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General
Weight Bearing
Active Movement
Passive Movement
Positioning
100
Minimize changes in the viscoelastic properties of connective tissue and muscle Alter neural patterns of spasticity and spasms Improve or maintain levels of function
What are the goals of physical therapy management of spasticity?
100
Tilt table Standing frame Vector Overground standing with/without assistive device
What is the equipment available at UMROI for weight bearing?
100
Progressive resistive exercise Aerobic exercise Neurodevelopmental treatment NMES/FES Robotics Treadmill training
What are types activities included in the active movement category for physical therapy management of spasticity?
100
Self stretch Assisted stretch Continuous passive motion robotics
What are the types of stretching used for spasticity management?
100
Serial casting Static splinting Dynamic splinting
What are the interventions included as positioning techniques to address spasticity?
200
Weight bearing Active movement Passive movement Positioning Alternative approaches
What are the categories of physical therapy management of spasticity?
200
This is promoted in trunk and lower extremity muscles
What is antigravity muscle activation?
200
Increased strength and function without increased tone/pain Enhance motor learning Reverse disuse weakness Strengthen spastic and antagonist muscles
What are the effects of progressive resistive exercise?
200
Low load, long duration stretching
What is the most effective type of stretching to address spasticity?
200
Decrease motor neuron excitability Increase flexibility Decrease tensile stress of soft tissues
What are the effects of positioning interventions?
300
Accupuncture EMG biofeedback Repetitive transcranial magnetic stimulation TENS Hydrotherapy
What are some alternative approaches to spasticity management?
300
Weight bearing helps to modulate this component of spasticity through prolonged stretch and altered sensory input
What is the neural component?
300
Increase muscle strength Increase endurance Increase AROM Enhance motor learning
What are the effects of aerobic exercise?
300
Maintain or increase joint mobility
What is the effect of stretching?
300
Serial casts Bi-valved casts Dynasplint Static splints
What is the equipment available at UMROI to address positioning?
400
Physical therapy interventions must be customized to the patient Consider task specific interventions from multiple categories to address all goals Consider coordination with medical management
What are some take home points regarding physical therapy management of spasticity?
400
These are decreased with lower extremity weight bearing
What are lower extremity spasms?
400
Enhance effects of botulinum toxin injections Produce functional movement May improve motor return (acute) May reinforce neural connections Enhance motor learning Equipment: L300, Plus, NMES units, stim bikes
What are effects of NMES/FES and equipment available at URMOI?
500
One important positive effect of standing/lower extremity weight bearing
What is positive psychological benefit?
500
Decrease spasticity Allow early training Facilitate motor learning of gait cycle Equipment: Lokomat, Biodex BWSTT, LiteGait, treadmills
What are the effects of treadmill training and equipment available at UMROI?
500
Decrease spasticity Address mechanical factors of spasticity Sends increased afferent stimulation to motor cortex to guide motor relearning Equipment: CPM machines, UE robot, ankle bot
What are the effects of continuous passive motion robotics and equipment available at UMROI?