Psych 403 quiz 6

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Common rodent rehab tasks

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Common rodent rehab tasks

running, skills training, cognitive rehab, general enrichment

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cognitive rehab for rodents usually consists of

mazes

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BLANK rehab is often combined with other therapies

cognitive

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common treatment parameters in rodent rehab studies

intervention delay, duration and intensity

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most animal rehab studies examine

the mechanism of action

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EE is

environmental enrichment

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a modified montoya box is

an example of skilled teaching training

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key treatment parameters in any study are

timing and intensity

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what is the assumption of looking at timing and intensity of rehab in studies

we need to target the sensitive period to maximally take advantage of brain plasticity

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when should rehab begin

within two days as long as the patient is stable, able, and willing

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most clinicians believe that rehab is given BLANK, and begins BLANK

at one time, sooner and at higher intensity than is achievable

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in an experimental study using young male rats training on reaching tasks after an MCAO, rats that got rehab sooner did

better

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BLANK is a common complication to stroke recovery

pneumonia

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in a mild stroke people will move from hospital to BLANK in a timeframe of BLANK

home, days

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with a moderate stroke patients will move from hospital to BLANK in a timeframe of BLANK, and BLANK to home in a timeline of BLANK

rehab hospital, weeks, rehab weeks to months

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with a severe stroke patients will move from hospital to BLANK in a timeline of BLANK, and then the assisted living

a transition unit, days to months

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predictors of recovery

family support, injury size and location

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why might cerebellar infarcts be hard to rehab

cerebellum is central to posture and balance, and full of white matter

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possible assesments of funciton

bed mobility, transfers, stairs, walking, sitting and standing, balance

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hypertonia

more muscle tone, harder to move

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hypotonia

less muscle tone, floppy limbs

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assessments of impairments after stroke are done in the following areas

strength, sensation, reflexes, tone, coordination, range of motion

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what impairments contribute to the following walking deficits: strength, balance, bracing and stretching

weakness, balance deficits, spasticity

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what factors make a patient a good candidate for rehab

they are making progress in acute care, they have enough cognition, language, and motivation to participate, requires one person assistance, can tolerate 2 hours sitting and 1 hour activity, has a discharge plan

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external factors that effect rehab potential and outcome

age, stroke severity, aphasia and perception, motivation, family support, advocacy

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major challenges of rehab

communication issues, limited resources, emotionally and physically taxing, struggle for practitioners to keep up with evidence

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generally, starting rehab BLANK is a better approach

earlier

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why not do an RTC when studying effects of delayed rehab

ethics

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adverse effects can be seen when starting rehab within BLANK after stroke

1 month

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youtube prompt: intention to treat analysis

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AVERT trials mean

a very early rehabilitation trial

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advantages of early mobilization

avoids harmful effect of bed rest, avoids immobility complications, takes advantage of neuroplasticity

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risks of early mobilization

effects on BP and CBF, higher risk of fall, risk of bleeding

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in general early mobilization is BLANK to recovery

detrimental

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early rehab doesn’t really help anybody, but is especially harmful to BLANK and BLANK

hemorrhages, severe strokes

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why do we do secondary analysis

the more you look for something the more likely you are to find something

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youtube prompt: secondary analysis

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how did the avert authors explain their findings

initial data suggested harm to those with severe stroke and ICH, rehab interactions with stroke type and severity expected, re analysis suggests more frequent and briefer mobilization was helpful but longer was not

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exceeding a certain level of reaching is a BLANK

critical threshold

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what is the implication of the finding that allowing rats unlimited reaching in rehab inproved outcomes

maybe a lot of rehab just isn’t often enough to make a difference

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you need a certain amount of therapy to drive plasticity, without the right intensity

you don’t get enough to rewire the brain

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in this type of stroke, researchers are unable o find benefit to rehab

striatal ICH

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why does rehab protocal fail in striatal ICH

when you damage the striatum it damages the corticospinal tract going through it

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when talking about rehab intensity, generally

more is better

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problems with studying rehab intensity in animals

patients get less intense rehab than animals ( a few dozen vs 100s), human rehab focuses on ADLs where rodents may just use forced running

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translational research issues in rehab studies

quality issues, insufficient consideration to species effect, clinically unrealistic treatment protocols, focus on endpoints not quality of movement, inability and diminished ability to account for stroke effects in animal models, forgetting medical stability effects, mismatch in terminology, animal studies are not strong evidence

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impact of exercise varies by

personal factors, exercise type, duration

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exercise, especially aerobic exercise, improves BLANK, BLANK, and BLANK

mood, cognition, memory

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exercise decreases many risk factors, for example BLANK

vascular damage

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exercise causes reductions in BLANK, better BLANK, less BLANK, enhanced BLANK, greater BLANK, and fewer BLANK

stress, sleep, anxiety and depression, muscle mass, flexibility, disorders

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exercise results in better glucose BLANK, enhanced BLANK protection, greater BLANK defenses, better BLANK function, and alterations in BLANK pathways

control, growth factor, anxti-oxidant, mitochondrial, cell death

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in general with exercise we see less BLANK, enhanced BLANK, and greater BLANK

inflammation, synaptic plasticity, stem cell response

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true/false exercise promotes angiogenesis, maintains blood flow,and prevents the accumulation of protein aggregates and damaged mitochondria

true

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whole brain benefits to exercise

greater cognitive reserve from enhanced synaptic plasticity, improved electrophysiological function, increases in brain volume

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mechanisms of post stroke rehab vary by

patient factors, type of insult, treatment type, therapy parameters

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mechanisms of normal learning and spontaneous recovery are BLANK by rehab

enhanced

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dendritic and spine growth, formation of new terminals, and changed in neurotramsmitters and receptors act to

modify synaptic transmission and alter physiological function

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what are some actions resulting from modifying synaptic transmission and altering physiological function

map reorganization, unmasking dormant pathways, removal of diaschisis

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possible mechanisms of improvement in blood flow

opening of collateral vessels, angiogenesis

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improvements in blood flow can sustain penumbral tissue and heighten activity in rewired circuits, also known as

neuroprotection

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transcriptional changes leading to elevations in BDNF promote

dendritic growth and synapse formation

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true/false rehab therapies are sometimes neuroprotective

true

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rehab drives a lot of the same effects as

spontaneous recovery

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rehab can be neuroprotective or

damaging

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rehab increases dendritic BLANK after focal ischemia and ICH in rats

arborization

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rehab will drive dendritic growth through BLANK

remaining structures, including distal structures

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early rehab is associated with greater BLANK in the undamaged motor cortex

dendritic branching

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greater dendritic branching in the undamaged motor cortex is an example of these mechanisms

unmasking and reorganization

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study groups:

animals with no BNDF and rehab BLANK

animals with blocked BDNF BLANK

animals with blocked rehab BLANK

got better, did not get better, did not get better

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what does it mean that if you block BDNF recovery goes down

blocking bdnf prevents rehab effects

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question: is there evidence that aerobic exercise can influence recovery

yes

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was forced or voluntary aerobic exercise harmful in animal rehab studies

no

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will forced or voluntary aerobic exercise reduce lesion volume

forced

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is early or later treatment better in animal rehab

earlier

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when should rehab start in animal models for best results

a few days

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exercise in animal models lessens BLANK, BLANK, and BLANK while increasing BLANK and BLANK

cell death, inflammation, oxidative injury, neurogenesis, angiogenesis

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components of constraint induced movement theraopy

forced use, massed practice (5-6 hours per day), transfer package (practice on ADLS)

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prompt: watch a video on constraint induced movement therapy

-

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research on constraint induced movement therapy findings

mixed but positive findings

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broad mechanisms of constraint induced movement therapy

neural changes like axonal sprouting, cortical re-organization and thickening, counteracting learning non-use

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during learned non use…

use of the good hand is reinforced, impaired hand is punished

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learned non use develops during

initial period with the greatest neurological impairment

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forced use therapy timeline

2 weeks, 80% of waking hours, massed practice 506 hours a day, transfer package for ADLs

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why does constraint induced movement therapy work

counteracts learned non use

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