemisphere syndrome |
| Spatial disorientation | Getting lost Right hemisphere syndrome |
| Left hemisphere dysfunction | Language deficits: dysarthria, anarthria, expressive aphasia, receptive aphasia Akinesia Apraxia Agnosias- visual, astereognosia |
| Dysarthria | Oral motor coordination problem, comprehension intact Left hemisphere dysfunction |
| Anarthria | Severe dysarthria - no motor production of speech Left hemisphere dysfunction |
| Akinesia | Inability to initiate movement Left hemisphere dysfunction |
| Apraxia | Inability to perform purposeful voluntary movements Left hemisphere dysfunction |
| Agnosias | Inability to comprehend/ interpret sensory info Posterior parietal lobe damage Left hemisphere dysfunction |
| Limbic System | senses connecting with emotions recognizing facial expressions autonomic and behavioral responses, sensory processing of emotions such as anxiety, fear, pleasure, pain Motivation and drive for human action, learning, and memory |
| Damage to the limbic system leads to... | increased anger and violent behavior |
| Contralaterality | hemisphere contralateral to one side of the body responsible for interpreting sensory input from one side of the body |
| Damage to a sensory area of the left cortex will result in... | impaired ability to interpret sensory input incoming from the peripheral nervous system from the right side of the body |
| Modulation and interpretation of sensory input occurs at... | Reticular formation, midbrain, thalamus, limbic system |
| Special senses- vestibular, proprioception- are interpreted at ... | brainstem |
| Primary brain structure responsible for coordinated movement | cerebellum |
| Cerebellum | involved with motor learning, cognition, and emotions |
| Lesions in the cerebellum lead to... | difficulty with shifting from one thought to another, and/or one movement to another |
| Ataxia | uncoordinated movement |
| Asthenia | generalized muscle weakness |
| Hypotonicity | low muscle tone occurs proximally --> impaired distal mobility |
| Dysmetria | inability to direct movement to where you want it to go Inappropriate amount of force or incoordination unable to grasp object bc of motor difficulties |
| Autonomic NS | integrate autonomic, endocrine, motor response, emotion homeostasis stress response cardiovascular respiratory GI blood flood conscious and unconscious sensations of body reflexes & reflexive actions |
| Influencing factors of CNS pathology | Size of lesion, location of lesion Gradual vs. sudden onset age pre-morbid level of activity |
| Praxis | Ability to conceive and plan a motor act Relies on memory of previously learned movements |
| Apraxia | Inability to perform skilled motor movements Acquired - TBI, stroke |
| Apraxia is more common in... | left brain dysfunction- often coexists with stroke |
| Dyspraxia | born with inability to perform skilled movements |
| Types of apraxia | Verbal- deficits with oral-motor function Limb- ideomotor, ideational constructional dressing |
| Area of cortical damage- limb apraxia | Left brain dysfunction in (R) dominant person Right brain dysfunction in (L) dominant person |
| Ideomotor Limb Apraxia | A production deficit- problem generating an action plan and carrying it out Client knows what they want to do & understand the concept of the task, but cannot physically perform the task with skill; clumsy/awkward task perf Unable to pantomime actions |
| Ideational Limb Apraxia/ Conceptual Apraxia | client does not understand the concept of performing task Presents with errors of knowledge of objects, so uses objects incorrectly Errors of knowledge of actions, sequencing Motor actions are less clumsy/awkward No automatic task performance |
| The client with which type of limb apraxia will have more functional deficits? | Ideational |
| Assessment of limb apraxia | Non-standardized observation of task performance Request patient pantomime tool use If client cannot pantomime, OT pantomimes and asks client to copy If client is still unable, then actual object is given to patient to demonstrate use |
| Constructional Apraxia | A deficit of spatial organization and conceptualizing Person displays inability to construct or build things- putting together a recipe Usually associated with L parietal lobe injures; a dysfunction of concept and executive functioning |
| Assessment of Constructional Apraxia | Nonstandardized- have client copy 2D and 3D images; observe task performance with assembly tasks Stadardized- Test of Visual-Motor Skills for Adults; 3D block Construction |
| Dressing Apraxia | Inability to coordinate and execute the task of dressing one's own body and orienting it correctly Assessment through non-standardized observation |
| OT Treatment for Apraxia | Determine if apraxia interferes with function- some can get by Treat co-existing deficits Client must have self-awareness Top-down, task specific, combine compensatory & remedial strategies |
| Compensatory Strategies for Apraxia | Utilize as normal an environment as possible Minimize need for tool use Do not use adaptive equipment Eliminate steps, simplify sequencing Strategy training- Internal & external strategies |
| Strategy Training (Apraxia) | Apply activity analysis to task performance OT assesses client performance while completing a task- initiation, execution, motor control Client is taught to apply strategies that target the specific aspects of task completion they find challenging |
| Internal Strategies- Apraxia | Training in self-verbalization- memorize steps for task & recite while completing task Visual & tactile cues- client develops habit of attending to details |
| External strategies- Apraxia | physical assistance (hand over hand) Checklist including all steps of the task Using a series of sequential picture cards Verbal striations and cuing from another person |
| Remedial Interventions for Apraxia | Gross motor activities that stimulate sensory input, manually guide UE through task, chaining, guided imagery, minimize verbal cues, task-specific training, errorless learning & training of details, gesture training, combine mental & physical practice |
| Cognition | Interrelated processes, including the ability to perceive, organize, assimilate, and manipulate information to enable client to process information, learn, and generalize Acquiring information, processing it, and applying it to everyday life |
| What does cognitive functioning affect? | Who we are how we approach ADLs How we re-acquire ability to perform ADLs after injury One's ability to continue ADLs during the course of degenerative disease |
| Cognitive dysfunction | Functioning below expected normative levels or loss of ability in any area of cognitive functioning Can be transient or permanent, progressive or static, general or specific, and of different levels of severity |
| Why is it important for OTs to address cognition? | Safety Determine cognitive deficits from physical deficits Address self-awareness The most important predictor of client's outcome from the rehab process |
| Components of Cognition | Primary Cognitive Operations, executive functioning, self-awareness |
| Primary Cognitive Operations | Precursors to higher order thinking- orientation, attention, memory |
| Orientation | The ability to understand the self and the relationship between the self and the past and the present environment |
| Sustained attention | Ability to consistently engage in an activity over time |
| Selective attention | ability to attend to relevant stimuli while inhibiting distractions or irrelevant information |
| Divided attention | mental tracking simultaneously keeping track of 2+ stimuli during an ongoing activity |
| Alternating attention | shifting of attention between tasks of different cognitive or motor requirements |
| Where is short term memory stored? | pre-frontal cortex |
| What function is necessary for info to be stored in STM? | Sustained- 30 seconds |
| Working memory | a subset of STM # of bits of info that can be held in working memory |
| Where is LTM stored? | hippocampus |
| Procedural memory | Implicit memory direct experience, "how to " memory skills, habits, behavior Cannot be accessed consciously |
| Non-procedural memory | Explicit memory, declarative Memory for facts, events, & data General knowledge Can be intentionally accessed through conscious recollection |
| Memory impairments | amnesia- anterograde, retrograde, traumatic deulsions hallucinations CNS dysfunction may exhibit memory dissociation |
| Antereograde amnesia | inability to recall information post trauma |
| retrograde amnesia | difficulty recalling memories before onset |
| Traumatic amnesia | result of event itself |
| Delusions | false beliefs- superheros |
| Hallucinations | interpreting non-existent sensory stim. |
| Executive functioning | complex cog processing requiring the coordination of sub processes to achieve a goal- decision making, problem solving, planning, task switching, modifying behavior w new info, self-correction, developing strategies, formulating goals, sequencing actions |
| Problem solving | ID problem, define problem, generate possible solutions, choose a solution, implement solution, assess outcome |
| Volitional behavior & goal formulation | self awareness, initiation, & motivation social etiquette |
| Purposeful action | steps to reach a goal |
| Effective performance | having a successful end result |
| Executive functioning impairments may lead to... | impaired judgement, impulsive, apathy, poor insight, and the lack of organization, planning, and ability to make decisions May be able to verbalize plan, but unable to execute it |
| Types of self-awareness | intellectual, emergent, anticipatory |
| Intellectual awareness | understand at some level that a function is impaired |
| Emergent awareness | Recognize a problem when it is happening |
| Anticipatory awareness | anticipate a problem will occur as a result of impaired function |
| Why do OTs assess cognition? | to id any deficits that require intervention- plan goals & tx establish baseline level of client functioning Identify need for a specialist referral Educate caregiver for ADLs and safety Identify deficits that have ramifications for discharge planning |
| Ecological validity | The degree to which the cognitive demands of the test theoretically resemble the cognitive demands in the everyday environment, and sometimes termed functional cognition |
| Visual perception | putting meaning behind visual stimuli |
| Spatial relations | Ability to process how objects relate to one another, and to oneself, in terms of orientation in space Utilized to orient clothing on body, effectively orient silverwear to pick up food and bring to mouth, orient body in space for functional mobility |
| Assessing spatial relations | Non-standardized: ask client to copy 2D design pattern, ask client to place objects in certain orientation (pack a suitcase) Standardized assessments |
| Depth perception | Ability to interpret depth and hence the dimensionally of a scene Utilized to pour a beverage into a glass, ascend/descend stairs, judge distance of a vehicle in traffic |
| Assessing depth perception | Non-standardized: ask client to identify which objects are closer to them and which are farther away |
| Figure ground discrimination | Ability to distinguish various objects from one another, visually: foreground and background. Utilized to distinguish objects from one another in a drawer, distinguish sleeve from the torso of a shirt, distinguish level of chocolate milk in a brown cup |
| Assessing figure-ground discrimination | Nonstandarized: ask client to locate an object from many, especially with similar color Standardized: MVPT |
| Visuospatial impairments lead to... | increased risk of falls, decreased ADL ability (dressing), decreased mobility |
| Implications for visuospatial impairments | familiar objects feel unfamiliar difficulty reaching for objects feels like UE are too short difficulty finding everyday objects Hard to maneuver body into a car generally feeling unsafe |
| Spatial relations impairment | inability to relate objects to oneself, one another May demonstrate smooth motor movements, but be unable to connect hand and object together perceptually |
| Stereopsis | impaired depth perception |
| Figure ground impairment | inability to distinguish objects from various items, or distinguish a foreground from a background |
| Treatment for visuospatial impairments | Address self-awareness Encourage client to work slowly, increase attention to detail Environmental modifications- labeling, color contrast items, decrease clutter Therapeutic use of self: avoid instructions with spatial based language Use other senses |
| Compensatory approaches to visuospatial impairments | Compensate with other senses- touch Visual attention- look for visual cues or labels |
| Restorative approaches to visuospatial impairments | Practice concepts such as placing objects over and behind to relearn, practice locating items from each other, progressively increasing the similarities between objects, computer based practice games |
| Diplopia | double vision due to motor (ocular alignment) or cranial nerve impairment |
| Diplopia assessment | Convergence and tracking (ocular mobility) Cranial nerve signs- change in pupils, ptosis Cover-uncover test- uncovered eye must move for attention |
| Diplopia treatment | Patch one eye- short term bc side effects- eye fatigue, blocks peripheral vision, safety concerns & mobility impairments Spot patch- partial visual occlusion Prism glasses Orthoptics- ocular muscle strengthening exercises |
| Visual midline shift syndrome | May be caused by any loss of field of vision Clients perception of body midline shifts to the side of actual midline Inability to orient COG of body accurately- impaired gait, balance, decreased ADL function & mobility |
| Visual midline shift syndrome treatment | Prism glasses to correct visual input Remedial visual motor exercises |
| Treatment for visual field deficits | Primarily compensatory- cueing to side, encourage increased attention to side, increase tracking & saccade exploration areas, larger eye movements For reading- experiment with varying angles, orientation of paper & print size, provide color anchors |
| Balance | The ability to control our center of gravity over a base of support, resulting in stability and equilibrium |
| Balance is dependent on... | Neurological CNS, PNS, musculoskeletal system |
| Lack of self-awareness | Promote metacognition |
| Interventions to enhance self awareness | Goal rating- chart over time Self-prediction- rate performance after Videotape feedback, self-questioning, journaling |
| Attention deficits | Client appears unmotivated or shows signs of neglect person demonstrates general poor performance, decreased productivity |
| Compensatory strategies for attention deficits | eliminate distractions, simplify tasks, reduce options, break tasks into smaller tasks, follow audio recorded instructions of a task, promote visual attention through colored tape & labels, strategy training |
| Strategy training for attention deficits | a compensatory approach self-monitor thoughts schedule frequent breaks develop a habit of reviewing, double-checking Talk through task identify distractors & eliminate them |
| Restorative strategies for attention deficits | less effective than compensatory Practice a task repeatedly, over time increasing demands placed on attention: increase time on task, introduce distractors, alternate between tasks Computer based games |
| Compensatory strategies for memory deficits | memory prostheses- memory notebooks, alarms, checklists, audio recordings, phone apps, electronics with automatic shut-offs |
| Strategy training for memory deficits | Errorless learning- learn via doing, self-talk, and not being allowed to make a mistake Backward & forward chaining Visual imagery |
| 3 As | Acquisition: starting/initially practicing a new strategy or technique Application: using strategy Adaptation: tweaking & individualizing |
| IDEAL | Identification of a problem Defining the problem Evaluating options Action Look back, reflect |
| Goal management training | Stop & think Define & set goal Delineate steps Learn & Do Check-review outcome |
| Co-Op: Cognitive Orientation to Occupational Performance | Client-centered, performance based, problem solving approach that enables skill acquisition through a process of guided discovery and strategy use Focuses on strategy use to support the acquisition, generalization, and transfer of 3 client chosen skills |
| Skill-Task Habit Training | Performing a task by habit allows one to do so with little cognitive effort, relying on automaticity: perform task with little use of conscious thought Procedural learning, errorless learning |
| Steps to Skill Task- Habit training | Client & OT collaborate to identify task & behavior sequence, context specific task practice attending to environmental cues and following steps outlined via task analysis Implement chaining, prompting, reinforcement Overlearning via constant repetition |
| How could we take a remedial approach and address the necessity of generalizing the skill? | Make situation as real as possible Games that apply to real life Multi-Contextual approach |
| Perservation | Inability to shift from one concept to another, change/stop action Inability to translate knowledge into action Treatment- trial and error for what will work with client, cueing |
| Right/left discrimination | Inability to apply concepts of right & left, to self or objects Compensatory tx with visual cues |
| Topographical disorientation | inability to find one's way in space, even in familiar surroundings Treatment through compensatory visual cues; some may relearn & overcome condition in familiar surroundings and gradually eliminate need for cues |
| Unilateral body neglect | Inattention to one side of the body= decreased inclusion of side of body in tasks, decreased acknowledgement of stimuli to side |
| Unilateral spatial neglect | Inattention to extra personal space on side, objects, and environment on side Extrapersonal: neglect of far space Peripersonal/near extra personal: neglect of space w/i arms reach & beyond |
| Theoretical causes of neglect: | attention-arousal theory hemispheric specialization theory disengagement theory interhemispheric interaction & inhibition theory |
| attention-arousal theory | due to damage at parietal or frontal lobes &/or limbic system, structures directly responsible for attention & arousal not operating properly; and/or sensory info is not transmitted to structures adequetely |
| Hemispheric specialization theory | normally, our R hemisphere is capable of attending to R & L hemispace, however L hemisphere can only attend to R hemispace |
| Disengagement theory | inability to stop attending to one side (intact) in order to shift attention to other side |
| Interhemisphereic interaction & inhibition theory | strong focus of attention to one side (intact) overshadows ability to attend to the other |
| Treatment for neglect | Monocular full or partial patching or hemi-spatial sunglasses worn to intentionally occlude vision on intact side- forcing attention to neglected side; lighthouse strategy; limb activation; constraint induced therapy; sensory input to neglected side |
| Constraint-induced therapy | intentionally restrain intact UE so that client is forced to utilized impaired UE; client must have AROM of involved UE and some incise into deficit; has implications for motor recovery of involved UE |
| Limb activation | AROM of impaired UE activated the attentional and perceptual systems of brain; do not use with complete hemiplegia; less beneficial if both extremities engage in AROM simultaneously |
| Lighthouse strategy | Client is taught to assume their head, neck, and eyes serve as beams of a lighthouse, encourages client to turn head completely, forcing attention to inattentive side |
| Sensory input to neglected side | Tactile- electrical stimulation/vibration to neck, tactile cueing Auditory- tapping, TV, music Visual- bright colors; video feedback |
| Somatoagnosia (Asomatognosia) | Decreased awareness of body scheme, relation of body to environment and relation of body parts to one another |
| Somatoagnosia assessment | Ask client to point to body parts or imitate you touching body parts Have a client draw a person or put together a body part jigsaw puzzle Nonverbal directions if aphasia, ask client questions about body part locations |
| Compensatory Tx Somatoagnosia | remove mirrors, environmental modifications for safety, labeling cues (matching) |
| Restorative tx for somatoagnosia | Reinforce feeling & sensory feedback, reinstate body awareness, emphasize body part name, description, orientation |
| Anosognosia | Person does not recognize body part as their own, does not recognize paralysis, sees limb as an object or as someone else's limb . Person's perception of their capabilities does not match the reality of their actual impairments |
| Anosognosia assesment | observation of behavior, response to injury; ask client to engage in bilateral tasks |
| Restorative tx for anosognosia | visual feedback- perform in front of mirror, video feedback- client watches performance, sensory input- increase proprio/kines to affected side; reality checking- guided self-reflection of performance; feedback from clinician |
| Compensatory tx for anosognosia | Fall prevention- environmental modifications, caregiver ed & training, casually ignore confabulations, name a body part |
| Eval process for neurobehavioral deficits | Begin w top-down assessment, observation skills, hypothesize possible impairments & test, eliminate verbal requirements (aphasia) |
| Aphasia | partial or complete loss of language capability |
| Global aphasia | damage to temporal & frontal lobes, poor language comprehension & little to no language expression capability |
| Broca's/expressive aphasia | Language production impairment, frontal lobe damage |
| Conduction | Client repeats words as a result of Broca's aphasia |
| Paraphasia | Misuse or replacing words or sounds; Broca's aphasia |
| Wernicke's/receptive aphasia | Posterior temporal lobe damage- unable to comprehend written or spoken language; inaccurate self-feedback on own language production |
| Jargon | unintelligible speech as a result of Wernicke's aphasia |
| Echolalia | perserverating on what is heard as a result of Wernicke's aphasia |
| The cerebellum is responsible for ... | symmetrical, smooth, & coordinated movement; balanced muscular activity; influencing timing & synergy of muscle action, influencing muscle tone |
| Impairment to the cerebellum leads to... | Ataxia , incoordination of agonist/antagonist muscles, unsteady gait, visual implications |
| Basal ganglia functions | receive information from cerebellum and cortex that is transferred to the motor cortex; continuous postural adjustments |
| Impairment to the basal ganglia leads to... | Rigidity, tremors, akinesia, bradykinesia, athetosis, chorea |
| Brainstem functions | houses vestibular nuclei, integrate vestibular input, compensatory oculomotor function |
| What individual musculoskeletal functions are necessary for intact balance capability? | AROM, PROM, strength, basic postural functions |
| Neurological components of balance | Somatosensory, vision, vestibular SS- proprioceptive input from skin, muscles, joints Vision- vertical info from environment; integration of body in space & movement in environment Vestibular- head position, body in space |
| Balance impairment | decreased ability to control COG over BOS --> asymmetrical posture & weight shift |
| The most common remedial intervention for balance impairments is .. | Weight-shifting - client will learn to shift weight w.o losing center of gravity |
| Clients with somatosensory impairments will rely on .. | visual system |
| What do clients with SS impairments present like? | Cannot look at you while walking- look ahead or at feet; attend to environment |
| Clients with SS impairments will lose their balance under which conditions? | Walking in crowded areas, anywhere vision is compromised |
| Remedial tasks & purposeful occupations that can be progressively graded to promote function during OT for clients with SS impairments.... | Practice functioning under difficult situations; teach client to work w the proprioceptive input they have left; close eyes when washing hair in shower; head-eye coordination activities |
| Clients with visual impairments rely on .... | SS, vestibular input |
| What do clients with visual impairments present like? | Surface dependent, hold on to wall |
| Clients with visual impairments will experience LOB under which conditions? | When surfaces are unavailable or send mixed messages, changes in walking surfaces, when carrying things |
| Remedial tasks & purposeful occupations that can be graded to promote function for clients with visual impairments... | Practice difficult situations with uneven surfaces |
| Clients with vestibular impairments will rely on ... | Vision or SS |
| What do clients present like with vestibular impairments? | Walking with a wide BoS, focusing visually on the environment |
| Clients with vestibular impairments will lose their balance when... | required to change their body position- rounding corner, going up stairs |
| Remedial tasks & purposeful occupations that can be progressively graded to promote function for clients with vestibular impairments... | functional activities requiring head movements- walking down hall turning head from side to side, hanging clothes on a clothes line, sports |
| ankle strategies | Small weight shifts on solid surfaces--Praticing reaching in cabinent, standing while concentrating on something else |
| hip strategies | medium weight shifts on a narrow BOS- doing tasks while standing on balance beam, reaching for items with knees locked, standing on step stool |
| Step strategies | large weight shifts that require client to step outside BOS- playing catch, place items purposefully out of reach and ask client to reach for them |
| Multi-Context approach | Identify a behavior that results in a functional problem, as opposed to targeting a specific impaired cognitive component; OTR & client determine a processing or compensatory strategy to change behavior; strategy is practiced in various contexts |
| Under the multi-context approach, the transfer of learning occurs... | during the learning process, not in the future |
| Five components of the MC approach | use multiple environments; task analysis & establishment of criteria for transfer; metacognitive training; processing strategies; relate new info to previously learned knowledge/skill |
| MC approach- abilities the client must possess in order to achieve generalization | evaluate difficulty level of a task, predict consequences of an action, formulate goals, plan, self-monitor performance, self-control |
| General processing strategies | selecting, prioritizing, categorizing |
| Situational processing strategies | rehearsing, mental pictures, self-initiate breaks |
| Nonsituational processing strategies | Strategies you can apply to different situations- time management skills, self talk, verbalizing plans |
| The vestibular system is responsible for... | detection of the forces of gravity & body motion; helps maintain clear vision (vestibular ocular reflex) |
| Vestibular ocular reflex | moves eyes in the opposite direction of head motion to focus visual gaze |
| symptoms of impaired vestibular ocular reflex | difficulty reading, objects appear to be jumping, difficulty maintaining a sense of equilibrium, objects appear to be jumping, blurry vision, unstable gaze |
| Sensory organization test | differentiating vestibular function from visual & SS; isolate 3 systems to see which one will cause client to feel unbalanced |
| Benign Paroxysmal Positional Vertigo (BPPV) | most common peripheral vestibular disorder; sudden onset vertigo instigated by head movements in certain positions; treated by vestibular rehab exercises & Eply maneuver |
| Vestibular neuritis | viral or bacterial infection leads to inflammation of vestibular nerve or labyrinth; symptoms: sudden onset vertigo, nystagmus, nausea, senses movement at rest, room spins; pharmacologic tx & vestibular rehab |
| Meniere's Syndrome | membranous inner ear fills with endolymph; symptoms: tinnitus, episodic vertigo, hearing loss, nausea, vomiting, sweat; sudden onset of symptoms lasting 1/2-24hrs, 2x; tx: diuretics, vestibular rehab not during acute attacks, surgery |
| Aging & vestibular system | Use it or lose it, ampulla hair cell loss, neuronal loss (vestibular nuclei ) |
| CNS & vestibular dysfunction | Longer recovery & poorer prognosis; TBI & CVA- structures responsible for interpretation & integration of vestibular sensory input are impaired |
| Vestibular rehab interventions | substitutions, adaptation, habituation |
| Substitution | Compensatory strategy for CNS dysfunction or permanent PNS dysfunction; prevent onset of dizziness while engaged in ADL; strengthen visual & proprioceptive input; |
| substitution examples | change body positions slowly, refrain from blinking, sit in front of car, focus on distant object while walking, cane |
| adaptation | CNS re-learns, compensates, adapts, recalibrates & accommodates for abnormal vestibular input, leading to improved postural stability. Exercises/functional movement patterns that incorporate vision w head and body motion, varying speed & SS input |
| adaptation examples | client sits on a balance ball, reads two lists of word while moving head side to side |
| Habituation | restorative technique; intentionally provoking symptoms of vertigo leading to increased tolerance levels of threshold; strengthening vestibular system by challenging it; movement patterns are unique to client |
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