Neuro rehab

Part one

Part two

Neuro Assessment

Physiology

Exercise

Neuroplasticity

Key Features

Assessment

Parkinson's Disease

Multiple Sclerosis

Assessment

Key Features

Rarer Neuro Conditions

MND, MSA, PSP/CBS, GBS, HD

Further Reading

Summary

Neuro plasticity Principles

Motor Learning

Principles

Neuroplasticity and Assessment

• An educational process

• Central involvement of the disabled person in programme planning

• Key involvement of family, friends, and colleagues

• A process that requires clear goals to be set and measured

• An interdisciplinary process

• A process based on the concepts of disability (activity) and handicap (participation)

• Approaches that reduce disability

• Approaches designed to acquire new skills and strategies, which will maximize activity

• Approaches that help to alter the environment, both physical and social, so that a given disability carries with it minimal consequent handicap

The Rehabilitation Process

Basic orientation and cognition

Communication/Swallow

Vision

Next

Oculomotor

• Oculomotor ROM
• Cover – uncover / Cross-cover (skew deviation - vertical movements are pathological, horizontal are benign)
• Gaze holding nystagmus (Primary gaze / Gaze evoked elicited @ 30 deg up/down/left/right -Gaze evoked is CNS driven)
• Smooth pursuit
• Vergence
• Saccades
• VOR (Dolls Head)/VOR Cancellation (VOR cancellation mediated by cerebellum)
• Dynamic visual acuity
• Head thrust test (need Snellen chart)
• Head shaking (need frenzel lenses) indicates asymmetry in vestibular circuits; beats to stronger side
• Dix Hallpike (Nystagmus, latency, vertigo, resolution of symptoms)

Sensation

Proprioception

• Cuneocerebellar tract – Upper limbs
• Rostral spinocerebellar / tract –Upper limbs
• Anterior spinocerebellar tract – Lower limbs
• Posterior spinocerebellar tract – Lower limbs

Motor

Hypotonia

Hypotonia

Hypertonia

Tone

An awesome title

Spasticity

Rigidity

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Coordination

DDK

Reflexes

Rehabilitation focuses on empowering the individual to learn to maximise their residual function, with a goal of minimising the impact of the impairment on the day to day activity

• Use dependent plasticity
• Specificity
• Repetition
• Intensity
• Timing

• Sensory and environmental enrichment
• Adaptive plasticity
• Cross-model plasticity
• Cognitive and emotional influence
• Age-Dependent

- Spontaneous movements, generally reduced in PD- Hands gestures while talking, usually reduced or absent - Eyeblink, whose spontaneous rate is reduced - Resting tremor, usually affecting one hand only - Fidgeting and crossing/uncrossing of the legs, that may indicate dyskinesia, a complication of chronic Levodopa therapy

Bradykinesia-Finger tapping-Fist open close-Toe/Heel tapping- Monitor during a periodRigdigty -Passsive movement: Lead pipe/Cogwheel-Wrist/Elbow + contralateral tapping (unmasking)-Ankle/Knee + TappingTremor-Resting: Pill-rolling-Postural: Position against gravity- Shoulder flexion-Kinetic (action): Finger- nose static

Motor adaptation & Skill acquisition

Practice

Transfer of learning

Feedback

Attentional Focus

Individual Differences

Mental Practice

Feedback Timing

Task Specifcity

Cueing

Variability

Retention

Motor Learning stages

Immediate Delayed

Repetition Distribution

Positive TransferNegative Transfer

Variable Random

Knowledge of Results Knowledge of Performance

Retention Interval

VerbalVisual

External Internal

Adaptability

Visualisation

Cognitive Associative Autonomous

Specificity of practice

Power

Tone

Reflexes

Coordination

Vision

Motor

Spasticity

Gait

Emontional and mood

Speech and Swallow

Fatigue

Sensory changes

Balance/Coordination

Bladder and Bowel

Cognitive

Sexual Dysfunction

MS

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Did you know? We retain 42% more information when the content has movement. It may be the most effective resource for capturing your audience’s attention.

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Note: In Genially, we use AI (Awesome interactivity) in all our designs so that you can level up with interactivity and turn your content into something that engages and provides value.

Note: In Genially, we use AI (Awesome interactivity) in all our designs so that you can level up with interactivity and turn your content into something that engages and provides value.

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Note: In Genially, we use AI (Awesome interactivity) in all our designs so that you can level up with interactivity and turn your content into something that engages and provides value.

Did you know? We retain 42% more information when the content has movement. It may be the most effective resource for capturing your audience’s attention.

Note: In Genially, we use AI (Awesome interactivity) in all our designs so that you can level up with interactivity and turn your content into something that engages and provides value.

• Activates tropomyosin-related receptor kinase B - Influences neuronal dendritic spine growth (synaptogenesis) , ultimately increasing post-synaptic drive to the motor neuron and improving nervous system communication.
• Elevates insulin-like growth factor-1 - facilitates exercise-induced growth of blood vessels (angiogenesis) and the formation of new neurons (neurogenesis)
• Promotes vascular endothelial growth factor - linked to the proliferation of neurons and the growth of blood vessels

Brain Derived Neurotrophic Factor

Cerebellar function tests:

• Finger-nose
• Heel-shin
• Dysdiadokinesia
• Arm push-down

Expanded Disability Status Scale (EDSS): This widely used scale assesses disability in MS by evaluating various functions, including mobility, coordination, sensory functions, bowel and bladder function, and visual function.

Features

Autonomic

Cognitive

Tremor

Mood/psychiatric

Bradykinesia

Postural Instability

Rigidty

Gait

Dyskinesia

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TBC

Links/Resources

Involves a complex interplay of coordinated neurotransmitter release, including acetylcholine, nor/adrenaline, dopamine brain-derived neurotrophic Factor (BDNF)Changes in both white and gray matter through neurogenesis, synaptogenesis, angiogenesis, and gliogenesis create stronger and more efficient connections within the relevant neural pathways

CNS's ability to forge, reinforce, and restructure neural connections in response to changes in sensory inputs or motor demands

Fundamental components of exercise that enhance neuroplasticity and promote brain reorganization, including specificity, intensity, repetition, and salience of treatment

Overall concepts not to achieve a cardiovascular or metabolic challenge, but to engage the brain with specific, complex, and coordinated activity that demands a higher degree of cortical involvement

Cognition

Communication

Vision

Proprioception

Sensation

Motor Neuron Disease

Upper and lower motor Neuron

Multiple System Atrophy

Alpha-Synuclionopathy

Progressive Supranuclear Palsy

Tauopathy

Guillian-Bare Syndrome

Acute Demylinating Polyneuropahy

Huntington's Disease

Genetic Disease

Traumatic Brain Injury/Spinal Cord injury