Neurodegenerative Diseases NBCOT – Flashcards

decreased coordination of movement

impairment of voluntary and spontaneous movement invitation resulting in freezing, especially in gait activities

involuntary muscle contraction and relaxation; observed as a muscle twitch

small rapid steps resulting from a forward-tilted head and trunk posture

numbness and tingling because of sensory nerve changes

-Teach compensatory strategies (memory aids, written instructions, increase time for tasks, problem-solving techniques, decrease distractions) -Energy Conversation (complete higher priority tasks in morning, alternate rest, orthotics/adaptive equip) -Provide environmental modifications -Help delegate roles to family members -exercise programs within client's limit (ex. short exercise periods every day, as opposed to long exercise periods 3X a week)

Impaired balance and coordination (ataxia), partial or complete paralysis of part of the body; muscle spasticity (esp. in LB); muscle weakness, fatigue; intention tremors; dysphagia; paresthesia; impaired sensation; vertigo, pain; diplopia or blurred vision; Optic neuritis; slurred speech or scanning speech; incontintence or urinary retention; sexual dysfunction (women can still carry children); short-term memory loss, decreased attention and processing speed, impaired executive functioning and judgement; Depression, Lability, inappropriate euphoria

slow enunciation with frequent hesitations at the beginnings of words or syllables; symptom of MS

visual disturbances, dizziness, and weakness

causes sudden loss of vision with pain in or behind the eye, with symptoms subsiding after 3-6 weeks without residual impairments; consists of partial loss of vision (scotoma); nystagmus; and loss of visual acuity in 80% of people with MS

People have no functional limitations 15 years after onset

progresses rapidly, causing significant disability or death in a short period

Standarized Eval Tools: Modified Fatigue Impact Scale, Beck Depression Inventory-18, FIM, Nine-Hole Peg Test or Purdue Pegboard Test, Semmes-Weinstein monofilament; Modified Ashworth for Spasticity; assess pain, cognitive deficits, dizziness, sleep patterns, fine motor, falls, balance, incontinence; goals should be compensatory since it is progressive

hot temperatures, heat modalities (such as hot packs or flulidotherapy), excessive physical activity or overexertion; increased emotional or physical stress

Fall reduction, Home Safety Assessment; Adaptive Equipment; Sensory reeducation; Compensatory sensory strategies (testing water using unaffected body part); yoga or group exercise classes, energy conservation techniques; stretch to decrease spasticity; resting splints for pain; maintain hips at 90 degrees flexion to reduce extensor tone; monitor body mechanics to avoid stressing joints; identify type/cause of fatigue; keep fatigue diary; reduce periods of standing or mobility; instruct client using ergonomic positioning; cooling techniques (ice modalities, liquid cooling vest); encourage proximal stabilization for improved distal movements, HOH A for fine motor tasks (ex. using the unaffected extremity over the hand with tremor when dialing a phone); cervical collar to reduce the travel of the head and neck; wrist splints; collaborate with speech therapists for dysphagia; screen for signs of aspiration; cognitive retraining, external memory aids; coping strategies; stress management techniques; group therapy; weighted utensils for feeding or wrist weights during self-care to reduce tremors; ADL adaptations

used to overcome weakness in dorsiflexors (could be used with MS)

progressive; occurs later in life (onset usually 55-60 years); major degenerative changes occur in the basal ganglia (gray matter that contributes to complex movements); loss of dopamine results in decreased accuracy of motor skills, postural stability, condition, and affect/expression

a condition in which people experience symptoms similar to those of PD, but the cause is related to the ingestion of drugs or other toxic chemicals; certain medications used to treat mental illness may produce parkinsonian symptoms if not monitored

unilateral symptoms, typically a resting tremor, with no or minimal loss of function

bilateral symptoms, balance is not affected, although problems develop with trunk mobility and postural reflexes

impaired balance secondary ot postural instability resulting in mild to moderate impairments in function

decrease in postural stability, decrease in function, impaired mobility, need for assistance with ADL's, poor fine motor and dexterity

total dependence for mobility and ADL's

resting tremor (affects one side, pill rolling), muscle rigidity (cogwheel motions), bradykinesia, fatigue, shuffling gait, freezing, and postural instability (posture is stooped, lack of arm swing during mobility, and loss of postural reflexes); fall risk is increased d/t decreased balance

Gait Dysfunction, Fine motor impairments, Freezing, cognitive deficits (dementia in later stages, memory loss, impaired executive functioning); communication deficits, micrographia, hypophonia (reduced volume of speech), flat affect, sensory loss (including sexual dysfunction), dysphagia (and drooling), depression, apathy, lack of initiative

COPM; evaluate for fine motor/dexterity deficits; mobility impairments; ADL and IADL deficits; swallowing or feeding issues; sexual dysfunction; disrupted sleep; social isolation (Symptoms increase just before the next medication dose, so evaluate different times of day to get accurate picture); may require additional cognitive screening

energy conversation (planning important activities around medication schedule); caregiver training, support and advocacy groups; home exercise programs (simple calensthetics or AROM) functional mobility; transfers, assistive devices, auditory cues (rhythm of counting outloud); distal wrist weights; mirror for facial expressions; groups for socialization, motivation, skills; button hooks, elastic shoe laces; stress reduction or relaxation techniques; home assessment (home environment modifications); moist heat, stretching, gentle ROM

antispasticity splint or a dynamic or static progressive splint that gives a low intensity stretch agains contraction of the antagonist muscles

also known as Lou Gehrig's disease; progressive degenerative disease; men are more affected than women; progresses rapidly; death usually occurs secondary to respiratory failure; life expectancy is 1-5 years after diagnosis

symptoms move distal to proximal; initial symptom: weakness of the small muscles of the hand or an asymmetrical foot drop with night cramps in calves; muscle atrophy, focal and multifocal weakness, spasticity, muscle pain, hyperactive reflexes, dysphagia, dysarthria

Stage 1: The person can walk; is independent with ADLS, and has some weakness Stage 2: The person can walk and has moderate weakness Stage 3: The person can walk, but has severe weakness Stage 4: The person requires a WC for mobility, needs some A with ADL's and has severe weakness in legs Stage 5: WC for mobility, dependent for ADL's, severe weakness in arms and legs Stage 6: confined to bed, dependent for ADL's

ALS Functional Rating Scale, Purdue Pegboard Test, Multidimensoinal Fatigue Inventory; Dysphagia screening and testing; write goals that focus on minimizing symptoms' effect on occupational performance

compensatory interventions; home safety assessments; safety (including positioning, transfers, and skin integrity), augmentative communication equipment; social participation; environmental modifications; AROM; PROM; strengthening, endurance, home breathing exercise programs; neck collar or universal cuff is used for UE stability during self-care or fine motor tasks; mobility aids (foot-drop splint, cane, walker) to minimize exertion during ambulation and to compensate for LE weakness

high backed and reclining; lightweight, turns in a small space, offers support for the head, trunk, and extremities; as ALS advances the client may consider a power WC with adaptable controls that is easily maneuvered with tilt or recline and head, trunk, and extremity support

an inflammatory disease that causes demyelination of axons in peripheral nerves; people can develop after after certain infections; cause is unknown;

Onset and Acute Inflammatory Phase: acute weakness occurs in at least two extremities that advances and reaches its maximum in 2-4 weeks; 20%-30% of people with GBS need mechanical ventilation Plateau Phase: Symptoms are at their most disabling, with little or no change over a few days or weeks Recovery Phase: Remyelination and axonal regeneration occur over a period as long as 2 years; recovery tends to start at the head and neck and travel distally; most people experience significant if not complete return of function, with fatigue as the most commonly reported residual symptom

Rapid progression of symptoms, typically in a symmetrical ascending pattern of flaccid paralysis that beings in the feet or respiratory muscles; pain in LE; fatigue, edema, absence of deep tendon reflexes, mild sensory loss in the hands and legs (glove-and stocking distribution); dysfunction of cranial nerves (including possible facial palsy); bladder dysfunction

during plateau phase: assess communication, control of physical environment, comfort and positioning, anxiety management, over occurs in intensive care because client is receiving extensive medical care during recovery phase: evaluation focuses on mobility, self-care/ADL's, communication, leisure, workplace and community integration, evaluation typically occurs in inpatient rehab, outpatient rehab or home/work settings

develop and train the client in the use of communication tools (such as picture boards); provide environmental modifications to ensure access to call button, remote controls, and phone; adapt the telephone for hands free use; Train caregivers on adjusting supine and sitting positions that optimize function and comfort and reduce risk of skin breakdown; position client for trunk, head and UE stability; educate client and family about anxiety reduction techniques

interventions aim to help the client resume occupations, roles, rituals and routines; design activities and dynamic splints to help maintain ROM (especially for wrist, fingers, and ankle); help with transfers, assistive devices; energy conservation and fatigue management; home assessment; client-centered fine motor program to maximize strength, coordination, and sensation in the hands and fingers

motor difficulties (chorea, akathisia, dystonia); voluntary movement patterns (bradykinesthia, akinesia, incoordination of movement); in later stages hypertonicity replaces chorea; in the middle stages gait and balance problems; during later stages, large bursts of movement when small movements are intended; deteoriation of cognitive and behavioral abilities; forgetfulness; difficulty concentrating; irritability and depression; dysphagia; slowing of saccadic eye movements and ocular pursuits Initial stage: difficulty maintaining work performance Middle stage: disturbances in memory/decision making Later stage: compromised pronunciation d/t dysarthria