Neurologic Considerations
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| What is the primary neurological disease of the elderly? | Parkinson's disease
🗑
|
||||
| Primary motor symptoms of Parkinson's disease (4) | Resting tremor
Bradykinesia
Rigidity
Postural instability
🗑
|
||||
| Hoehn and Yahr Stages of Parkinson's | 1) Unilat involvement, min func disable
2) Bilat/midline without balance impaired
3) Bilateral, mild to moderate disability impaired postural reflex, physically ind
4) Severly disabling, can walk or stand unassisted
5) Confinement to bed or w/c
🗑
|
||||
| Modified Hoehn and Yahr Stages | 0 = no sign
1 = unilat
1.5 = unilat + axial
2 = bilat without impairment of balance
2.5 = mild bilat, recovery on pull test
3 = mild - moderate bilat; postural instab; physically ind
4 = severe disable; walk or stand ind
5 = w/c or bedridden
🗑
|
||||
| How do you evaluate rigidity on a Parkinsonian patient? | Test by flexing and extending patient's relaxed wrist
Assess relaxed position or wrist drawn into flex, fingers ADD, pronation
🗑
|
||||
| Functional outcome measures for gait and balance in Parkinson's patients | 2 MWT
6 MWT
TUG (TGUG)
Sit-to-Stand
🗑
|
||||
| Parkinson's Disease Rating Scale | 10 listed items
Rated 0-3 higher number is more severe involvement
🗑
|
||||
| Parkinson's Disease Quality of Life Questionnaire | Consists of 4 subscales:
1) Parkinsonian symptoms
2) Systemic symptoms
3) Emotional functioning
4) Social functioning
🗑
|
||||
| Schenkman's Approach to treating PD | Relaxation/Breathing exercises
Passive stretching
AROM and Posture alignment
Weight shifting
Balance responses
Gait activities
HEP
🗑
|
||||
| Flewit-Hanford Exercises for PD | Designed to assist gait
1) Long sitting - flex/ext of toes, feet, and knees
2) Hooklying - rocking knees side to side
3) Supine Lying - alternate hip and knee flex/ext
4) Standing - high stepping, alternating DF, weight shifting, standing grapevine
🗑
|
||||
| Alberts study on Tandem Bicycle for PD | Group forced to pedal at 80-90 RPM had 30% improvement in symptoms vs voluntary group after 8 weeks
🗑
|
||||
| Music therapy has been shown to be beneficial in increasing gait speed and step length in patients with Parkinson's disease. T/F | True
🗑
|
||||
| How frequent is recurrent stroke? What is the time frame? | 25% of people who recover from their first stroke will have another within 5 years
🗑
|
||||
| Signs and Symptoms of Stroke | 1) Decreased level of consciousness
2) Aphasia/Dysarthria
3) Acute onset of hemiparesis/hemisensory loss
4) Monoparesis or Quadriparesis
5) Nystagmus, visual changes
6) Ataxia and vertigo
🗑
|
||||
| Which type of stroke is more severe hemorrhagic or ischemic? | Hemorrhagic is the most severe
🗑
|
||||
| Pushers Syndrome (what is it, whos affected, remission) | Patient pushes strongly away from unaffected side towards affected
Affects 10% of stroke patients
During remission typically disappears first in supine, then sitting, then standing
🗑
|
||||
| What is affected in pusher syndrome? | Sensory feedback in relationship to posture and gravity leading to misperception of position in space
🗑
|
||||
| When does recovery of tone generally happen post stroke? | First 7-14 days
🗑
|
||||
| Left CVA Behaviors (5) | Frequent and severe depression
Aware of own deficits
Slow cautious behavior
Hesitant - may need feedback and support
Difficulty learning new tasks
🗑
|
||||
| Left CVA Motor Programming Deficits (3) | Difficulty completing and initiating sequence of movement
Requires increased time for learning
Slower movements
🗑
|
||||
| Left CVA Treatment Strategies (3) | Speak slowly to allow processing of verbal instructions
Use visual cues
Use one step commands and decrease environmental distractions
🗑
|
||||
| Right CVA Behaviors (7) | Unrealistic/inappropriate positive emotions
Unaware of deficits
Tend to be impulsive
Decreased information processing
Decreased visual spacial perception
Decreased mathematical reasoning
Poor R vs L discrimination
🗑
|
||||
| Right CVA Motor Programming Deficits (2) | Difficulty sustaining movement and/or posture
Tend to move too fast
🗑
|
||||
| Right CVA Treatment Strategies (4) | Decrease environmental distractions
Maximize verbal cues
Keep visual cueing to a minimum
Address safety issues, encourage patient to slow down
🗑
|
||||
| Tripp's Model for Evaluating Stroke Patients | 1) Motor neuron response - eval tone and spastic, abil contract and relax mm
2) Fractioned movement - abil move limb segments
3) Movement consistency - gross motor activity
4) Mental status - abil follow command
5) Funct asses - mobility and UE func
🗑
|
||||
| Olney and Colbourne's Gait Assessment found 3 problems for stroke patients in last swing phase | 1) Inability to attain full hip flex during swing
2) Inability to ext the knee fully
3) Inability to activate ankle DF
🗑
|
||||
| 4 Principles of Carr and Shepard's Treatment Approach | 1) Analyze the task
2) Practice the missing component
3) Practice task as a whole
4) Transference of training
🗑
|
||||
| What common treatment for shoulder problems should be avoided in hemiplegia? | Avoid use of overhead pulley
🗑
|
||||
| Ranchos Los Amigos Treatment for LE Problems due to Stroke | AFO for DF
FES on glutes and quadriceps
Prolonged icing to inhibit tone
🗑
|
||||
| What 2 things are required to treat Pushers Syndrome? | Intact cognition
Active patient participation
🗑
|
||||
| 4 Aspects of PT treatment for Pushers Syndrome | 1) Early resumption of upright posture and transitioning ability
2) Recalibrate perception of an upright posture
3) Utilize tactile and proprioceptive inputs
4) Emphasize stability during early standing
🗑
|
||||
| Both over-ground gait training and treadmill training are needed to optimize over-ground walking in stroke patients. T/F | True. Both are needed in training sessions to optimize transfer to over-ground walking
🗑
|
||||
| Explicit information is beneficial for what types of strokes? Which is it detrimental for? | Beneficial: cerebellar damage
Detrimental: MCA and Basal Ganglia
🗑
|
||||
| How frequent should feedback be given for CVA patients? | Less than 50% of trials
Summary feedback after several trials is best
🗑
|
||||
| In patients with CVA guidance has a positive impact on retention of learning. T/F | False. Guidance has a negative impact on retention. NDT
🗑
|
||||
| Alzheimer's Disease Characterized | Deterioration of memory and other cognitive domains that leads to death within 3 to 9 years after diagnosis
🗑
|
||||
| 2 markers present in AD | Amyloid clumps
Tau neurofibrillary tangles
Clumps cause cell death in disease process
🗑
|
||||
| What part of the brain is affected first by AD? | Nerve cells in the hippocampus
🗑
|
||||
| What chromosomes are contributors in AD? | Chromosomes 1, 14, 19, 21
🗑
|
||||
| Non-Modifiable Risk Factors for AD (6) | Age
Genetics
Down's Syndrome
Gene mutation
Head trauma
Exposure to metals, infections, toxins
🗑
|
||||
| Modifiable Risk Factors for AD (5) | HTN
Obesity
Insulin resistance
Smoking
Inactivity
🗑
|
||||
| Stages of Alzheimer's Disease - Early Stage | Forgetfulness, mild memory deficit
Difficulty with novel tasks
Apathy and social withdrawal
🗑
|
||||
| Stages of Alzheimer's Disease - Middle Stage | Moderate to severe objective memory deficit
Disorientation to time and place
Language disturbance, apraxia, personality and behavioral changes
🗑
|
||||
| Stages of Alzheimer's Disease - Late Stage | Intellectual functions untestable, verbal communication severely limited
Incapable of self-care
Incontinence of bowel and bladder
🗑
|
||||
| Stages of Alzheimer's Disease - Terminal Stage | Bedridden
Mute
Unaware of the environment
Joint contracures
Myoclonus
🗑
|
||||
| Neurologic signs such as hyperactive reflexes, increasing primitive tone, and primitive reflexes occur during what stage of AD? | Later stages
🗑
|
||||
| What is one way to maintain environment when placing a patient with AD in a nursing home? | Use of patients own furniture in the room assists in responsiveness and connectedness with surroundings
🗑
|
||||
| What factors put patients with AD at risk for falls? | Failing to remember limitations in ADLs
Judgment errors and lack of awareness
Over-estimation of capacity for safe mobility
Refusing/Forgetting use of assistive device
🗑
|
||||
| What is "sundowning"? | A syndrome characterized by:
Restlessness
Excitement
Increased confusion
Hallucination
Agitation
Seen in late afternoon or early evening
Occurs in middle and late stages of AD
🗑
|
||||
| AD Visual Performance Dysfunction | Restriction of visual fields - loss of peripheral vision, homonymous hemianopia
Decrease in visuospatial function, depth perception
Loss of contrast sensitivity, agnosia
🗑
|
||||
| Motor incoordination during gait in AD | Alternating foot pattern is disrupted - pt. takes 2 to 3 steps with one foot without moving the other
COG is affected
🗑
|
||||
| Benefit of habitual exercise for AD | May improve cognitive functioning and reduce falls that result form poor judgment
🗑
|
||||
| What is the best practice for motor learning for AD? | Constant practice = i.e. practice of all transfers from the same chair
Pt.'s were unable to learn new tasks with random practice
Learning was impaired with blocked practice
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
jpwittman
Popular Physical Therapy sets