BG Disorders
According to the Modified Hoehn and Yahr staging system, this stage is characterized by bilateral symptoms with mild postural instability, yet patients remain physically independent.
What is Stage 3?
In this stage of Parkinson's Disease, compensatory strategies and environmental adaptations are prioritized to prevent complications and maintain independence.
What is the late stage?
This stage of huntington's disease is relatively hypokinetic and leads to rigidity and bradykinesia.
What is the late stage?
A physical therapist is working with a patient with mid-stage Parkinson’s disease who demonstrates poor movement sequencing when attempting sit-to-stand transfers. Despite good ROM and strength, the patient becomes “stuck” mid-task without external input. This type of motor planning deficit is best addressed using this strategy, which bypasses impaired self-generated movement initiation.
What is external cueing using visual or auditory input?
A patient presents with spontaneous horizontal nystagmus that increases when looking in the direction of the fast phase and diminishes with visual fixation.
This pattern of nystagmus is most consistent with this type of vestibular lesion.
What is a peripheral vestibular lesion?
This basal ganglia pathway inhibits movement and is overactive in Parkinson’s disease due to the loss of dopaminergic modulation.
What is the indirect pathway?
This self-report questionnaire evaluates the impact of Parkinson’s Disease on eight dimensions including mobility, emotional well-being, cognition, and stigma.
What is the PDQ-39?
The main therapeutic intervention for huntington's disease.
What is education of family and patient about movement disorders, gait, and safe mobility?
A therapist evaluates strength and bradykinesia in a patient with PD 90 minutes after their carbidopa/levodopa dose. On reassessment the next day, they test during the patient’s “off” state and note major differences in force production.
To ensure consistency and accuracy in progressive strengthening programs, strength testing and training should occur during this phase of the medication cycle.
What is the “on” phase of the medication cycle?
A patient with sudden dizziness and imbalance is evaluated with the HINTS exam. The head impulse test is negative, nystagmus changes direction with gaze, and the alternate cover test reveals vertical ocular misalignment.
Together, these findings point to this highly concerning central diagnosis.
What is a central vestibular infarct (e.g., stroke)?
This combination medication is considered the gold standard for treating Parkinson’s Disease and works by increasing dopamine availability in the brain.
What is carbidopa/levodopa (Sinemet)?
The cutoff score for 5xSTS for Parkinson's patients.
What is 16 secs?
This type of treatment is not started until choreiform movements interfere with function because the side effects are worse than chorea. name the disorder.
What is pharmacological management?
A therapist initiates treadmill gait training with a patient in early-stage PD. The plan includes step-length enhancement, reciprocal arm swing, and backward walking. The patient’s stride length improves but cadence remains low. This specific type of cueing, set 25% faster than the patient’s preferred pace, is most effective in enhancing temporal components of gait.
What is rhythmic auditory stimulation (RAS)?
A 72-year-old with suspected bilateral vestibular hypofunction has inconclusive caloric test results. The PT recommends referral for this gold-standard test that uses physiologic stimulus and is sensitive for bilateral loss.
What is rotational chair testing?
Levodopa responsiveness is considered the single best predictor of what treatment.
What is deep brain stimulation?
Name two common triggers of freezing of gait in Parkinson’s patients that clinicians should assess for during examination.
What are initiating gait, environment canes, attentional demands, time pressure, anxiety/stress and turning in tight spaces?
A 23 year old male with personality changes, incoordination, festinating gait, facial expressions absent is referred to PT. On exam, he has dystonia, bradykinesia and rigiditiy. he also as a kayser-fleisher ring in his eyes. name the disorder.
What is the dystonic form of wilson's disease?
A therapist prescribes stretching exercises to a 78-year-old patient with long-standing PD and reports of increased trunk rigidity. The therapist plans aggressive dynamic flexibility work to improve extension. Due to elevated risk of osteoporosis in this population, this specific type of stretching should be avoided.
What is ballistic stretching?
A PT completes head thrust testing and finds that when the patient’s head is rapidly rotated to the right, they require a corrective saccade to re-fixate on the examiner's nose.
This finding localizes vestibular hypofunction to this side.
What is the right side?
Name the brain structure and describe which dopamine receptor subtype it fails to activate, and what cardinal features that present.
What is the substantia nigra pars compacta; it fails to activate D1 receptors in the direct pathway; rigidity, bradykinesia, tremor, postural instability?
The OMs that are most significant predictors of future falls.
What is the ABC scale, previous fall history and UPDRS motor score?
A 67 year old female who as been taking antipsychotics for 10 years is referred to PT. She had jaw clenching, rapid eye blinking, tongue movement, lip smacking, twitching of the torso arms. name the disorder.
What is tardive dyskinesia?
A patient with advanced PD frequently freezes when transitioning through doorways or turning in tight spaces. The therapist integrates cognitive-motor dual tasking into treatment
to reduce episodes. This cognitive strategy, using a verbal sequence to break the freeze (“Stop, Stand Tall, Shift, Step”), is known as this.
What is the 4-S strategy?
A pt has a positive head thrust, DVA, and head shake test. Name the location of the issue.
What is a peripheral issue?