Week 2 Neuro Summary PDF

2.5 Rehabilitation Management - MS Intervention Types Preventative minimizing complications delaying exacerbation (good prognosis of baseline (later, severe stages) AD after exacerbation) - All to help w/ ADL neural plasticity recovery of mvmt task modification - secondary prevention - ex: nutrition...

2.5 Rehabilitation Management - MS Intervention Types Preventative minimizing complications delaying exacerbation (good prognosis of baseline (later, severe stages) AD after exacerbation) - All to help w/ ADL neural plasticity recovery of mvmt task modification - secondary prevention - ex: nutritionist Maintenance Restorative Compensatory caregiver) decrease disability education (pt/ assistive services not covered by insurance - tertiary prevention Early Stage Interventions/Impairments Relapsing Remitting - will not show limitations can affect instrumental ADLs, like social aspects compensatory strategies Preventative/Restorative Intervention CV exercise stretching strengthening education on energy conservation - know when overdoing things environmental modification middle stages compensatory strategies Preventative/Restorative mod independence bc mobility using AD consultations psychological support energy conservation activities - modify their sport late stages compensatory (improves QOL of pt/caregiver) Prevention WC cushion improve posture education on bed mob positioning to avoid contractures/atrophy pressure relieving AFOs/PRAFOs - decreases integumentary compromise lifting techniques Intervention for sensation Compensatory Restorative proprioceptive loading through jts weights w. resistance to improve body awareness vision - contrast/lighting to prevent falls in environment home environment - rugs moved sensory brushing/pharmacological - bright colored tape - heightened sensitivity at soles of feet eyepatch - diplopia & I I - do skin checks bc can lead to compounding integumentary dysfxn - 1 I , - - interventions for pain pain directly from MS Lhermitte’s sign - PT can’t directly impact - pharmacological agents/acupuncture/meditation pain due to MS symptoms use soft cervical collar for systemic body pain - pts will feel shocking pain if flex neck - ex: tight muscles/malaligned jts - postural reeducation - use swiss ball - stretching - improve flex, jt pain - aquatic therapy - calming - TENS pain following medication pain independent of MS - important to time therapy - referral interventions for exercise * exercise does not increase symptoms for people with MS usually* schedule & dosage important - avoid overheating or exacerbation current relapsing episode - no exercise until remission vitals - RPE, HR, BP stop when reach peak HR, dizziness, lightheadedness, or significant increase/decrease BP maintain diary to see sleep, how costly ADLs are distributed practice best, 3-5x a week alt days w. 60-85% HR peak per session recumbent bike water aerobics treadmills VR/gaming Interventions for strength progressive resistance bands weight training circuit training WEIGHTED VEST: activity based training closed chain exercises interventions for bowel and bladder control voiding times for improved QOL pelvic floor exercises interventions for flexibility - hold in end range for 30-60 seconds daily splinting spasticity Coordination & Balance: see ataxia/postural instability WB activities for trunk stab - reduces unintended mvmts manual over pressure - good for spasticity - Estim for strengthening of pelvic floor HEP PNF for coordination/stab - chop/lift/isotonic/reversal of antagonist/rhythmic stab - dont stretch too much bc can make worse - weather can make worse: heat packs help - proprioceptive feedback: WB dont do patterns emphasizing mvmts and not stability, can make it worse Interventions for gait: decreased balance, coordination, strength fxnal gait in all directions gait overground w/ assistance if can more assistanceL bodyweight supported treadmill Orthotics/AD compensatory avoid bracing until really need to encourage muscles to do work - AFOs: help w/ DF in swing phase, decreased genu recurvatum during stance, decrease PF spasticity later use power chair for energy conservation & participation in society summary combination of interventions preventative restorative compensatory maintenance interventions specific to symptoms and activity goal