Please enable JavaScript.
Coggle requires JavaScript to display documents.
CVA, TBI, Vestibular, Concussion, Outcome Measures, Neglect, Balance…
CVA
Pusher
-
-
-
-
62 % patients resolve in 6 weeks, 21 % longer than 3 months
-
-
TBI
-
-
JFK Coma Recovery Scale
6 subscales, auditory, visual, motor, oromotor, communication, arousal
-
Auditory Startle is 1, localization is 2
-
Rancho 2: Generalized Response, total assistance
-
-
5 Confused, inapprop, non agit
-
-
Vestibular
Treatment options
-
-
Substitution
working on visual, and somatosensory, and vestibulospinal
-
Oculomotor Exercises
smooth pursuit, saccades, convergence, visual fixation with gait
start 15-30 seconds, 2-3 x per day, increase by 15-30 seconds to max of 2 minutes if asymptomatic.
Vestibulo-Ocular Reflex
-
1:1 ratio, high speed, only reflex at high speed. images would blur without VOR (Oscillopsia)
-
-
-
-
20 min to 24 hours
Menieres, TIA, Perilymph fistula
Dysequilibrium
Cervicogenic Dizziness, Neuropathies, multisensory
24 hours: Vestibular Neuritis, CNS disease
Concussion
Most common Symptoms?
headache, balance/dizziness problems, double/blurred vision
-
Autonomic Issues (HR ^), uncoupling
-
Evaluation
-
ImPACT (Klima Lacrosse)
can't do after exertion within 3 hours, huge limiting factor
-
Examination
-
-
-
VOMS
pursuits, saccades, convergence, VOR, VOR cancellation
-
-
Cervicogenic Dizziness
Neck Torsion Test, Orthopedic Screen
-
Metabolic Issue!
-
Influx of Ca2+ poisons mito in brain, glutamate (toxic at high levels)
-
-
-
-
Management
-
Use Relative Rest, reduce Energy demands
24-48 Hours, limit school, tv, no physical exertion
-
-
Outcome Measures
Berg
-
-
MDC's: 8 older, 6.9 stroke, 5 parkinsons,
Tug
-
MDC: park 2.9, comm dwelling 3, same as DGI
-
5 times sit to stand
-
cutoff: commun dwl, 15, park 16
-
Neglect
Affects spatial perception, spatial representation, and motor action planning
-
Assessments
KF-NAP
-
0 No Neglect, 3 SEVERE (think 0 has a NO in it)
-
-
Balance Management
-
-
-
Strategies
Ankle: Slow, near COG, broad support base
Hip: Fast, COG near perimeter, narrow support base
-
