Neuro C4 Study Guide

CVA, TBI, SCI, etc.

Apraxia

A disorder of execution of learned movements that can't be accounted for by weakness, incoordination, sensory loss, or lack of comprehension.

TBI

Damage to brain tissue caused by an external mechanical force resulting in loss of consciousness and neurological findings.

• big three deficits: attention, memory, concentration

• increased initiation with tasks (impulsive)

• Post traumatic amnesia

Approaches: NDT FOR, Rehabilitative

Assessments: barthel, beck depression, berg, COPM, MOCA, GOAT, Glasgow, Ranchos

Glasgow Coma Scale

A scale used to assess a person's level of consciousness by evaluating their eye, verbal, and motor responses to stimuli. It helps determine the severity of brain injury.

Ranchos Los Amigos

A descriptive scale used to classify the cognitive and behavioral functional levels of individuals recovering from brain injury, outlining stages of recovery.

• 1 (no response) to 8 (purposeful, appropriate)

TBI Interventions

Various therapeutic strategies employed to facilitate recovery from traumatic brain injury, including physical, occupational, and speech therapy. These interventions focus on improving cognitive and physical functions.

• Family education, positioning

• ADLS - dressing, feeding, toileting, bathing

• Cognition, vision, safety awareness

• AE - scoop plate, built up handles, universal cuff, adapted cutting board, rocker knife, medication organizer

• ROM, strength, endurance

CVA

A stroke that can be ischemic or hemorrhagic, with MCA being the most common type.

• often leading to hemiplegia, aphasia, etc.

• Approach: NDT, Rehabilitative

• Assessment: Barthel, Beck depression, Berg Balance, COPM, MOCA

CVA Intervetentions

Include rehabilitation strategies focused on improving mobility, function, and activities of daily living, utilizing techniques such as Neuro-Developmental Treatment (NDT) and task-specific training.

• Reaching tasks, standing - balance and mobility

• Adaptive equipment - scoop plate, built up handles, universal cuff, adapted cutting board, rocker knife, medication organizer

• ADLs - dressing, functional mobility, feeding, toileting, bathing

• IADLs - meal preparation, home management (make bed), finances (cognition)

Broca’s Aphasia

Expressive aphasia characterized by poor speech production.

Wernicke's Aphasia

Receptive aphasia characterized by poor auditory comprehension, often resulting in 'word salad'.

Brown Sequard Syndrome

A neurological condition where one side of the body loses motor/proprioception, and the other side loses pain and temperature sensation.

Cauda Equina Syndrome

A condition resulting from compression of the nerve roots at the lower end of the spinal cord, typically leading to lower motor neuron signs.

Dysphagia

Difficulty or inability to swallow.

ALS

Progressive degeneration of both upper motor neurons and lower motor neurons, leading to paralysis and respiratory decline.

• Spasticity - PAMS, botox, orthotics, taping

• Patient Education

• Adaptations

Alzheimers

A progressive neurodegenerative disease characterized by memory loss, cognitive decline, and behavioral changes due to brain cell damage.

• impairment in recent memory, cognitive deficits

• patient education

• consistent daily routine

• exercise

• memory/environmental aids

Huntington’s Disease

An inherited degenerative disease causing choreiform movements and cognitive decline.

• choreiform movements, facial grimaces, tongue smacking

• daily routine, adaptations, ADLs, long term planning

Multiple Sclerosis

A chronic progressive autoimmune disease characterized by demyelination in the central nervous system.

• immunosuppressive drugs

• home environment modifications

• adaptive equipment - wheelchair, eye tracking

Parkinson’s Disease

A progressive neurological disorder affecting motor functions, characterized by symptoms like tremors and rigidity.

• neurotransmitter replacement therapy

• LSVT big and loud

• physical activity

• adaptive equipment - weighed tools

Guillain-Barre Syndrome

An acute inflammatory demyelinating disease of the peripheral nerves, often presenting with symmetrical ascending paralysis.

• immunosuppressive drugs

• ROM

• energy conservation - pacing, planning

Myasthenia Gravis

A chronic condition characterized by weakness and fatigue of voluntary muscles due to impaired Acetylcholine transmission.

• stress reduction

• patient education

• work simplification

• adaptive devices

• home evaluation

Montreal Cognitive Assessment (MoCA)

A cognitive screening tool used for mild cognitive impairment and early dementia.

Barthel Index

An assessment tool measuring the performance in activities of daily living (ADLs).

Functional Reach Test

An assessment that measures balance by evaluating the length of forward reach while standing.

Jebsen Test of Hand Function

7 activities: writing a sentence, turning over cards, simulated eating, picking up objects, moving cans, and stacking checkers

Mini-Mental State Examination

Mental status screening for orientation, registration of words, attention, recall, language, and visual construction

Tinetti Test

Assess Balance and gait in the older adult population

• patient stands from chair and walks back

Rivermead Test

An ecologically valid test of everyday memory using simulations of everyday memory tasks

A-One Assessment

A performance-based tool that observes upper and lower body tasks to detect impairments affecting function.

• Objectively measures dysfunction of self care and mobility

Beck Depression Inventory

A self-rating scale of 21 items assessing attitudinal, somatic, and behavioral aspects of depression

COPM

Client-centered assessment tool focusing on clients' identification of problems in performance in self-care, productivity, and leisure

Rehabilitative FOR

Aims to help clients focus on remaining abilities to attain their highest level of function through adaptation, compensation, and environmental modifications

Person-Environment- Occupation- Performance Model

Looks at how the environment, person, and activity requirements interact

• The environment can affect participation

• Modify activity requirements

Neuro- Developmental Treatment

Analyze and treat movement impairments by identifying atypical movements and targeting them. 

• Therapist handling is the primary technique

• Work to get normal movement patterns

SCI

Damage to the spinal cord - complete or incomplete

• ASIA scale (A-E)

• Autonomic dysreflexia

Approaches: NDT FOR, Rehabilitative, PEOP

Assessment: ASIA, barthel, beck depression, COPM, Mini-mental

SCI Levels C1-C3

Has sternocleidomastoid & neck accessory muscles

• dependence on ventilator

• can use breath or chin-controlled power W/C

• AE: sip and puff, eye control

• patient education, wheelchair recommendations, home modifications

SCI Level C4

has Upper trapezius and diaphragm

• neck movement, scapular elevation, inspiration

• AE: mouthstick, eye control, technology for environment

• patient education, wheelchair recommendations, home modifications

SCI level C5

has Deltoids & Biceps

• shoulder flexion, abduction, and elbow flexion. Patient is able to perform some self-care activities and use a powered wheelchair.

• AE: scoop plate, universal cuff

• Resting splint at night, mobile arm supports

• patient education, wheelchair recommendations, home modifications, shoulder strengthening

SCI Level C6

has ECRL, ECRB, Clavicular pectoralis major

• radial wrist extension for tenodesis grasp

• can be independent in most self care

• AE: adaptive utensils, universal cuff, writing splint, computer use

SCI Level C7

Has triceps, FCR, Latissimus dorsi, pectoralis major, ED

• elbow extension for transfers

• independent living possible

• AE: adaptive utensils, universal cuff, writing splint, computer use

SCI levels C8-T1

Finger flexors and intrinsic hands

• high independence with wheelchair

• weak hand function

• ADLs with or without adaptive equipment

• UE strength, driving, leisure

Perception

Process of organizing and interpreting the sensations as the individual receives from internal and external stimuli.

• The use made of sensations rather than the perceiving of the raw sensations themselves

• Assessments: MVPT4

• Functional tasks, bed mobility, reaching tasks, sit to stand, dressing

Vision

Assessments: MVPT4, nine points of vision, tests for suppression, line bisection, array

Interventions

• paper pencil tasks - array, maze, word search

• home eval - high contrast lighting, declutter space

• matching socks, sort laundry, meal preparation

Cognition

Assessments: Moca, Mini-Mental, barthel ADL, COPM

Interventions

• Task specific

• shopping list

• meal preparation

• craft kit with instructions

• weekly schedule

• plan an event

• memory notebook

• AE - voice recorder, smart phone, pill organizer, smart watch

• Environment - reduce clutter, simplify daily schedule, reminders around the house, label drawers