CVA gait
A patient's highest fall risk during gait training is during R terminal stance; the patient demonstrates an increase in tone at the R posterior calve that worsens during fast movement.
What is the cause of the fall risk?
What would you objectively test to monitor if the patient's fall risk is increasing/decreasing?
Spasticity -- MAS
What outcome measures could you also test?
A patient post-CVA presents with difficulty initiating and coordinating purposeful movements despite intact motor function. This term describes this deficit.
Apraxia
This refers to the ability of the nervous system to control and coordinate movement.
Motor control
A 7 month old baby is starting on solid foods ( rice puffs). Which type of grasp is most likely/appropriate to be used by this child?
Raking or Radial Palmar Grasp
A physical therapist assistant is integrating the TLR in an 18 month old child who is having trouble with standing. Which developmental position would be BEST to help facilitate an increase in lumbar spine and hip extension strength and control?
tall kneel (while changing head position during play)
A patient presents with R knee hyperextension in stance. What are some of the common causes of this gait deficit?
Weak Quadriceps
Plantarflexor spasticity
https://www.youtube.com/shorts/I7_DE1aYjnw
Weak PF as a compensatory strategy
A patient who experienced a right cerebrovascular accident (CVA) is having issues with body and spacial awareness of their affected side, showing neglect. Name two effective intervention strategies for this type of patient.
LUE/LE approximation, visual scanning/tracking, standing on patient L side when talking
NOT bilat LE strengthening
This describes the cellular repair processes that restore function in initially lost CNS tissue.
Spontaneous recovery
Name a neuromuscular facilitation technique that would be MOST appropriate to use with a child with typical Down syndrome in order to promote normal muscle activity.
faciliatory techniques, like tapping, quick stroke
An 18 month old child is having difficulty getting off of the floor due to the strong persistence of the landau reflex. What is the best position to treat the baby in?
Quadruped or tall kneel with UE play in flexion
These are the uses and limitations of a body weight supported treadmill system in stroke rehabilitation.
Uses: Improving gait pattern; Limitations: Cost and space requirements
A patient demonstrates a tendency to lean excessively away from the side of their lesion during standing and walking activities. This is commonly used to describe this phenomenon.
Pusher syndrome, contraversive pushing
This stage of learning is it MOST appropriate to practice in a closed environment.
Cognitive
At this age, a PTA expect to see a consistent heel strike gait pattern in a child.
3yo
7yo normalized gait (similar to adult)
While working with a patient in a neurological rehabilitation setting, you observe that despite having intact sensory abilities, they struggle to recognize familiar objects. This term describes this phenomenon.
Agnosia
A patient demonstrates mild foot drop during swing phase with good knee control and minimal plantarflexor tone. This AFO is MOST appropriate to improve toe clearance while allowing near-normal ankle motion.
posterior leaf spring (PLS) AFO
A post-stroke patient recently started a medication to reduce spasticity. During therapy, the PTA notices increased fatigue, dizziness, and decreased postural control.
What medication is the most common, and what should the PTA do?
Baclofen --> tell the Medical team & PT that this is occuring.
A patient undergoing neurologic rehabilitation is showing signs of improvement in their FIM scores after engaging in a series of task-specific exercises. This type of training is most likely contributing to this progress.
Function induced training
NOT Impairment based training
Which of the following would the MOST appropriate treatment technique for a patient with spastic diplegic cerebral palsy with an extension synergy pattern, in order to promote normal muscle activity? (Tell me why)
Slow stroking of bilateral biceps followed by play in modified plantigrade.
Rhythmic rocking to bilateral lower extremities followed by play in high kneeling.
Tapping of the adductors during quadruped play.
Deep pressure to bilateral quadriceps followed by play in supported standing.
2.
This was the FIRST legislation used to justify the provision of services for all pediatric patients with disabilities in the United States.
Brown v Board of Education
Review IDEA Act B and Act C
A stroke patient presents with excessive knee flexion during stance due to Gastroc weakness and poor stance stability. Which the best type of AFO to use for this patient?
ground/floor reaction AFO
A patient is demonstrating abrupt, choppy, and very frustrated speech, especially when the wrong word comes out. The patient also presents with motor deficits. What motor deficits are most likely to be found in this same patient?
LUE and L face weakness due to a L MCA lesion affecting Broca's Area
A physical therapist assistant is progressing a therapeutic exercise program for a patient in the subacute phase of stroke recovery. The patient is able to complete functional movements but demonstrates inconsistent coordination and difficulty adapting. To improve movement accuracy and promote transfer of skills to real-world activities, which type of practice should the PTA MOST emphasize?
Varying practice conditions
Please review massed vs distributed practice & Blocked vs random practice
A 5 month old child presents with considerable developmental delay and persistence of the tonic labyrinthine reflex. This is the position that the physical therapist assistant can place the infant in order to ensure the reflex does NOT interfere with the child's ability to independently practice reaching for objects in midline.
Side lying
This BEST describes an extension synergy pattern of the entire lower extremity.
Hip extension, adduction, and internal rotation, with knee extension and plantarflexion.