NeuroPT - 12 - Principles of Intervention

solver

the patient/client is the problem ________

• learning new skills

• re-learning to do skills differently

• re-learning the same skills

the problem solver is:

• learning ________

• re-learning ___________

• re-learning ___________

creator

the physical therapist is the problem ________

enhance, facilitate

the problem creator must _________ and __________ problem solving process

INTERNAL

1. principles of bioplasticity

2. practice organization

the problem creator must promote the patient’s _________ problem identification process through these two things:

ACTIVELY ENGAGED

the learner must be ______________ in the task, not just the recipient of some repetetive stimuli

remediation/recovery, compensation, prevention

the three purposes of interventions are _________, ___________, and __________

remediation/recovery

_____________ is enhancing skills and resources OR the reversal of impairments, and assumes the potential for change in the system and the person

compensation

______________ is the alteration of the environment or task

prevention

___________ is the management of anticipated problems

OVERLAP, INTENTION

there is _________ between the purposes of interventions, but it is all about the __________

FALSE - doesn’t always mean compensatory

T/F: the use of DME means that the purpose of the intervention is compensatory

neuro(bio)plasticity

every PT intervention should create ______________

LEARNING

we have to create an environment where there is ___________

guidance → assist as needed → unassisted → error augmentation

the progression of degree of skill acquisition through trial and error practice goes in this order:

assistance, error augmentation

with trial and error practice, as less _________ is needed, there can be more ____________

guidance

basic intervention principle: ___________

• physical or verbal assistance throughout a task

guidance

max to total assist is considered (guidance/assist as needed/unassisted/error aug)

guidance

assistance from a therapist or robotic assistance that moves body segments through the motions is an example of (guidance/assist as needed/unassisted/error aug)

guidance

solid bracing like locked KAFOS or solid AFOs is an example of (guidance/assist as needed/unassisted/error aug)

guidance

electrical stimulation to muscles without activation is an example of (guidance/assist as needed/unassisted/error aug)

guidance

verbal or tactile cues due to significant cognitive impairment are an example of (guidance/assist as needed/unassisted/error aug)

MOST OR ALL

with guidance, the PT is doing ____________ of the problem solving for the patient

EARLY ON

guidance should be used _________ in learning to demonstrate what needs to happen

very weak extremities, trunk, OR cognitive assistance

guidance should be used when someone needs significant assistance d/t ______, _______ or ____________

fine tuning

guidance can be used for brief ________ of a learned skill

LATER

guidance and assist as needed should not be used ______ in learning when the skill is already understood

REMOVE

you should _________ guidance and assist as needed as soon as possible

FALSE - doesn’t have to be perfect

T/F: a skill should be perfect before progressing beyond guidance

assist as needed

basic intervention principle: ___________

• physical or verbal assistance from the therapist at certain times

assist as needed

min to mod assist is considered (guidance/assist as needed/unassisted/error aug)

SOME

with assist as needed, the PT is doing ____________ of the problem solving for the patient

assist as needed

assistive devices that help only when needed, like SCKAFO or overhead harness for balance, are an example of (guidance/assist as needed/unassisted/error aug)

assist as needed

electrical stimulation that can be graded, like DF FES for foot drop, with some activation from the patient is an example of (guidance/assist as needed/unassisted/error aug)

assist as needed

verbal assistance or cues as needed, but only used at certain times, are an example of (guidance/assist as needed/unassisted/error aug)

MID STAGE

assist as needed should be used in ___________ learning to correct movements

CERTAIN PARTS

assist as needed should be used to provide physical or verbal support during ____________ of a movement

unassisted

basic intervention principle: ___________

• transition the problem solving to full internal error detection and problem solving

unassisted

CGA, supervision, SBA, and mod I are considered (guidance/assist as needed/unassisted/error aug)

NONE

with unassisted, the PT is doing ____________ of the problem solving for the patient

mid-late

unassisted should be used in __________ stage learning

EARLY, UNSAFE

unassisted should NOT be used _______ in learning or when it is _________ to perform unassisted

bc we’re either pushing them toward unassisted or pushing beyond unassisted to error aug

why don’t we spend a lot of time with unassisted?

error augmentation

basic intervention principle: ___________

• the PT creates more problems through frequency, type, or magnitude for the problem solver to solve

• accentuates the problems and allows the person to perform the skill under a wide variety of conditions

LATE

error augmentation should be used in _______ stage learning

• early in learning

• unsafe to perform

• learner not familiar with skill

• learner unable to perform unassisted

when should error augmentation NOT be used: (3)

creating problems :)

with error augmentation, the therapist is purposefully ______________ for the patient

**go look at the walking as an example videos and notes!

**go look at the walking as an example videos and notes!