Rehab Techniques

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Author:
Vincent
ID:
105962
Filename:
Rehab Techniques
Updated:
2011-10-03 13:52:12
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Coordination Balance
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Coordination and Balance
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  1. Ability to execute smooth, accurate, and controlled motor responses.
    Coordination
  2. Control of discrete movements of the extremities.
    Nonequilibrium coordination
  3. Control of multi-joint movements for posture and gait, including the trunk.
    Equilibrium coordination
  4. Coordinated movement requires muscles and joints activated with appropriate _____ & _____.
    Timing and Scaling
  5. Time to initiate movement, time to move, and time to terminate movement.
    Timing
  6. Gradation of forces for a particular task.
    Scaling
  7. Age related changes impacting coordination:
    • - Decreased strength
    • - Slowed reaction time
    • - Decreased flexibility
    • - Postural changes
    • - Alterations in sensation, perceptual skills, and visual & hearing acuity.
  8. Cerebellar impairments impacting coordination:
    Hypotonia, Dysmetria, Dysdiadochokinesis, Tremor, Dyssynergia, Ataxia, Dysarthria, Asthenia, Rebound phenomenon, Nystagmus
  9. Basal ganglia impairments impacting coordination:
    Bradykinesia, Akinesia, Rigidity, Tremor, Chorea, Athetosis, Choreoathetosis, Hemiballismus, Dystonia
  10. Dorsal column impairments compacting coordination
    • - Decreased proprioception
    • - Decreased kinesthesia
    • - Decreased discriminative touch
  11. Timing and grading of muscles of the trunk and LE's to maintain an upright position with the COG over the BOS in a given sensory environment.
    Equilibrium Coordination
  12. Environmental conditions, real or imagined, that provide sensory information; the context in which an action occurs.
    Sensory environment
  13. State of remaining fixed or steady against the force of gravity.
    Stability
  14. Body is at rest while maintaining a position.
    Static balance
  15. Body or parts of the body are moving while repeatedly realingning the COG over the BOS.
    Dynamic balance
  16. Greatest distance in any direction that a person can sway or will sway without altering the original base of support or losing balance.
    Limits of stability (LOS)
  17. An automatic response of muscles to changes in COG.
    Muscles act in synergy thereby freeing higher brain levels from attending to aspects of maintaining balance.
  18. Postural adjustments made in preparation for voluntary movement (feedforward).
    Anticipatory of proactive
  19. Automatic responses to disruptions of stability from a specific stimulus (feedback).
    Compensatory or reactive.
  20. Components of Balance:
    • 1. Biomechanical / musculoskeletal
    • 2. Coordinated normal motor strategies
    • 3. Sensory organization
  21. 5 main areas of movement capabilities:
    • 1. Alternate or reciprocal motion
    • 2. Movement composition
    • 3. Movement accuracy
    • 4. Fixation of limb holding
    • 5. Equilibrium
  22. Compensatory motor strategies used to maintain balance:
    • 1. Ankle strategy
    • 2. Weight-shift strategy
    • 3. Hip strategy
    • 4. Stepping or grasping strategies
  23. - Delayed onset of muscle action
    - Co-contraction of muscles resulting in stiffness

    Examples of what?
    Timing problems
  24. Ability to reverse movement between opposing muscle groups.
    Alternating or reciprocal motion
  25. Muscles working together.
    Movement composition or synergy
  26. Ability to gauge and judge speed and distance.
    Movement accuracy
  27. Maintain control in response to alterations in COG or BOS.
    Equilibrium or postural stability
  28. Muscles feel soft, little resistance.
    Hypotonia
  29. Inability to judge distance or range of movement.
    Dysmetria
  30. Impaired ability to perform rapid alternating movements.
    Dysdiadochokinesis
  31. - Movement decomposition
    - Movement performed in a sequence of component parts.
    - Asynergia
    Dyssynergia
  32. Loss of coordination in gait, posture, and movement pattern with diffficulty in initiating, rate, rhythm, and sequencing.
    Ataxia
  33. - Disorder of motor component.
    - Scanning speech characteristic of cerebellar involvement: slow with prolonged syllables and inappropriate pauses.
    Dysarthria
  34. Generalized muscle weakness.
    Asthenia
  35. Inability to stop motion following an isometric contraction.
    Rebound phenomenon
  36. Rhythmic, oscillatory back and forth movement of the eyes.
    Nystagmus
  37. Decreased amplitude and velocity of movement.
    Bradykinesia
  38. Inability to initiate movement.
    Akinesia
  39. Seen at rest; decreases with purposeful movement; increased with stress.
    Resting tremor
  40. Involuntary, rapid, irregular, jerky movements.
    Chorea
  41. Slow, involuntary, twisting movements; "wormlike"
    Athetosis
  42. Large, sudden, flailing movements.
    Hemiballismus
  43. Involuntary sustained muscle contractions.
    Dystonia
  44. Cone of stability:
    • 12 degrees A-P
    • 16 degrees M-L
    • (Normal stance width of 4 inches)
  45. Primary sensory systems used for sensory organization:
    • Somatosensory
    • Visual
    • Vestibular
  46. Detractors from balance:
    • Cognitive deficits
    • Musculoskeletal limitations
    • Pain
    • Loss of sensory acuity
    • Faulty scaling and timing of muscle activation
  47. For hip strategy, which muscles contract when the body gets perturbed anteriorly?
    Abdomen and quads
  48. For hip strategy, which muscles contract when the body gets perturbed posteriorly?
    Erector spinae and hamstrings
  49. - Small perturbations well within the LOS
    - Muscle activation distal to proximal
    Ankle strategy
  50. - Pelvis is the key point of control
    - COM moves in frontal plane primarily with hip abductor and adductor muscles
    Weight-Shift strategy
  51. - Response to rapid and/or large external perturbations or on marrow BOS
    - COG near LOS
    - Muscle activation proximal to distal
    - Results in realigning pelvis over the BOS
    Hip strategy
  52. - Large, fast perturbations
    - Often used before the others or in combination with other strategies
    Stepping or grasping strategies
  53. Lowering BOS in an unstable surface (ice)
    Suspensory strategy

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