Neuro Interventions

Question 1

Define motor program

Answer 1

• A set of prestructured muscle commands that when initiated results in the production of a coordinated movement sequence (learned task)

Question 2

Define motor plan

Answer 2

• An overall strategy for movement
• An action sequence requiring the coordination of a number of motor programs

Question 3

Describe feedback versus feedforward

Answer 3

• Feedback: afferent (sensory) info sent by various sensory receptors to control centers; allows motor responses to be adapted to the demands of the environment
• Feedforward: readies the system in advance of movement; anticipatory responses that adjust the system for incoming sensory feedback for future movements

Question 4

Define motor learning

Answer 4

• A change in the capability of a person to perform a skill; the result of practice or experience

Question 5

Define generalizability

Answer 5

• The acquired capability to apply what has been learned to other similar tasks (transfer tests)

Question 6

Define resistance to contextual change

Answer 6

• Acquired capability to apply what has been learned to other environmental contexts

Question 7

Describe intrinsic versus augmented feedback

Answer 7

• Intrinsic: sensory info normally acquired during performance of a task
• Augmented: externally presented feedback that is added to that normally acquired during task performance

Question 8

Describe knowledge of results versus knowledge of performance

Answer 8

• Results: augmented feedback about the outcome of a movement
• Performance: augmented feedback about the nature of the movement produced

Question 9

Describe the different types of practice

Answer 9

• Blocked: practice of a single motor skill repeatedly
• Variable: practice of varied motor skills in which the performer is required to make rapid modifications of the skill in order to match the demands of the task
• Random: practice of a group of motor skills in random order
• Serial: practice of a group of motor skills in serial or predictable order
• Massed: relatively continuous practice in which the amount of rest time is small
• Distributed: practice time is less than rest time
• Mental: cognitive rehearsal of a motor skill w/o overt physical performance

Question 10

Define transfer of a skill

Answer 10

• The effects of having previous practice of a skill or skills upon the learning of a new skill or upon performance in a new context

Question 11

Describe part-whole versus bilateral transfer

Answer 11

• Part-whole: a learning technique in a which a complex motor task is broken down into its component parts for separate practice before practice of the integrated whole
• Bilateral: improvement in movement skill performance with one limb results from practice of similar movements with the opposite limb

Question 12

When to provide feedback to improve performance versus learning/retention

Answer 12

• Performance: feedback after every trial
• Learning/retention: feedback should be variable

Question 13

What type of feedback is good for early/cognitive phase of learning versus later/associative phase

Answer 13

• Cognitive: visual feedback
• Associative: proprioceptive feedback

Question 14

What should be the focus of feedback in early versus later stages of learning

Answer 14

• Early: feedback on correct aspects of performance
• Later: feedback on errors as they become consistent

Question 15

Strategies to vary locomotor task demands

Answer 15

• Walking forward/backward
• Side-stepping
• Cross-stepping (braiding)
• Stopping, starting, and turning on cue
• Head movements
• Step-ups, step-up and over, and stair climbing
• Obstacles

Question 16

CPG for locomotor training for chronic (≥6 months) stroke, SCI, or brain injury

Answer 16

• Perform: mod-high intensity over ground ambulation and virtual reality TT
• Consider: strength training multiple sets at 70% 1RM, cycle training (high intensity), circuit training, and virtual reality standing balance exercise
• Do not perform: sitting/standing balance w/o visual feedback, robotic assistance walking training, or BWS TT w/PT assistance

Question 17

Adherence-enhancing behavioral strategies for constraint induced movement therapy (CIMT)

Answer 17

• Daily administration of motor activity log
• Home diary
• Problem-solving to overcome barriers to use of the more affected UE
• Behavioral contract
• Caregiver contract
• Home skill assignment, home practice, & daily schedule

Question 18

Training parameters for BWS TT (body weight support treadmill training)

Answer 18

• High frequency: 3-5 days/wk
• Moderate duration: 20-30 minutes
• Maximum tolerated intensity: speed and slope

Question 19

Training parameters for constraint induced movement therapy (CIMT)

Answer 19

• High intensity: several hours/day
• High frequency: daily for a period of 2-3 consecutive weeks

Question 20

Describe a short interval HIIT protocol

Answer 20

• Typically use repeated 30s burst of high intensity exercise at maximum but safe speeds, alternated with 30-60 secs of lower intensity or rest periods

Question 21

Describe a long interval HIIT protocol

Answer 21

• Often targeted at repeated cycles of 3 minutes of high intensity activity followed by 4 minutes of lower activity or rest

Question 22

What are the benefits of HIIT

Answer 22

• Improved peak VO2
• Improved balance (Berg Balance Scale)
• Increased gait speed
• Increased endurance (6-minute walk test)
• Improved domains of cognition (Trail Making test part B)

Question 23

Contraindications to HIIT

Answer 23

• Unstable cardiac condition
• Significant arrhythmia or myocardial ischemia on treadmill ECG stress test
• Poorly controlled resting BP (>180/100)
• Subarachnoid hemorrhage
• Other conditions where VO2 peak is contraindicated

Question 24

Describe UE D1 flexion and extension movements/diagonals

Answer 24

• Flexion: flexion, adduction, and ER of shoulder
• Extension: extension, abduction, and IR of shoulder

Question 25

Describe UE D2 flexion and extension movements/diagonals

Answer 25

- Disco movement/pulling out a sword - Flexion: flexion, abduction, and ER of shoulder - Extension: extension, adduction, and IR of shoulder

Question 26

Describe LE D1 flexion and extension movements/diagonals

Answer 26

- Flexion: flexion, adduction, and ER of hip - Extension: extension, abduction, and IR of hip

Question 27

Describe LE D2 flexion and extension movements/diagonals

Answer 27

- Flexion: flexion, abduction, and IR of hip - Extension: extension, adduction, and ER of hip

Question 28

Describe a chop and lift movement/diagonal

Answer 28

- Chop: upper trunk flexion with rotation to R/L, lead arm moves in D1E, assist arm holds on top of wrist - Lift: upper trunk extension with rotation to R/L, lead arm moves in D2F, assist arm holds beneath the wrist

Question 29

Describe spatial versus temporal summation

Answer 29

- Spatial: multiple techniques - Temporal: repeated application of the same technique