Movement Science and Treatment Techniques Quiz

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Questions and Answers

Which technique involves applying pressure at a muscle's origin or insertion to inhibit specific muscle activity?

Pressure (correct)

Vibration

Compression

Traction

What is the purpose of quick alternating movements in treatment techniques?

To facilitate co-contraction

To improve circulation

To increase muscle stiffness

To enhance movement responsiveness (correct)

Which of the following is NOT a component of a treatment session aimed at improving mobility?

Parental involvement

Equipment usage

Strengthening exercises (correct)

Movement responses

What does Functional Electrical Stimulation (FES) aim to produce?

Sequenced stimulation for functional movement Signup and view all the answers

Which technique is characterized by using light tremors applied manually?

Vibration Signup and view all the answers

What is the primary focus of motor learning and movement science?

Skill acquisition in a context-specific environment Signup and view all the answers

Which technique best supports the functional strengthening of children with motor control issues?

Functional strengthening exercises Signup and view all the answers

Which of these treatment techniques involves the use of mobile surfaces?

Use of equipment Signup and view all the answers

What type of communication device does Nicole use?

Tech Talker Signup and view all the answers

What is the main benefit of the MOVE Program for Nicole?

Enhanced independence in mobility Signup and view all the answers

How frequently should Body Weight Supported Treadmill Training (BWSTT) be conducted?

2-5 days per week Signup and view all the answers

What physical support does Nicole use to walk into the classroom?

Gait trainer Signup and view all the answers

What is a key motor learning principle that supports the use of BWSTT?

Active engagement in task performance Signup and view all the answers

Which activity can Nicole participate in with her classmates?

School play Signup and view all the answers

What type of chair does Nicole use to participate in classroom activities?

Adaptive chair Signup and view all the answers

What is the allowed speed range for BWSTT?

0.5 mph - 3 mph Signup and view all the answers

What is the main purpose of Kinesio Tape in therapy?

To facilitate movement patterns and increase stability Signup and view all the answers

What precaution should be taken before applying Kinesio Tape?

Use a test patch over the area for four days Signup and view all the answers

Who developed Conductive Education and where?

Peto in Hungary Signup and view all the answers

What type of equipment is utilized in Conductive Education?

Specialized plinths and ladder frames Signup and view all the answers

Which of the following is NOT a step in the MOVE program?

Increasing bracing Signup and view all the answers

What is the primary goal of Neurodevelopmental Therapy (NDT)?

Enhance function through active participation Signup and view all the answers

What is the primary goal of the MOVE curriculum?

To ensure independence in functional activities Signup and view all the answers

Which group is primarily included in the MOVE program?

Children and adults with motor disabilities Signup and view all the answers

In the context of treating a child at home, what is important to schedule?

Visits that accommodate both the family and child’s schedule Signup and view all the answers

Which treatment approach emphasizes the gradual withdrawal of therapist input?

Neurodevelopmental Therapy Signup and view all the answers

What aspect does the MOVE program's top-down approach focus on?

Evaluating the learner’s existing skills Signup and view all the answers

What is a key component of the treatment methods for mobilizing a child after long periods in a wheelchair?

Gradual engagement and stretching before skill-based practice Signup and view all the answers

What technique is employed in NDT to assist clients in learning movements?

Gradual handling and guidance by a therapist Signup and view all the answers

What area does NDT specifically focus on enhancing for clients?

Increasing functional performance and age-appropriate movements Signup and view all the answers

Which of the following is NOT a focus area of Neurodevelopmental Therapy?

Using solely passive techniques Signup and view all the answers

How does the clinician help clients expand their movement repertoire in NDT?

By gradually removing direct handling in varied environments Signup and view all the answers

What is the primary focus of therapeutic riding sessions?

To emphasize group dynamics and encourage individual success Signup and view all the answers

Which intervention method is based on the theories of Temple Fay?

Dolman Delacato/Patterning Signup and view all the answers

What kind of input is emphasized in Dolman Delacato/Patterning?

Systematic reciprocal movements and sensory inputs Signup and view all the answers

What is the weight of touch used in craniosacral therapy?

Around 5 grams, approximately the weight of a nickel Signup and view all the answers

Why might a child require craniosacral therapy?

Due to complications arising from a difficult labor. Signup and view all the answers

What does therapeutic riding aim to provide?

Educational and recreational opportunities for individuals with disabilities Signup and view all the answers

What limitation do the American Academy of Pediatrics and AACPDM have regarding Dolman Delacato/Patterning?

Position statements against this intervention Signup and view all the answers

Which aspect of riding does therapeutic riding emphasize for its participants?

Proper riding position and rein skills Signup and view all the answers

What is a primary focus of pediatric physical therapy during treatment sessions?

Enhancing development through play Signup and view all the answers

Which of the following is NOT a component of pediatric therapy evaluation?

High-level surgical interventions Signup and view all the answers

What is the recommended sequence of activities during pediatric therapy sessions?

Work – Play – Work – Play Signup and view all the answers

At what developmental stage does pediatric therapy begin to focus more on function and functional skills rather than play?

School age children Signup and view all the answers

Which common treatment technique in pediatric therapy is designed to improve mobility and function?

Wheelchair training Signup and view all the answers

What is a critical approach to treatment planning for pediatric physical therapists?

Preparing for varying responses of the child Signup and view all the answers

What type of play is most appropriate for toddlers during therapy sessions?

Movement-based play Signup and view all the answers

Which statement best describes the nature of treatment in pediatric physical therapy?

Treatment is mostly 1:1 and often long term Signup and view all the answers

Study Notes

Treatment Planning and Approach for Pediatric Patients

Long Island University's DPT program developed the treatment approach
Original developer: Nia Mensah, PT, DPT, PhD, PCS
Revisions by Melanie O'Connell, PT, PhD, PCS

Enhancing Pediatric Development

Pediatric physical therapists help families enhance a child's development
This is achieved through various strategies:
- Positioning during daily routines and activities
- Adapting toys for play
- Expanding mobility options
- Effective use of equipment

Pediatric Therapy Evaluation and Treatment Focuses

Mobility, muscle and joint function, strength and endurance, cardiopulmonary function
Posture and balance, oral motor skills and feeding
Sensory and neuromotor development, use of assistive technology

Traditional Components of Adult Rehabilitation in Pediatric Treatments

Range of Motion (ROM) exercises
Strengthening exercises
Stretching exercises
Gait training
Postural training
Wheelchair training/management
Pain management
Fitness

Differences between Pediatric and Adult Treatments

Pediatric PTs commonly avoid high levels of modalities
Treatment is often one-on-one (1:1)
Treatment tends to be more long-term with potential episodes of care

Treatment Planning

Prepare and plan for each treatment session
Tailor sessions to each child based on their developmental needs and responses
Vary treatment techniques based on age:
- Infants: Sensory motor play and exploration
- Toddlers: Movement-based play
- Pre-schoolers: Imaginative play and creating scenarios
- school-aged children: Focus on function with less play
- Adolescents: Focus on sporting activities, function, real exercise

Treatment Sequence

Treatment progression from easy to more challenging activities
Utilizing developmental sequences as a guide
Following a "work-play-work-play" cycle
Child-driven activities, with preparation, muscle activation, and movement responses/functional activities
Adapting treatment to the child's arrival and departure locations, especially wheelchair users

Treating at Home

Scheduling sessions to accommodate family and child schedules
Using home materials and toys suitable for practice
Involving caregivers in treatment sessions and providing strategies to incorporate activities to daily routines
Including siblings in therapy sessions

Treatment Approaches

Neurodevelopmental therapy (NDT)
Strengthening
Motor learning
Electrical stimulation
Sensory integration
Conductive education
Movement curriculum
Body weight support gait training
Constraint-induced therapy

Neurodevelopmental Therapy (NDT)

Developed by Bobath in response to lack of neuro-based treatment for children with cerebral palsy (CP) and hemiplegia
Goal: Enhancing function
Active participation and direct handling from the therapist to optimize function, accompanied by gradual withdrawal of direct input

NDT principles

Utilizing the understanding of normal development to evaluate problem areas and missing components in an individual's function
Addressing problem areas to improve appropriate function
Focus on efficient motor function (ability to combine a variety of movements into functional activities in various situations)
Emphasis on increasing function and utilizing patients' strengths to address impairments through therapeutic handling
Clinicians teach the movement through handling; gradually reducing guidance, making the client responsible for their movement
Expanding movement to different environments

NDT techniques to reduce stiffness

Relaxation (gentle rocking, warmth, talking gently)
Pressure at muscle origin or insertion (inhibits specific muscle activity)
Quick alternating movements (reciprocal movements with large amplitude oscillation)
Rotation (axial rotation breaks up total synergies, limb rotation to decrease stiffness)
Vibration (light tremor applied manually)

Treatment techniques continued

Traction
Compression
Tapping
Mobile surfaces
Incorporating rotation and diagonal movements
Treating with the movement direction
Working proximally to effect distally

Treatment Session

Beginning with prep work to relax stiffness, and elongate muscles
Incorporating muscle activation in allowing muscle group integration
Working on movement responses, righting, balance, weight shift, and protective responses
Continuing with mobility, utilizing key points and facilitation to improve gait
Employing equipment like balls, bolsters, and wedges
Involving parents

Strengthening

Result of working with children post SDR (rebirth) - a need to strengthen children emerged
Addresses the negative signs of upper motor neuron lesions: loss of motor control, weakness, fatigue, and poor motor planning
Most effective when children have isolated voluntary muscle control
Functional strengthening is crucial
A range of resistive exercise methods are utilized

Motor Learning/Movement Science

Developed from the science of movement
Focus on skill acquisition in specific contexts
Strategies involve practice, feedback, feedforward, knowledge of results (KR), and knowledge of performance (KP)
Does not rely on facilitation or handling

Electrical Stimulation

Neuromuscular electrical stimulation (NMES): High-intensity stimulation to augment exercise
Functional electrical stimulation (FES): Sequenced stimulation to produce functional movement
Threshold electrical stimulation (TES): Low-intensity stimulation at the sensory threshold to increase blood flow for growth and repair

Kinesio-Taping

Facilitates movement, improves alignment, and increases stability
Using test patches for assessments reduces reactions and sensitivity
Trunk is more sensitive than extremities; Milk of Magnesia can reduce sensitivity under the tape

Conductive Education

Developed by Peto in Hungary, it's a system focusing on achieving "orthofunction"
Teachers/therapists structure all daily life activities to ensure all activities promote function
Utilizing specialized equipment like plinths, ladder frames, chairs (without much bracing)
Employing task series or exercise routines in group settings with rhythmic initiation
Widely used in the UK

MOVE: Mobility Opportunities via Education/Experience

Activity-based program supporting sitting, standing, walking, and transitions
Utilizing specific equipment
Using systematic instruction for functional tasks, especially functional movement
6 steps of the program: Testing, Setting goals, Task analysis, Measuring prompts, Reducing prompts, and Teaching skills

MOVE Curriculum

A structured program that assesses and measures gross motor skills
Top-down approach that evaluates current skills in teaching necessary skills for independent function
Skilled practice incorporated through a learner's daily functional activities
Functional level and cognitive impairment are not barriers to participation in the MOVE Program
Program often includes wheelchair users

Body Weight Supported Treadmill Training (BWSTT)

Rationale is supported by current motor learning principles
Active engagement in task performance over time for neuroplasticity (re-wiring of the brain) to occur
Allows for repetition and intensity of training in task-specific practice of walking/movement
- Frequency: 2-5 days/week
- Session length: 5-30 minutes/session
- Treadmill speed: 0.05 mph-3 mph
- % body weight support
Load stance limb use
- Least amount of body weight support to maintain erect postural alignment
Manual assistance
- Least amount required for stepping; to assist intra- and inter-limb coordination
Support using arms/hands: fading the use of handrails. Episode of treatment 2-16 weeks, with pre/post assessments including walking speed, 6MWT, and GMFM dimensions D&E

Body Weight Supported Treadmill Training Evaluations

A Cochrane Systematic review shows little evidence but improvement on efficacy of walking/motor skills with the use of BWST
Best with children with Down syndrome (Improve age of onset of independent walking), developmental disabilities (walking velocity), and somewhat in cerebral palsy

Constraint-Induced Therapy

Based on adult studies by Taub
Stronger arm is restrained for 6 hours/day for 21 days while the weaker arm is facilitated and trained in appropriate tasks to change motor behavior in the brain

Alternative Therapies

Hippotherapy, Craniosacral Therapy, Patterning
Specific websites for further details given

Hippotherapy

Completed by a therapist and a professional horse handler
Therapist's hands-on participation is essential during training
Horse movement is essential
The goal is for treatment to improve cognitive levels, body movement through training and organization
Therapist continually assesses and adjusts treatment based on client response

Therapeutic Riding

Guided by professional horseback-riding instructor and optional involvement from therapists as consultants
Instructor is primarily teaching from center of the arena
Horses' temperament is crucial for this training method
Focus is on social, educational, and sporting aspects, including recreational and adaptability to individuals with disabilities
Activities use group format, fostering individual success while emphasizing proper riding posture, and rein skills

Dolman Delacato/Patterning

Based on Temple Fay’s theories about motor development mimicking animal evolution
Employing systematic reciprocal movements and sensory inputs to stimulate brain cells for restoring normal movement
Requires significant parental and volunteer work (passive movement)
American Academy of Pediatrics has position statements against this intervention technique.

Craniosacral Therapy

Gentle, hands-on method to evaluate the function of the craniosacral system (membranes and cerebrospinal fluid surrounding and protecting the brain and spinal cord)
Use of soft touch (no more than 5 grams) to release restrictions in the craniosacral system to improve central nervous system function
Possible need for craniosacral therapy if child experiences difficult births; symptoms could involve extreme crying, irritability and wakefulness
Insufficient evidence to support therapeutic effects

Adeli Suit

Developed in Russia (1971) as a cosmonaut suit, it provided resistance
Adapted in 1992 for neuromuscular problems, particularly Cerebral Palsy (CP)
Goal: Improve proprioception and change; reduce pathological reflexes, restore muscle synergies, load the body with weight
Research shows no significant advantage over intensive therapy itself

Suit Therapy Research

Published and unpublished reports support limited data on study participants
Age-matched randomized trials are used for control/experimental group design

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Description

Test your knowledge on various treatment techniques in movement science, including muscle activity inhibition methods and Functional Electrical Stimulation (FES). This quiz also explores principles of motor learning and mobility improvement strategies. Challenge yourself with questions on the MOVE Program and Body Weight Supported Treadmill Training (BWSTT).