Neuromuscular Practice Week 1

Handling via key points of control, task specific, quality of movement

Rancho Levels of Cognitive Functioning 7-10 are considered which of the following?

I. Mobility, II. Stability, III. Controlled Mobility, IV. Skill.

Difficulty with spoken language

Free, flexible motion that translates the body or body part in space & includes qualities of range & speed.

Difficulty with comprehension of written language

All of the following are part of the CAPE model except?

Pt continues to require therapy but can't tolerate 3hrs. Receives 1.5hrs of therapy.

Trying to improve sit to stand - currently moderate assist

Rancho Levels of Cognitive Functioning 1-3 are considered which of the following?

Pt continues to require therapy and supervision during the day.

Which hemisphere do we expect to be damaged (in the majority of people) when a person presents with aphasia?

Synergies. Stages of motor recovery - 7 stages

R wrist/hand weak. Pt does resisted mvmt w/ entire R UE to get increased activation on wrist/hand. Which technique?

Constraint from outside of the body

Stroke, No voluntary movement.

Movement patterns utilizing specific techniques (RI, RS, Contract Relax)

Distal body parts are fixed on support surface & proximal segment moves over a fixed distal segment(weight-shifting).

Distal part of extremity free from support surface & coordinated mvmt of this segment is superimposed on prox stability.

Use in combo w/ mvmt patterns to assist w/ initiation, speed, direction, timing of mvmt, increase muscle strength...

Normal coordination & Voluntary function

Decreasing synergy patterns & Coordination increases.

Focus on abnormal synergistic patterns & stages of motor recovery following stroke.

Conduction Aphasia: Speech & writing may be meaningless, ability to understand written & spoken language is normal.

Visual Processing

Optimal Theory proposes that enhancing expectancies and autonomy facilitate motor performance and learning.

Activities that are meaningful to pt & include enhanced sensations (tactile, vestibular, proprioceptive...)

Pt continues to require therapy but us able to leave the house and get transportation.

Broca's Aphasia: Language comprehension impaired. Easily produce spoken sounds, but meaningless.

Synergy patterns still present.

Motor Learning is the acquisition and/or modification of movement

Coordination increases & Almost normal coordination.

Function Model: Effects of acute & chronic disease on human functioning at system, individual, & societal levels.

Rancho Levels of Cognitive Functioning 4-6 are considered which of the following?

Patients who require complex, intensive care. Can include ventilator needs or any significant nursing requirement.

Working on components of a floor to chair transfer

Prolonged use of neurofacilitation techniques in isolation from activity-based task practice.....

Performance: Act of executing a motor skill that results in a temporary nonpermanent change.

Sensory perception, Spatial orientation, Movement coordination, Info processing, Integration of touch/pressure/temp

Perception and Recognition of Auditory stimuli, Memory, Speech

Reasoning, Planning, Parts of Speech, Movement, Emotions, Problem Solving

Constraints related to a specific task os skill

Basic Synergy Patterns.

Pt unable to return home & requires continued supervision. May continue to receive some maintenance therapy.

In acute care setting getting a person OOB. You use key points of control for norm mvmt to help them. Which technique?

Weak quads - patient in acute care and unable to get OOB

Cocontraction of agonists & antagonists that fixes parts of body to allow for WB & later allow for dynamic holding.

Decreasing synergy patterns.

Which of the following PNF techniques would NOT appropriately align with promoting mobility?

Goal/Function focused. Holistic. Posture & effect on function: core stability/alignment. No practice of "abnormal mvmt"

Inability to write

What does it mean for a patient to plateau?

Pt can tolerate 3hrs of therapy & requires at least 2-3 disciplines (PT/OT/SLP). Requires CMS-13 dx (neuro,burn, trauma)

Pt able to be discharged home but is unable to tolerate leaving the house for therapy or needs nursing.

A patient presents with Wernicke's aphasia. What area of the cortex is most likely damaged?

Use of unintended words or phrases

Working on having enough ROM & strength in UE so they will be able to reach

Constraints related to the body's structure and/or behavioral function

Nonfluent Aphasia: Language expression is impaired. Ability to understand & control muscles used in speech not affected.

Sensory stimulation techniques and sequence of motor developement

Global Aphasia: Inability to use language of any form. Usually secondary to large lesion damaging lateral L cerebrum.