Test 1 - part 1

impairment, activity limitation, participation restriction, health condition (diagnosis)

4 Components of the ICF model

Which is NOT a component of the ICF model?

disability

Environmental, financial, Psychosocial (individual/personal)

3 Factors that affect patient performance

self-esteem, anxiety level, problem solving ability, learning style, happiness/life satisfaction, mastery/control

6 psychosocial factors

recreational interests, occupation, education level, community, nutrition, living conditions, support system

7 environmental factors

yes

Is there a correlation between the factors that can affect patient recovery?

systems theory

series of interacting systems that contribute to different aspects of control for motor function

systems theory

2 or more systems that work together to produce movement/ cardiovascular endurance to sustain movement

musculoskeletal (MS), Nervous (N)

The two systems that work together to produce movement

movement

MS + N =

cardiovascular-pulmonary, musculoskeletal (M)

what two systems permit the capacity for movement?

capacity for movement

CVP + M =

closed-loop system

uses sensory input and feedback to modify or make changes

closed-loop system

feedback is used to detect errors and modify the movement responses

closed-loop system

movement patterns are modified and initiated using sensory inputs and feedback info.

open-loop system

movement patterns are stored and can be initiated using preprogrammed instructions without peripheral inputs or feedback info

closed-loop system

system used when you take critcism from your boss at work and apply it to your performance

open-loop system

system where input triggers the output

open-loop system

not needing feedback for activity or performance to occur

open-loop system

system used when applying E-stim. The parameters are already and the tx will proceed as normal without any other input from the therapist

mobility, stability, controlled mobility, skill

The 4 MAIN stages of motor control

btw controlled mobility and skill

Where does static -dynamic fall in the stages of motor control?

Spontaneous recovery

restoration of function in neural tissues initially lost after injury, resulting from naturally occurring repair processes within the CNS

Spontaneous recovery

Example of this is a pt. with a stroke regaining some motor function approximately 2-3 weeks after insult as cerebral edema rersolves

Spontaneous recovery

not something you have been working towards, but happen somewhat suddenly

function-induced recovery

nervous systems ability to modify itself in response to changes in activity and the environment

function-induced recovery

restoration of the ability to perform a movement in the same or similar manner as it was performed before the injury

function-induced recovery

use-dependent cortical reorganization occurring in response to changes in activity and the environment

function-induced recovery

use-dependent cortical reorganization

function-induced recovery

neuroplastisisity: “using it helps reconnect things”

learned nonuse

stimulation early after injury is important to prevent this

learned nonuse

behavioral learned response to paresis associated with preferential use of less affected limbs can interfere with recovery from neurological insult

learned nonuse

example of this is when a stoke pt. learns to use the less affected extremity and fails to meet goals using more affected extremities.

learned nonuse

“If you do not use it, you will lose it.”

cognitive, associative, autonomous

3 stages of motor learning

cognitive stage

stage with a lot of mistakes and a lot of trial-and-error

visual feedback

guides early learning

visual feedback

cognitive stage learner is highly dependent on this type of feedback

cognitive stage

relies on visual feedback

cognitive stage

stage where your figure out what does not work

cognitive stage

performance is inconsistant and uncoordinated

closed environment

what type of environment is best for the cognitive stage?

cognitive stage

stage with considerable cognitive activity and high degree of conscious attention and thought

“what to do?”

phrase that describes the cognitive stage: the decision being made.

cognitive stage

retains some strategies during initial task while discarding others to develop a strategy

cognitive stage

is the first stage of motor learning

cognitive stage

stage where you figure out what to do

associative stage

is the second/middle stage of motor learning

associative stage

the learner practices and refines motor patterns, making subtle adjustments

associative stage

spatial, temporal organization increases while errors, extraneous movements decrease

decrease, increase

In the associative stage errors and extraneous movements ______ while spatial and temporal organization _____.

associative stage

performance becomes more consistant and cognitive activity decreases

consistant

associative stage: perfomance becomes more_____.

cognitive activity

associative stage: this decreases

proprioceptive feedback

what type if feedback is most used in the associative stage?

proprioceptive feedback

associative stage: learner becomes less dependent on visual feedback and use of ____ increases.

associative stage

learner begins to get a “feel” for the movement

“how to do?”

phase that describes the associative stage: decision being made

associative stage

stage that can persist for a long time depending on the learner and level of practice

associative stage

learner in this stage learn how to do it

autonomous stage

the last/ third stage of motor learning

autonomous stage

learning perfects task and figures out how to succeed

“how to succeed?”

phrase that describes the autonomous stage: decision that is being made

autonomous stage

learner continues to practice and refine motor patterns

autonomous stage

spatial and temporal components of movement become highly organized

autonomous stage

stage where the learner is skilled in all walking speeds in all environments

autonomous stage

stage where movements are largely error free and automatic

autonomous stage

learner uses minimal level of cognitive monitoring and attention

autonomous stage

patients are often discharged before achieving this stage: progress with HEP.

open environment

type of environment appropriate for autonomous stage

autonomous stage

A pt. with TBI might not ever reach this stage

restorative interventions

focus on targeted movement deficiencies and utilize activity-based interventions and motor learning strategies

restorative interventions

repetitive and intense practice of task-oriented functional activities

restorative interventions

strategies that enhance active motor learning and adherence

restorative interventions

strategies that encourage use of more -impaired body segment/ limits use of less impaired segment

restorative interventions

restore what has been lost

restorative interventions

Which interventions should be used at the beginning of tx: restorative interventions or compensatory interventions?

compensatory interventions

include altered movement strategies, AD, environmental adaptation and use of uninvolved limbs to function

compensatory interventions

patients with severe impairments, multiple comorbidities, and limited recovery potential would benefit from these

compensatory interventions

compensations to replace what has been lost

restorative interventions

strengthening dorsiflexion to decrease foot drop: compensatory interventions or restorative interventions?

restorative interventions

improving grip strength in affected UE: restorative interventions or compensatory interventions?

compensatory interventions

Applying an AFO to improve foot drop: or restorative interventions or compensatory interventions?

restorative interventions

strength and balance training to improve gait: compensatory interventions or restorative interventions?

compensatory interventions

Teaching an SCI pt. tenodesis grasp and how to use a universal cuff: restorative interventions or compensatory interventions?

compensatory interventions

Teaching a pt. how to use an AD: compensatory interventions or restorative interventions?

compensatory interventions

Increasing lighting and adding a shower chair to reduce falls: restorative interventions or compensatory interventions?

repetition, environment, intensity

3 learning variables to consider for interventions

pt. capacity to change, tissue healing, physiological stress, resources, environment, positioning

What must be considered when developing an intervention strategy? (6)

tissue healing

determine WB restrictions and time frames for healing

physiological stress

affects on heart rate, blood pressure, respiration rate and O2 saturation

intrinsic, extrinsic

two main types of feedback

intrinsic feedback

also called inherent feedback

intrinsic feedback

feedback from within the patient

visual, vestibular, proprioceptive, cutaneous

4 examples of intrinsic feedback

visual, auditory, tactile cueing

3 examples of extrinsic feedback

extrinsic feedback

include verbal cues, tactile cues, manual contacts, and biofeedback devices

extrinsic feedback

also called augmented feedback

extrinsic feedback

feedback that comes from external sources

extrinsic feedback

sensory feedback that is augmented