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Vincent
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What are the goals to apply to most diagnoses?
- Prevent deformity or minimize contracture.
- Promote a variety of movement possibilities.
- Increase function.
- Train caregivers to help accomplish goals.
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Proximal low tone and weakness masked by spasticity and excessive contraction or co-contraction in the extremities.
Spasticity problem
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Movement restricted to midranges with predictable patterns, often seen as patterns of persistent reflexes.
Spasticity problem
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Incomplete righting, equilibrium, and protective reactions secondary to limited range of movement.
Spasticity problem
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Very high risk for orthopedic deformities secondary to muscle shortness, joint contractures, and spasticity.
Spasticity problem
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- Increase sustained control of postural muscles while decreasing excessive contraction of extremities.
- Increase range and variety of joint movements.
Spasticity treatment objectives
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- Avoid positions that stimulate reflexes or stereotyped movement patterns.
- Avoid static postures, work toward concentric/eccentric movement.
Spasticity treatment objectives
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Help them to accomodate to changes on speed and direction of movement - requires more reciprocating movement.
Spasticity treatment objective
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- Decreased proximal control and ability to co-contract around joints.
- Decreased grading and sustaining of muscle contractions.
Hypotonia problem
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- Decreased response to input secondary to decreased incoming sensory-motor information secondary to lack of active motion.
- Can't learn if you can't move.
Hypotonia problem
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- Hypermobility secondary to decreased muscle activation and decreased joint stability but at risk for tightness due to lack of movement.
- Postural responses usually absent or severely diminished.
Hypotonia problem
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- Facilitate functional head and trunk alignment and static control, especially stability around joints.
- Increase ability to move anti-gravity.
Hypotonia treatment objectives
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-Provide support to some areas of the body to encourage movement in other areas
- ie. provide proximal stability to facilitate controlled distal movement.
Hypotonia treatment objectives
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- Facilitate automatic reactions.
- Increase sensory input, especially proprioceptive, to increase registration of sensory information.
Hypotonia treatment objectives
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- Lack of sustained co-contraction and proximal stability.
- Asymetrical posturing and movements, often as an attempt to stabilize.
Athetosis problem
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- Uncontrolled righting and equilibrium reactions.
- Persistent early reflexes.
- Difficulty with selective control of head, eye, jaw, and arm movement.
Athetosis problem
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- Increase sustained proximal control with emphasis on gaining and maintaining midline control.
- Improve ability to hold postures while controlling symmetry of extremity movement away from midline.
Athetosis treatment objectives
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- Improve ability to time and grade muscle contraction.
- Provide support to some areas of the body to encourage controlled movement in other areas.
Athetosis treatment objectives
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- Jerky disorganized movements with impaired force and power output.
- Poor coordination and sequencing of movement.
- Poor sense of position in space.
Ataxia problem
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- Decreased movement away from midline secondary to poor equilibrium, therefore movement options are limited.
- Mild hypotonia with fluctuations toward normal tone.
Ataxia problem
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- Increase proximal muscle muscle control using sustained, deep somatosensory input and visual cueing to build stability.
- Work on transitions while giving guidance for initiation and increased excursion of movement.
Ataxia treatment objectives
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- Emphasize building eccentric control followed by shifts between eccentric and concentric muscle contractions.
- Develop automatic movement strategies for balance.
Ataxia treatment objectives
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