Mngmt of Neuro

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Mngmt of Neuro
2011-11-19 22:47:33
Altered tone movement dysfunction

Altered tone and movement dysfunction
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  1. 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.
  2. Proximal low tone and weakness masked by spasticity and excessive contraction or co-contraction in the extremities.
    Spasticity problem
  3. Movement restricted to midranges with predictable patterns, often seen as patterns of persistent reflexes.
    Spasticity problem
  4. Incomplete righting, equilibrium, and protective reactions secondary to limited range of movement.
    Spasticity problem
  5. Very high risk for orthopedic deformities secondary to muscle shortness, joint contractures, and spasticity.
    Spasticity problem
  6. - Increase sustained control of postural muscles while decreasing excessive contraction of extremities.
    - Increase range and variety of joint movements.
    Spasticity treatment objectives
  7. - Avoid positions that stimulate reflexes or stereotyped movement patterns.
    - Avoid static postures, work toward concentric/eccentric movement.
    Spasticity treatment objectives
  8. Help them to accomodate to changes on speed and direction of movement - requires more reciprocating movement.
    Spasticity treatment objective
  9. - Decreased proximal control and ability to co-contract around joints.
    - Decreased grading and sustaining of muscle contractions.
    Hypotonia problem
  10. - 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
  11. - 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
  12. - Facilitate functional head and trunk alignment and static control, especially stability around joints.
    - Increase ability to move anti-gravity.
    Hypotonia treatment objectives
  13. -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
  14. - Facilitate automatic reactions.
    - Increase sensory input, especially proprioceptive, to increase registration of sensory information.
    Hypotonia treatment objectives
  15. - Lack of sustained co-contraction and proximal stability.
    - Asymetrical posturing and movements, often as an attempt to stabilize.
    Athetosis problem
  16. - Uncontrolled righting and equilibrium reactions.
    - Persistent early reflexes.
    - Difficulty with selective control of head, eye, jaw, and arm movement.
    Athetosis problem
  17. - 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
  18. - 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
  19. - Jerky disorganized movements with impaired force and power output.
    - Poor coordination and sequencing of movement.
    - Poor sense of position in space.
    Ataxia problem
  20. - Decreased movement away from midline secondary to poor equilibrium, therefore movement options are limited.
    - Mild hypotonia with fluctuations toward normal tone.
    Ataxia problem
  21. - 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
  22. - Emphasize building eccentric control followed by shifts between eccentric and concentric muscle contractions.
    - Develop automatic movement strategies for balance.
    Ataxia treatment objectives