Term
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Definition
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Term
| the brain does NOT control... |
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Definition
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Term
| Movement may be limited by the restraints of... |
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Definition
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Term
| Movement is a resposne to what? |
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Definition
| a motor task presented by teh CNS |
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Term
| Movement occurs as a combination of...(3) |
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Definition
| cerebellum, cerebral motor cortex, and the musculoskeletal system function |
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Term
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Definition
| "readiness" of a muscle to contract. It's resistance to passive movement and stretch, or it's resting tension |
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Term
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Definition
| high enough to support the body against gravity, but low enough to allow coordinated, free, fluid movement |
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Term
| Problems with tone result from damage to CNS that sends signals for.... |
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Definition
| GABA release (inhibition) |
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Term
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Definition
| motor disorder characterized by velocity dependent hypertonia, hyper-active deep tendon reflex, or clonus |
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Term
| difference between hypertonia and spastcity |
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Definition
| hypertonia is a symptom of spasticity |
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Term
| Clinical Manifestations of Spasticity: abnormal patterns |
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Definition
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Term
| Clinical Manifestations of Spasticity: reduction in |
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Definition
| the threshold angle for stretch reflexes |
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Term
| Clinical Manifestations of Spasticity: abnormal muscle |
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Definition
| co-contraction during volitional movements |
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Term
| Clinical Manifestations of Spasticity: hypersensitivity to |
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Definition
| various sensory input in addition to muscle stretch |
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Term
| Clinical Manifestations of Spasticity: delays in... |
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Definition
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Term
| normal postural tone allows for refinement in (3) |
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Definition
| postural stability, co-contraction, and grading of movement |
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Term
| what reaction plays a dominant role in teh regulatoin and distribution of muscle tone? |
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Definition
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Term
| the balance of controlled antigravity flexor and extensor tone is essential for what? |
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Definition
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Term
| where does tone first develop? |
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Definition
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Term
| why does tone develop proximally first? |
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Definition
| to provide stability for distal control and movement |
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Term
| which system regulates postural tone? |
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Definition
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Term
| the proprioceptive system regulates postural tone, which systems enhance it (3) |
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Definition
| visual, vestibular, tactile systems |
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Term
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Definition
| sensory stimulation, task demands, intention of the mover, behavioral state, medication |
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Term
| what affects tone: sensory stimulation: which sensory systems (5) |
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Definition
| auditory, visual, vestibular, tactile, proprioception |
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Term
| what is the best behavioral state to assess tone? |
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Definition
| awake and alert, and child is not agitated |
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Term
| do spastic muscles respond to weight training? |
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Definition
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Term
| what happens when spastic muscles are strengthened? |
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Definition
| there is no increase in spasticity |
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Term
| benefit of strengthening spastic muscles |
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Definition
| improvement of functional abilities |
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Term
| fluctuating tone is seen in what types of CP? |
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Definition
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Term
| fluctuating tone is seen in what adult disorder? |
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Definition
| parkinson's intention tremor |
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Term
| In pediatrics, the PT must be a good observer for canges in (4) |
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Definition
| posture, functional skills, endurance, quality of movement against gravity |
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Term
| Limitations of both Ashworth scales? |
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Definition
| subjective, does not measure hypotonia |
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Term
| Long term consequences of abnormal tone? (6) |
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Definition
| contractures, dislocations, subluxations, circulatory problems, deformed bone, muscle atrophy |
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Term
| Principles of the Modified Tardieu Scale |
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Definition
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Term
| Modified Tardieu Scale: V1 |
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Definition
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Term
| Modified Tardieu Scale: v2 |
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Definition
| speed limb would "fall" with gravity |
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Term
| Modified Tardieu Scale: V3 |
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Definition
| fast passive (quick stretch) |
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Term
| Modified Tardieu Scale: R1 |
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Definition
| where 1st "catch" is felt |
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Term
| Modified Tardieu Scale: R2 |
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Definition
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Term
| Modified Tardieu Scale: 0 |
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Definition
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Term
| Modified Tardieu Scale: 1 |
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Definition
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Term
| Modified Tardieu Scale: 2 |
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Definition
| clear catch at precise angle R1 |
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Term
| Modified Tardieu Scale: 3 |
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Definition
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Term
| Modified Tardieu Scale: 4 |
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Definition
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Term
| Modified Tardieu Scale: 5 |
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Definition
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Term
| 3 other clinical measures for tone |
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Definition
| DTR's, electrodynamic hammer, EMG |
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Term
| what ages can DTR's be assessed? |
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Definition
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Term
| problem with EMG as a clinical measure for tone |
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Definition
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Term
| Assessment of Neuromotor control in children: gross movement against gravity aka |
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Definition
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Term
| Assessment of Neuromotor control in children: fine movement aka |
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Definition
| is there isolated (associated) movement |
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Term
| Assessment of Neuromotor control in children: initiation of movement aka |
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Definition
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Term
| Assessment of Neuromotor control in children: weight shift aka |
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Definition
| where is the CoG in relation to the BoS? Controlled? |
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Term
| Assessment of Neuromotor control in children: sustained posture aka |
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Definition
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Term
| Assessment of Neuromotor control in children: anticipatory/transitional movement aka |
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Definition
| getting out of postures and posistions (speed, power, force control (agonist/antagonist), compensation patterns?) |
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Term
| Assessment of Neuromotor control in children: clinical handling aka |
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Definition
| how does the child "Feel" as you move them passively |
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Term
| Assessment of Neuromotor control in children: range of motion aka |
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Definition
| are there limitations to movements |
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Term
| Treatment approaches: Positioning primary purpose |
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Definition
| improve alignment and postural control |
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Term
| Treatment approaches: secondary purpose |
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Definition
| prevention of secondary orthopedic deformities |
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Term
| Treatment approaches: positioning changes in head and body position allow for what? |
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Definition
| significant alteration of the degree and distribution of tone/spasticity with upper neuron syndromes |
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Term
| Treatment approaches: purpose of assistive devices |
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Definition
| achieve or maintain positions throughout the day |
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Term
| Treatment approaches: purpose of orthotics and serial casting |
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Definition
| prolonged stretch, promote alignment |
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Term
| Treatment approaches: purpose of modalities |
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Definition
| facilitate the antagonist, inhibit the spastic muscle, provide general relaxation |
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Term
| purpose of sustained heat |
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Definition
| local relaxation, superficial vs deep heat |
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Term
| duration of effect of neutral warmth |
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Definition
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Term
| how to achieve neutral warmth |
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Definition
| covering/wrapping body segment |
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Term
| effective method for sustained heat delivery for feet and hands |
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Definition
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Term
| along with massage this modality allows for assisted movements, effects can last 30 min-12 hours |
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Definition
| whirlpools/therapeutic pools |
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Term
| precaution with hot packs |
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Definition
| monitor tolerance and skin |
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Term
| sustained cold does what for tone |
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Definition
| direct inhibition of spastic muscles |
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Term
| precaution with cold modalities |
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Definition
| monitor tolerance and skin integrity |
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Term
| NMES has its best effect when |
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Definition
| applied ruing active, functional activity |
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Term
| Treatment approaches: relaxation (5) |
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Definition
| autogenics, visuals, contract/relax, hypnosis, biofeedback |
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Term
| Treatment approaches: what is autogenics |
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Definition
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Term
| Treatment approaches: which relaxation technique is not recommended for high tone? |
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Definition
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Term
| 6 oral medications for spasticity |
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Definition
| diazepam, gabapentin, baclofen, progabide, riluzole, tizanidine |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| oldest anti-spasticity medication |
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Definition
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Term
| diazepam (valium) is centrally acting on what structures? |
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Definition
| brain stem reticular formation and spinal polysynaptic pathways |
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Term
| diazepam (valium) stimulates relsase of what from pre-synaptic neuron temrinals |
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Definition
| gamma-aminobutyric acid (GABA) |
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Term
| diazepam (valium) stimulates relsase of gamma-aminobutyric acid (GABA) from what |
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Definition
| pre-synaptic neuron terminals |
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Term
| Diazepam (valium): CNS depression meaning what? |
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Definition
| suppress arousal levels, reduce motor coordination, impair intellectual function |
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Term
| Diazepam (valium): intoxication (overdose) leads to what |
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Definition
| somnolence (sleepiness) progessing to coma |
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Term
| Diazepam (valium): withdrawal symptoms (5) |
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Definition
| anxiety, agitation, restlessness, irritablity, and nausea |
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Term
| Baclofen (lioresal): acts on the CNS influencing what structures? |
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Definition
| superficial layers of the SC |
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Term
| Baclofen (lioresal) impedes what |
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Definition
| monosynaptic and polysynaptic transmission |
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Term
| Baclofen (lioresal) mimics what |
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Definition
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Term
| Baclofen (lioresal) adverse effects (5) |
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Definition
| drowsiness, lethargy, GI distress, Ataxia, dizziness |
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Term
| adverse effects of oral meds: diazepam(valium) [1] |
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Definition
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Term
| adverse effects of oral meds: gabapentin (neurontin) [1] |
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Definition
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Term
| adverse effects of oral meds: riluzole (rilutek) [2] |
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Definition
| tachycardia and hypertension |
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Term
| adverse effects of oral meds: tizantine (Zanaflex) [1] |
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Definition
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Term
| adverse effects of oral meds: baclofen (lioresal) and Botox |
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Definition
| black box warning (fatalities directly correlated to the use of this drug) |
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Term
| Where would a intrathecal pump be placed? |
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Definition
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|
Term
| how often does a intrathecal pump need to be refilled |
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Definition
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|
Term
| how often does an intrathecal pump need to be replaced |
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Definition
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Term
| advantage of ITB compared to oral baclofen (3) |
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Definition
| smaller dose needed, dose can be adjusted, can be reversible |
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Term
| indications for ITB: presence of spasticity tat... |
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Definition
| is severe enough to impair motor function and self-care |
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Term
| indications for ITB: clinical presentation (6) |
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Definition
| pain, interrupted sleep d/t spasms, abnormal posture/movements, urinary catheritization, hygiene problems, limited ADLs |
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Term
| ITB is not indicated for what (3) |
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Definition
| low tone, chorea, athetosis |
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Term
| Botox provides a paralytic effect at the neuromuscular junction inhibiting what? |
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Definition
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|
Term
| major point about botox applicatoin |
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Definition
| not effective for diffuse spasticity, used for specific muscles |
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Term
| calf injections of botox are to prevent what |
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Definition
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Term
| hamstrings injections of botox are for what |
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Definition
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|
Term
| last resort for tone improvement |
|
Definition
| selective dorsal rhizotomy |
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Term
| Candidates for SDR: "pure" spasticity without... |
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Definition
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Term
| Candidates for SDR: (2) limited by spasticity |
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Definition
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Term
| Candidates for SDR: which reflexes cannot be dominating |
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Definition
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Term
| Candidates for SDR: pt's motor control |
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Definition
| pt must have some selective motor control |
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Term
| Candidates for SDR: strength |
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Definition
| adequate underlying strength |
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Term
| Candidates for SDR: ambulation? |
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Definition
| must have ability/potential |
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Term
| Candidates for SDR: balance |
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Definition
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Term
| Candidates for SDR: types of spasticity |
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Definition
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|
Term
| Candidates for SDR: minimal joint... |
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Definition
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Term
| Pre-op SDR PT exam should include (7) |
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Definition
| spasticity measure, RoM, gross motor function assessment, gait analysis, posture evaluation, adaptive equipment/orthotic evaluation, post-op resources for family |
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Term
| Post op SDR what is absolutely required |
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Definition
| intense stregthening program required |
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Term
| Post-op SDR PT responsibilites |
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Definition
| RoM, gait training, postural control, functional use of adaptive equipment, therapy 2x per day for several weeks |
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Term
| Inhibition techniques (12) |
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Definition
| slow rotation, counter rotation, manual vibration, oscillations, prolonged stretch, deep pressure, slow bouncing, slow rocking, slow swinging, distraction, traction, reciprocal inhibition |
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Term
| facilitation techniques (6) |
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Definition
| tapping, sweeping, vibration, compression, pressure, bouncing |
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