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Multiple sclerosis body attacks myelin sheath resulting in scar tissue and plaque further resulting in impaired nerve conduction and inflammation
Multiple sclerosis symptoms motor ataxia, spasticity, weakness, intention tremors sensory paresthesia, vertigo, pain visual deficits diplopa, scotoma, nystagmus slurred and scanned speech cognition, sexual deficits, emotional deficits
Phases/Types of MS Relapse-remitting secondary progressive-- cessation of fluctuations primary progressive--deterioration from beginning progressive relapsing Benign vs malignant
MS intervention goals are compensatory c/i: heat, alcohol, increased emotional or physical stress, overexertion therapy: rest and avoid fatigue, stretch proximal before distal
Parkinson's basal ganglia, substantia nigra depigments with decreased production of dopamine
Primary symptoms of Parkinsons tremor: resting, pill rolling muscuel rigidity/stiffness: cogwheel bradykinesia: slow movements postural instability: stooped psoture, decreasd arm swing
Secondary symptoms of Parkinsons gait, fine motor, freezing, cognition, sensory loss, dysphagia, communication, mood
Stages of PD 1: unilat, resting tremor, no fxl deficit 2: bilat, no balance deficits, trunk mob affected 3: impaired balance 2nd to postural instab, mild/mod dec in fxn 4: decrease in function, impaired mobility, A with ADL poor FMC 5: w/c bed, max A ADL & mob
PD intervention active music therapy Voiding schedule large tip pens heat, stretch, ROM for rigidity antispasticity or progressive splint for contractures Sedentary job with min verbal communication
ALS motor neurons destoryed and replaced with scar tissue--> progressive muscle atrophy DISTAL TO PROXIMAL and asymmetrical, starts with muscle weakness in hands
ALS symptoms dysphagia, spasticity, cramping, fasciculations cognition, sensation, vision, hearing, bowel, bladder intact
Stages of ALS 1: walk, independent, some weakness 2: walk, mod weakness 3: walk, severe weakness 4: w/c, some assist with ADL, weakness in LE 5: w/c, dep for ADL, weakness UE and LE 6: bed, dep for ADL
Wheelchair for ALS high backed, reclining, lightweight, support for head, trunk, extremities
Guillian Barre inflammatory, demyelination of axons in peripheral nerves, symmetrical ascending pattern of flaccid paralysis begins in feet
GBS symptoms pain, fatigue, edema, sensory loss in hands and feet dysfunction of CN, ANS
GBS stages 1: onset and acute inflammatory: 2-4 weeks 2: plateau: most debilitating up to 2 years 3: recovery: remyelination and axonal regeneration, fatigue residual sx
Huntingtons hereditary, progressive loss of nerve cells in the brain
HD symptoms motor: chorea, akathisia, dystonia, bradykinesia, akinesia, ataxia cognitive, dyshpagia, slow eye movements Later stages unable to walk, talk, BADL
Alzheimer's cortical atrophy, accumulation of amyloid tau protein
Alzheimers symptoms progressive impairment of memory, executive function, attention, language, praxis, visual process
Vascular dementia TIA's, less memory involvement than AD, abrupt decline
Frontotemporal dementia progressive aphasia, corticalbasal syndrome, symptoms similar to AD or PD immediate distinct onset, progressive
Lewy Body dementia protein in limbic or neocortical, decrease in ach and dopamine ex fxn, attention, memory, visuospatial --> aphasia, apraxia, spatial disorientation
Stages of dementia early: IADL affected middle: no longer live alone, neglect ADL/IADL later: dep in ADL, no longer ambulate safely, communication lost
paratonia involuntary resistance to passive movement of extremity
hyperflexia overflexion of limb
agnosia inability to interpret sensations or recognize them
chorea rapid, involuntary, irregular movements
akathisia motor restlessness
dystonia abnormal, sustained posturing
akinesia delayed initiation of movement, impaired voluntary and spontaneous movement initiation resulting in freezing, during walking esp.
dysmetria decreased coordination
fasciculation involuntary muscle contraction and relaxation, muscle twitch
festinating gait small rapid steps resulting from a forward tiled head and trunk posture
paresthesia numbness and tingling because of sensory nerve changes
Allen Level 6 Planned actions, independent, no disability
Allen Level 5 Exploratory actions, supervision for cognitive assist visible, concrete, meaningful stimuli w/ external cuing trial & error problem solving follow 4-5 step process & learn new concrete ideas diff with jdugment, reasoning, planning, semantic & episodic
Allen Level 4 Goal directed activity, min cognitive assist attention directed to visual/ tactile cues understands cause& effect, cant problem solve 2-3 step activities, labels/pics task set up for bathing and grooming eat I, assist for amt wandering, 24 hr sup
Allen Level 3 manual actions, mod cog assist attention to tactile cues 1-step familiar and action oriented activity cannot learn new behaviors routine, avoid sensory overload during grooming/bathing, items presented 1 at a time
Allen Level 2 postural actions, max cog assist highly disorganized thinking, internal cues one step, imitated, reflexive, familiar and gross motor ADL by imitating caregiver spontaneous behaviors, eat finger foods, paces, wanders, clock void
Allen Level 1 automatic, total cog assist attention subliminal internal cues 1 word, near reflexive directions monitoring for nutrition assist with ambulation and transfers, dep for ADL