Parkinson's
List 3 AROM and strengthening exercises specific to Parkinson's
Neck rotation
shoulder rolls
bridging
trunk rotation
toes raises
stationary bike
ALS causes muscle weakness and atrophy: how are muscles impacted?
Progresses distal to proximal: legs then to arms
Greatest weakness 2-3 weeks after symptoms first appear
flaccid paralysis and loss of deep tendon reflexes
List 4 potential complications of SCI
pressure sores, autonomic dysreflexia, orthostatic hypotension, DVT, spasticity, pain, bowel and bladder dysfunction, respiratory issues, ectopic bone growth
This disease causes inflammation of the gray matter in the brainstem or spinal cord
What is poliomyelitis
What are 2 keys to remember when doing PT with post-polio syndrome patients?
Endurance training
d/c exercise if excessive fatigue occurs
pain management
What is the definition of Parkinson's disease?
These are the common tests used to diagnose CTS
Phalen's test, Tinel's test, electromyogram and never conduction study
C1-C3 expected level of function
no phrenic nerve innervation (diaphragm)
dependent on ventilator
dependent on ADL’s
electric W/C: sip and blow
Name 2 complimentary treatments to decrease stress and 2 diet/lifestyle things to change in MS patients
Complimentary tx: craniosacral, massage, acupuncture, chiropractor, myofascial, herbal remedies
Diet/lifestyle: eliminate processed foods and caffeine, add fruits and veggies, add organics
What are 3 of the 5 PT treatments for ALS patients?
ROM, work on functional activities, massage, percussion for lungs, aquatic therapy
Name the two methods/techniques to decrease rigidity in a Parkinson's patient
Diaphragmatic breathing, rhythmic rotation, rocking chair
2 symptoms and 2 treatments of MS
Problems with muscle control, decreased strength, visual problems, numbness and tingling in hands and feet, psychological and cognitive issues: prone to depression. Can be unilateral or bilateral, symmetrical or asymmetrical.
TX:
strengthening, work on function, aquatic therapy, slow static stretching to gain range, Frenkel's coordination exercises
What is autonomic dysreflexia and at what level must the lesion be and what do you do?
automatic reflex triggered by bladder irritations, stimulus from bowel or pressure sores
patients BP suddenly elevates and nervous system unable to inhibit the response
Injuries above T6
PTA: sit or stand pt, do not lie them down, check catheter blockage
Acute onset
Ascending paralysis
1st symptom is often paresthesia in the toes
Name disease and what is ascending paralysis?
Guillain-Barre
Distal to proximal, symmetrical
LE to UE to diaphragm and resp. ms
30% require mechanical ventilation due to hypoventilation and respiratory failure
alteration of consciousness, usually transient (< 24 hrs): c/o vertigo, nausea, HA, weak pulse
damage to both side of the brain, bounces in rigid skull
state of consciousness from which cannot be aroused
post comatose awareness
concussion
coup-countercoup
coma
persistent vegetative state
What is the medical management for Parkinson's disease?
meds: levadopa: chemical brain can use to make dopamine. anticholergic drugs
neurotrophic factors: gene therapy
surgery: implant tissue in the brain, deep brain stimulation surgery, pallidotomy and thalamotomy
What are 3 of the 5 PT treatments for Bells Palsy?
massage, heat for soreness, ice to decrease inflammation, facial exercises, e-stim
Differentiate complete lesion, incomplete lesion, Brown-Sequard
Complete: No sensory or motor function below level of lesion
Incomplete: Some sensory or motor function below level of lesion
Brown-Sequard: Partial cord lesion, loss of sensation on same side, loss of pain/temperature on opposite side
What is the Glascow Coma Scale?
Which disease is it associated with?
TBI
Determines level of consciousness and severity of injury
Areas assessed: eye opening, motor response, verbal response
< 8 = severe head injury
9-12 = moderate
13-15 = mild
List 2 upper motor neuron S&S for ALS
spasticity, stiffness, difficulty swallowing and difficulty with speech
What are the 13 classic signs of Parkinson's and explain them
Rigidity: Increased resistance to passive stretch in both directions
cogwheel: jerky, rachetlike movements
leadpipe: constant uniform resistance
Bradykinesia: Slowness of movement, difficulty initiating mvmt.
Resting tremor: Initial sign in 50% of pts
pill rolling: disappears with voluntary movement
Impaired postural reflexes
lacks protective responses
Delay in initiating movement
Lack of arm swing
Impaired balance
Soft muffled speech
Freezing of movement
Postural abnormalities: stooped posture, forward head, rounded shoulders, posterior pelvic tilt, flexed hips and knees
Festinating gait
Lack of facial expression: hypertonicity of facial muscles, infrequent blinking
Psychological and cognitive impact: depression, anxiety, dementia
Explain spinal shock and what occurs
immediate and temporary period of flaccid paralysis, loss of reflexes, loss of B/B function and poor temperature regulation below level of injury
normally lasts 24-48 hours, absence of reflexes, level of injury cannot be assessed
once it passes, reflex activity below the level of the lesion will return and spasticity occurs
List one activity possible for each SCI level: C4, C5, C6, C7, C8-T1, T4-L1, L2-5
C4: good head and neck control, respiration, scapular elevation, electric w/c
C5: limited self care, most shoulder motions, scapular retraction, elbow flex/sup, manual w/c projections, transfers w/ slideboard and assist
C6: I bed mobility, I transfer w/ slideboard, shoulder fully innervated, wrist extensors
C7: I w/ ADLs, triceps, wrist flexors, transfers I w/out slideboard
C8-T1:full innervation of UE
T4-L1: improved trunk control, amb w/ bilat orthoses and crutches
L2-5: hip flexors, hip adductors, knee extensors, knee flexors and functional amb with bilat KAO and crutches
Name the 3 PT treatments for CTS and and exercise for each
1. Educate: neutral wrist position, self massage, minimize repetitions, reduce speed and force, use whole hand grip, rest your hand
2. Stretching and nerve glides: carpal tunnel stretch, median nerve glide, tendon glides, stretch cervical and shoulder area down to wrist, median nerve stretch
3. Strengthening and ROM activities
Differentiate locked in syndrome and chronic traumatic encephalopathy
Rare neurologic disorder after TBI occurs: complete paralysis of all voluntary muscles except those that control the eyes.
affects the pons-conscious and possesses cognitive function but cannot move
CTE: degenerative brain disease found in those with history of repetitive brain trauma.
protein called Tau forms clumps that slowly spread throughout the brain killing brain cells