Neurological Disabilities Assessment and Treatment

by Bennett, Susan E.; Karnes, James L.

• ISBN13: 9780397551514
• ISBN10: 0397551517
• Format: Hardcover
• Copyright: 1998-02-27
• Publisher: LWW

Summary

Never before has this conceptual model of analysis and treatment been presented in one text! This practical text presents a framework for the assessment and treatment of adults with neurological dysfunction. Emphasis is placed on identifying disabilities and their underlying impairments. Readers will learn to understand and assess disabilities and impairments through detailed review of the anatomy of movement, and through discussion of the basic concepts of treatment. Coverage includes the four most common impairments: weakness, balance dysfunction, incoordination, and sensory/perceptual loss. The text's unique problem-solving approach is from the perspective of the physical therapist as movement scientist -- readers develop problem solving skills that can be used to assess any patient.

Table of Contents

CHAPTER 1 Conceptual Models of Disability	1	(12)
Conceptual Models	2	(7)
Nagi Model	2	(2)
The ICIDH Model	4	(2)
Comparison of the Two Models	6	(1)
Application of the ICIDH Model	7	(2)
Analysis and Treatment	9	(1)
Quality of Life	9	(1)
Standardized Measures of Disability	10	(3)
CHAPTER 2 Anatomy of Movement: Why Movement Problems Exist	13	(24)
Functional Neuroanatomy	14	(17)
Movement Pathways	14	(1)
Anatomy Overview	15	(15)
Integration of Sensory Information	30	(1)
Neuroplasticity	31	(1)
Summary of Movement Pathways	31	(1)
Impairments Resulting From Lesions of the Movement Pathways	31	(6)
CHAPTER 3 Analysis of Functional Mobility	37	(32)
Neurophysiologic Theories of Movement and a Model of Neurological Rehabilitation	39	(6)
Reflex Model	39	(1)
Hierarchical Model	40	(2)
Systems Model	42	(3)
Neurological Rehabilitation Model	45	(1)
Task-Oriented Model	45	(1)
Description of Functional Movement	46	(6)
Movement Strategies in Healthy Adults	46	(6)
Disabilities	52	(1)
Neurological Assessment	52	(4)
Assessment Model--Rationale	54	(1)
Schenkman and Butler Model	54	(1)
Contrasting the Traditional Models for Neurological Assessment	55	(1)
Assessment Procedures	56	(9)
Step 1: Observation	58	(1)
Step 2: Testing for Disabilities	59	(2)
Step 3: Testing for the Presence of Impairments	61	(2)
Step 4: Observation After Assessment	63	(1)
Step 5: Community Mobility	64	(1)
Standardized Scales for Functional Assessment	65	(4)
CHAPTER 4 Theoretical Approach to Treatment	69	(16)
Traditional Theorists and Their Approaches	70	(6)
Rood	70	(2)
Karl and Berta Bobath: Neurodevelopmental Treatment (NDT)	72	(2)
Brunnstrom	74	(1)
Kabat, Knott, and Voss--Proprioceptive Neuromuscular Facilitation (PNF)	75	(1)
Summary of Traditional Theorists' Contributions	76	(1)
Contemporary Task-Oriented Model	76	(3)
Carr and Shepherd	77	(1)
Gordon	78	(1)
Horak	79	(1)
Summary of the Task-Oriented Model	79	(1)
Theories of Motor Control and Motor Learning	79	(3)
Integrated Treatment in the Task-Oriented Model	82	(3)
CHAPTER 5 Weakness	85	(46)
Impairment: Muscle Weakness	86	(3)
Strength	86	(1)
Muscle Weakness	87	(1)
Abnormal Tone	87	(2)
Anatomy Overview	89	(3)
Lesions	90	(2)
Assessing Disabilities Resulting From Muscle Weakness	92	(9)
Rolling	92	(1)
Supine-to-Sitting Maneuver	92	(1)
Stable Sitting Posture	93	(1)
Sit-to-Stand Maneuver	93	(1)
Stable Standing Posture	94	(1)
Transfers	95	(1)
Ambulation	96	(3)
Case Study	99	(2)
Assessing the Impairment: Muscle Weakness	101	(4)
Active Range of Motion	101	(1)
Manual Muscle Test	101	(1)
Hand-Held Dynamometer	102	(1)
Isokinetic Dynamometer	103	(1)
Electromyography	104	(1)
Assessing Strength in Patients With Synergy	105	(1)
Percent of Isolated Active Range of Motion	105	(1)
Brunnstrom's Stages of Motor Recovery	105	(1)
Assessing Strength in Patients With Spasticity	106	(1)
Case Study	106	(1)
Treatment of Muscle Weakness	107	(1)
Strengthening Patients With Flaccidity	108	(6)
Task-Oriented Treatment	108	(1)
Selected Techniques of Facilitation to Enhance Functional Postures or Movement	109	(3)
Other Treatment for Flaccidity	112	(1)
Progression of Treatment for Patients With Flaccidity	112	(2)
Strengthening Patients With Weakness	114	(11)
Task-Oriented Activities	115	(3)
Other Treatments for Strengthening	118	(4)
Case Study	122	(3)
Increasing Range of Motion	125	(6)
CHAPTER 6 Sensory and Perceptual Dysfunction	131	(26)
Impairment: Sensory and Perceptual Dysfunction	132	(1)
Anatomy Overview	132	(3)
Lemniscal System	132	(1)
Spinothalamic System	133	(1)
Dorsal Spinocerebellar Tract	133	(1)
Ventral Cerebellar Tract	133	(1)
Lesions	134	(1)
Assessing the Disability	135	(4)
Rolling	136	(1)
Supine-to-Sit Maneuver	136	(1)
Static Sit and Static Stand	137	(1)
Sit-to-Stand Maneuver	137	(1)
Transfers	137	(1)
Ambulation	138	(1)
Climbing Stairs	138	(1)
Case Study	138	(1)
Assessing the Impairment	139	(10)
Sensation	140	(1)
Perception	141	(7)
Case Study	148	(1)
Treatment of Deficits	149	(8)
Sensory	150	(1)
Perceptual	151	(2)
Case Study	153	(4)
CHAPTER 7 Incoordination	157	(24)
Impairment: Coordination	158	(1)
Motor Control	158	(1)
Timing and Accuracy	159	(1)
Anatomy Overview	159	(3)
Lesions	160	(2)
Assessing the Disability	162	(4)
Rolling	163	(1)
Supine-to-Sit Maneuver	163	(1)
Stable Sitting Posture	163	(1)
Sit-to-Stand Maneuver	163	(1)
Stable Standing Posture	163	(1)
Transfers	163	(1)
Ambulation	164	(1)
Climbing Stairs	164	(1)
Case Study	164	(2)
Assessing the Impairment: Incoordination	166	(6)
Clinical Tests to Assess Coordination	166	(2)
Standardized Tests to Measure Coordination	168	(2)
Tests of Higher Functional Coordination	170	(1)
Case Study	170	(2)
Treatment of Incoordination	172	(9)
Functional Activities	172	(2)
Coordination Exercise	174	(3)
Case Study	177	(4)
CHAPTER 8 Balance Dysfunction	181	(40)
Impairment: Balance Dysfunction	182	(3)
Motor Response to Balance Perturbation	183	(1)
Sensory System	184	(1)
Anatomy Overview	185	(1)
Assessing the Disability	186	(5)
Rolling	187	(1)
Supine-to-Sitting Maneuver	187	(1)
Stable Sitting Posture	187	(1)
Sit-to-Stand Maneuver	187	(1)
Stable Standing Posture	188	(1)
Transfers	188	(1)
Ambulation	188	(1)
Climbing Stairs	189	(1)
Case Study	189	(2)
Assessing the Impairment: Balance Dysfunction	191	(5)
Determining the Origin of the Impairment	191	(3)
Case Study	194	(2)
General Balance Tests	196	(8)
Romberg Test (Static)	196	(1)
Clinical Test for Sensory Interaction in Balance (Static)	197	(1)
Fregly and Graybiel Quantitative Ataxia Test Battery (Static and Dynamic)	197	(3)
Berg Balance Scale (Static and Dynamic)	200	(1)
"Get Up and Go" Test (Static and Dynamic)	201	(1)
Timed "Up and Go" Test (Dynamic)	201	(1)
Clinical Balance Assessment (Static)	201	(1)
Functional Reach (Dynamic)	202	(1)
Tinnetti Tests (Static and Dynamic)	202	(1)
Fukuda Stepping Test (Dynamic)	203	(1)
Postural Stress Test	204	(1)
Laboratory Results	204	(1)
Platform Perturbation Test	204	(1)
Caloric Tests	205	(1)
Rotational Tests	205	(1)
Treatment of Balance Dysfunction	205	(16)
Weakness	206	(1)
Vestibular Dysfunction	206	(2)
Somatosensory Loss	208	(1)
General Balance Program	209	(6)
General Strengthening/Aerobic Exercise	215	(1)
Case Study	216	(5)
APPENDIX A Standardized Measures of Disability	221	(10)
APPENDIX B Validity and Reliability of Standardized Instruments	231	(4)
Glossary	235	(10)
Index	245