Mngmt of Neuro

What are the goals to apply to most diagnoses?

Proximal low tone and weakness masked by spasticity and excessive contraction or co-contraction in the extremities.

Movement restricted to midranges with predictable patterns, often seen as patterns of persistent reflexes.

Incomplete righting, equilibrium, and protective reactions secondary to limited range of movement.

Very high risk for orthopedic deformities secondary to muscle shortness, joint contractures, and spasticity.

- Increase sustained control of postural muscles while decreasing excessive contraction of extremities.
- Increase range and variety of joint movements.

- Avoid positions that stimulate reflexes or stereotyped movement patterns.
- Avoid static postures, work toward concentric/eccentric movement.

Help them to accomodate to changes on speed and direction of movement - requires more reciprocating movement.

- Decreased proximal control and ability to co-contract around joints.
- Decreased grading and sustaining of muscle contractions.

- 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.

- 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.

- Facilitate functional head and trunk alignment and static control, especially stability around joints.
- Increase ability to move anti-gravity.

-Provide support to some areas of the body to encourage movement in other areas
- ie. provide proximal stability to facilitate controlled distal movement.

- Facilitate automatic reactions.
- Increase sensory input, especially proprioceptive, to increase registration of sensory information.

- Lack of sustained co-contraction and proximal stability.
- Asymetrical posturing and movements, often as an attempt to stabilize.

- Uncontrolled righting and equilibrium reactions.
- Persistent early reflexes.
- Difficulty with selective control of head, eye, jaw, and arm movement.

- 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.

- Improve ability to time and grade muscle contraction.
- Provide support to some areas of the body to encourage controlled movement in other areas.

- Jerky disorganized movements with impaired force and power output.
- Poor coordination and sequencing of movement.
- Poor sense of position in space.

- Decreased movement away from midline secondary to poor equilibrium, therefore movement options are limited.
- Mild hypotonia with fluctuations toward normal tone.

- 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.

- Emphasize building eccentric control followed by shifts between eccentric and concentric muscle contractions.
- Develop automatic movement strategies for balance.