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دانلود کتاب Umphred's neurological rehabilitation (without Index)
دانلود کتاب توانبخشی عصبی Umphred (بدون شاخص)
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Umphred's neurological rehabilitation (without Index)
ویرایش: [7 ed.] نویسندگان: Myla Quiben (editor), Sandra Reina-Guerra (editor), Rolando T. Lazaro (editor), Darcy Ann Umphred سری: ISBN (شابک) : 9780323641944, 0323641962 ناشر: Elsevier سال نشر: 2020 تعداد صفحات: [1362] زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 157 Mb
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Front Matter Front Matter Umphred’s Neurological Rehabilitation Copyright Copyright Dedication Dedication Contributors Contributors Foreword Foreword Preface Preface Overview of the seventh edition Contents Contents Section I Foundations for clinical practice in neurological rehabilitation Section II Physical rehabilitation management of individuals with neurological system pathologies Section III Neurological disorders and application issues 1. Foundations of clinical practice 1 Foundations of clinical practice Keywords: Objectives Key terms What are the foundations of clinical practice in neurological rehabilitation? Complexity of the nervous system as a control center Professional roles in neurological rehabilitation Identity, efficacy, and advocacy The present and our future: The movement system and the physical therapist’s identity Movement system diagnosis: What is this? Models and constructs for the different elements of the patient care management cycle Therapeutic models of neurological rehabilitation: What are “models” of intervention? How are they useful? Conceptual frameworks for patient/client care management: Who needs to use a framework? Patient-client management: Examination Medical screening by the therapist Examination with a movement system framework Patient-client management: Evaluation and diagnosis Differential diagnosis within a therapist’s scope of practice Patient/client management: Prognosis How long will it take to get from point a to point B? Patient/client management: Interventions Patient/client management: Outcomes Patient and provider relationship is a determinant of outcomes Learning environment Patient’s/client’s internal environment Patient’s/client’s external environment Clinician’s internal environment Clinician’s external environment Conclusion References 2. Movement analysis across the life-span 2 Movement analysis across the life-span Keywords: Objectives Key terms Theories of development General systems theory Biological and chronological age Aging Theories of aging Physiological changes in body systems across the life-span Musculoskeletal system Cardiovascular and pulmonary systems Neurological system Cognitive system Memory Emotional system Language Perceptual system Motor development Prenatal (0 to 40 weeks’ gestation) development Infancy (birth to 12 months) Early childhood (1 to 5 years) Childhood (5 to 10 years) Adolescence (11 to 19 years) Adulthood (20 to 39 years) Middle adulthood (40 to 59 years) Older adulthood (60+ years) Strategies for fostering acquisition and retention of motor behaviors across the life-span Development of head control as an example of movement development across the life-span and its impact on quality of life Flexor control Extensor control Assessment of head control Application of the development of head control to rehabilitation Analysis between normal and impaired motor function Clinical example Head control development summary Summary References 3. Contemporary issues and theories of motor control, motor learning, and neuroplasticity 3 Contemporary issues and theories of motor control, motor learning, and neuroplasticity Key words: Objectives Key terms Motor control Theories and models of motor control Motor programs and central pattern generators The person, the task, and the environment: An ecological model for motor control Body structures and functions that contribute to the control of human posture and movement Role of sensory information in motor control Choice of motor pattern and the control of voluntary movement Coordination Execution of movement plans Adaptation Anticipatory control Flexibility Role of the cerebellum Role of the basal ganglia Information processing Movement patterns arising from self-organizing subsystems Controlling the degrees of freedom Finite number of movement strategies Variability of movements implies normalcy Errors in motor control Motor control section summary Motor learning An illustration of motor learning principles Stages of motor learning Variables that affect motor learning Variables related to the individual Variables related to the environment Principles of neuroplasticity: Implications for neurorehabilitation Rehabilitation, research, and practice Integration of sensory information in motor control Foundation for the study of neuroplasticity Principles of neural adaptation Neuroplasticity and learning How are learning sequences controlled? What constrains learning progressions? What facilitates the development of permanent “automatic” motor behaviors? Integration and implementation into clinical practice References 4. The limbic network Influence over motor control, memory, and learning 4 The limbic network: Influence over motor control, memory, and learning Keywords: Objectives Key terms Introduction The limbic network The limbic network “MOVEs” us Motivation Memory Olfaction Visceral or autonomic Emotional The neuroscience of the limbic network Neuroanatomy Basic structure and function Interlinking the components of the system Neurochemistry Neuropeptides Monoamines Neurobiology of learning and behavior Limbic influence on memory and motor learning Limbic influence on emotions and behaviors: The F2ARV and general adaptation syndrome continua Fear and frustration, anger, rage, and violence or withdrawal continuum. General adaptation syndrome. Limbic influence on motor performance and function Clinical implications of the limbic state Examination and evaluation Interventions Therapeutic alliance: Clinician and patient Trust. Responsibility. Flexibility and openness. Vulnerability. Therapeutic environment Facilitating the internal environment. Nutrition and hydration. Sleep and biorhythms. Medication compliance and effectiveness. Achieving an optimal external environment. Linking motivation and reward. Therapeutic activities Emerging interventions Common disorders with limbic network problems Grief, depression, and anxiety Fear Anxiety and posttraumatic stress disorder Anger Substance abuse and dependence Disorders of cognition and memory Head injury Traumatic injury Nontraumatic head injuries Vestibular disorders Parkinson disease Cerebrovascular accidents Tumor Ventricular swelling Chronic pain Summary of clinical problems affected by limbic involvement The “mind, body, spirit” paradigm: Insights on the limbic system from a master clinician By darcy umphred References 5. Psychosocial aspects of adaptation and adjustment during various phases of neurological disability 5 Psychosocial aspects of adaptation and adjustment during various phases of neurological disability Keywords: Objectives Key terms Psychological adjustment We understand more about suffering than we think Awareness of psychological adjustment in the clinic, society, and culture Growth and adaptation A new normal Societal and cultural influences Attachment and evolving sense of self: Foundations of adjustment The evolving sense of self: Growth over the life-span Undoing aloneness: The need for community, friendship, belonging. Building resilience: Felt sense as an underpinning for positive strengths and neural integration Establishment of self-worth and healthy body image Sense of control Hope, grief, and spiritual aspects to adjustment for the patient and therapist Practice: Developing attitudes of willingness to hold it all in awareness Adjustment using the stage concept Shock Expectancy for recovery Mourning Defense Adjustment Body image Support system Loss and the family Family needs Parental bonding and the disabled child The child dealing with loss The adolescent dealing with loss Family maturation Coping with transition Treatment variables in relation to therapy Role of the therapeutic environment Conceptualization of assessment and treatment Assessment Specific therapeutic interventions Problem-solving process Support systems The adult patient with brain damage Conclusion Acknowledgment References 6. Differential diagnosis of the patient with a neurological condition 6 Differential diagnosis of the patient with a neurological condition Keywords: Objectives Key terms Introduction Differential diagnosis: Medical screening Identifying patients’ health risk factors and previous conditions Symptomatic investigation of functional restriction Symptom pattern History of symptoms Review of systems Musculoskeletal system Integumentary system Nervous system Depression. Suicide. Physical examination Examination summary Response to treatment Conclusion Acknowledgment References 7. Examination and evaluation of functional movement activities, body functions and structures, and participation 7 Examination and evaluation of functional movement activities, body functions and structures, and participation Keywords: Objectives Key terms Introduction History and systems review Tests and measures Tests of activity and functional performance Tests of body functions and structures Tests for participation and self-efficacy Choosing the appropriate examination tool Examination process in practice Acknowledgments References APPENDIX 7.A Summary of Recommendations From the Evaluation Database to Guide Effectiveness (EDGE) APPENDIX 7.B Core Set of Outcome Measures for Adults With Neurological Conditions Undergoing Rehabilitation: A Clinical Pr ... APPENDIX 7.C Relevant Outcome Measures to use for Selected Impairment, Activity Limitations, or Participation/Quality of L ... APPENDIX 7.D Selected Pediatric Assessment Tools by International Classification of Functioning, Disability and Health Cat ... 8. Interventions for individuals with movement limitations 8 Interventions for individuals with movement limitations Keywords: Objectives Key terms History of development of interventions for neurological disabilities Intervention strategies Functional training Effect of functional training on task performance and participation Selection of functional training strategies Intervention for impairments Augmented therapeutic intervention Proprioceptive system integration of stretch, joint, and tendon receptors Muscle stretch receptors Stretch. Resistance and strengthening. Tapping. Positioning (range). Stretch pressure. Stretch release. Manual pressure. Vibration. The tendon. Maintained stretch to the tendon organ. Inhibitory pressure. Joint receptor approximation. Traction and distraction. Combined proprioceptive input techniques. Ballistic movement. Total-body positioning. Proprioceptive neuromuscular facilitation. Postexcitatory inhibition with stretch, range, rotation, and shaking. Rood’s heavy work patterns. Feldenkrais. Exteroceptive or cutaneous sensory system Differentiation of receptor site as augmented intervention. Treatment alternatives using the exteroceptive system. Quick phasic withdrawal. Short duration, high-intensity icing. Prolonged use of ice. Maintained stimulus or pressure. Light discriminatory touch. Vestibular system Vestibular treatment techniques. General body responses leading to relaxation. Techniques to heighten postural extensors. Facilitatory techniques influencing whole-body responses. Autonomic nervous system Treatment alternatives using the autonomic nervous system Slow stroking. Slow, smooth, passive movement within pain-free range. Maintained pressure. Progressive muscle relaxation. Combined multisensory approaches. Sweep tapping. Taping. Oral-motor interventions. Head and body movements in space. Gentle shaking. Innate central nervous system programming Holistic treatment techniques based on multisensory input Additional augmented interventions: Current focus Body weight–supported treadmill training. Constraint-induced movement therapy. Robotics, gaming, and virtual reality (see chapter 38). Summary of augmented intervention strategies. Conclusion Acknowledgment References 9. Medical and developmental challenges of infants in neonatal intensive care - Management and follow-up considerations 9 Medical and developmental challenges of infants in neonatal intensive care: Management and follow-up considerations Keywords: Objectives Key terms Theoretical framework Dynamic systems Neuronal group selection theory Hope-empowerment model Neonatal complications associated with adverse outcomes Preterm birth Intraventricular hemorrhage Posthemorrhagic ventricular dilatation Periventricular leukomalacia Cerebellar injury Bronchopulmonary dysplasia Sepsis Necrotizing enterocolitis Hypoxic-ischemic encephalopathy in term and near term neonates Maternal medication Opioids Cocaine Cannabis Selective serotonin reuptake inhibitors Clinical management: Neonatal period Educational requirements for therapists Neonatal pain and neurological assessment Pain assessment Neonatal behavioral assessment scale Newborn behavioral observations system Neurological assessment of the preterm and full-term newborn infant Assessment of preterm infant behavior Neonatal individualized developmental care and assessment program Nicu network neurobehavioral scale Test of infant motor performance Neurobehavioral assessment of the preterm infant General movement assessment Testing variables Summary Intervention planning Level of stimulation Timing Physiological and musculoskeletal risk management High-risk profiles Irritable, hypertonic infant. Lethargic, hypotonic infant. Disorganized infant with fluctuating tone and movement. Neonatal brachial plexus injury (NNBPI). Individualized early handling and NNBPI positioning while hospitalized. NNBPI discharge planning and parent teaching. NNBPI ongoing follow-up. Intervention strategies Positioning Extremity taping Therapeutic handling Neonatal hydrotherapy Oral-motor and feeding therapy Parental support Grief process Parent/caregiver teaching Clinical management: Outpatient follow-up period Purpose of outpatient follow-up for the at-risk infant Medical management Family support Follow-up clinic examination and evaluation processes Months 2 to 4 Months 6 to 8 Months 10 to 14 Months 18 to 24 Age correction Neuromotor assessment tools for at-risk infants Bayley scales of infant development Alberta infant motor scale Hammersmith infant neurological examination Movement assessment of children High-risk clinical signs Neonatal period Infancy Challenges to prediction of neurodevelopmental outcome Impact of medical status on test performance Variations in posture and movement caused by residual influences from time in the neonatal intensive care unit. Prolonged motor delay from chronic medical conditions. Differences between preterm and term infant neuromotor function Neuromotor intervention Levels of intervention Assessment as intervention Education Reinforcement for parenting skills Instruction in home management Activities to counteract shoulder retraction Reaching Head centering and symmetrical orientation Prone positioning Head balance Limited use of infant jumper or baby walker Summary Acknowledgment References 10. Management of clinical problems of children with cerebral palsy 10 Management of clinical problems of children with cerebral palsy Keywords: Objectives Key terms Overview Perspective Diagnostic categorization of the characteristics of cerebral palsy Evaluative analysis of the individual child Initial observations and assessment Reactions to placement in a position Visual-motor assessment Posture and movement compensations Other assessment considerations Nutritional aspects of neuromotor function Consideration of supplemental oxygen Roles of the therapist Role of the therapist in direct intervention Case management and direct intervention Special needs of infants Orientation to treatment strategies Research Medical influences on treatment Equipment Alternative therapies Developing a personal philosophy of treatment Involving the family Role of the therapist in indirect intervention Therapy in the community Psychosocial factors in cerebral palsy Documentation Case studies References Dedication 11. Genetic disorders - A pediatric perspective 11 Genetic disorders: A pediatric perspective Keywords: Objectives Key terms Genomic considerations for pediatric therapists An overview: Clinical diagnosis and types of genetic disorders with representative clinical examples Multifactorial inheritance disorders Chromosomal disorders Autosomal trisomies Trisomy 21 (down syndrome). Trisomy 18. Trisomy 13. Sex chromosome aneuploidy Turner syndrome. Klinefelter syndrome. Partial deletion disorders Cri-du-chat syndrome. Prader-willi syndrome and angelman syndrome. Translocation disorders Acute lymphoblastic leukemia. Monogenetic disorders Autosomal dominant disorders Osteogenesis imperfecta. Tuberous sclerosis complex. Neurofibromatosis. Autosomal recessive disorders Cystic fibrosis. Hurler syndrome (mucopolysaccharidosis I, severe type). Phenylketonuria. Spinal muscle atrophy. Sex-linked disorders Hemophilia. Fragile X syndrome. Lesch-nyhan syndrome. Rett syndrome. Mitochondrial deoxyribonucleic acid disorders Leigh syndrome Multifactorial disorders Body structure and function problems common to many pediatric genetic disorders Hypertonicity Hypotonicity Hyperextensible joints Contractures and musculoskeletal deformities Respiratory problems Developmental delay Behavioral phenotypes in genetic syndromes Medical management and genetic counseling Medical management Surgical intervention Pharmaceutics The age of precision medicine Genetic counseling Process of genetic counseling Early detection of genetic conditions Newborn screening Genetic testing in infants and children Prenatal testing Invasive procedures. Noninvasive procedures. Assisted reproductive technology and preimplantation genetic diagnosis Ethical, social, and legal issues in genetics Integrating genetics information for practical use in pediatric clinical settings Basic knowledge and skills competence for physical and occupational therapists Service delivery for children with genetic disorders and their families Family-centered service Assessment strategies Discriminative assessment Predictive assessments Evaluative assessments Family-driven goals and objectives Therapy goal orientation Individualized service plans Functional objectives General intervention principles Focus on activities and participation Delivery of services in natural environments Incorporating therapy activities into daily routines Use of assistive technology devices Summary References APPENDIX Vocabulary 12. Learning disabilities and developmental coordination disorder 12 Learning disabilities and developmental coordination disorder Objectives Key terms Keywords: An overview of learning disabilities Clinical presentation Definition Classifications Incidence and prevalence Perspectives on the causes of learning disabilities Subgroups Verbal learning impairments Dyslexia (developmental reading disorder). Dyscalculia (mathematics disorder). Dysgraphia (disorder of written expression). Nonverbal learning disability Motor coordination deficits Social and emotional challenges Assessment and intervention Specialists School-based service delivery models Learning disabilities and motor deficits or developmental coordination disorder Definition Clinical presentation Prevalence Perspectives on the causes of developmental coordination disorder Subtypes of developmental coordination disorder Diagnosis Neurophysiology Assessment of motor impairments Postural control and gross motor performance Coordination deficits Visuospatial deficits Fine motor and visual motor performance Fine motor skills. Eye-hand coordination, visual motor integration. Sensory processing Praxis and motor planning Physical fitness Intervention for the child with learning disabilities and motor deficits or developmental coordination disorder Creating an intervention plan Models of intervention Intervention approaches Motor learning theories Research on the co-op model of motor learning. Sensorimotor intervention Research on sensorimotor intervention. Motor skill training Physical fitness training Learning disabilities and developmental coordination disorder across the life-span Summary APPENDIX 12.A A Summary of Standardized Motor Tests Bruininks-oseretsky test of motor proficiency, second edition (2005)124 Authors Source Ages Administration Equipment Description Construction and reliability Comment Movement assessment battery for children, second edition (2007)112 Authors Source Ages Administration Equipment Description Construction and reliability Comment Peabody developmental motor scales, second edition (2000)125 Authors Source Ages Administration Description Subtests Composites Construction and reliability Comment Clinical observations of motor and postural skills, second edition (2000)134 Authors Source Ages Administration Equipment Description Construction and reliability Comment School function assessment (1998)199 Authors Source Ages Administration Equipment Description Construction and reliability Comment Beery-buktenica developmental test of visual-motor integration, six revision (2010)200 Authors Source Ages Administration Equipment Description Construction and reliability Comment Motor-free visual perception test, fourth edition Authors Source Ages Administration Equipment Description Construction and reliability Visual perceptual abilities assessed Comment Evaluation tool of children’s handwriting (1995)127 Author Source Ages Administration Equipment Description Construction and reliability Comment Minnesota handwriting assessment (MHA) Author Source Ages Administration Equipment Description Construction and reliability Comment The print tool128 Authors Source Ages Administration Equipment Description Construction and reliability References 13. Spina bifida - A neural tube defect 13 Spina bifida: A neural tube defect Keywords: Objectives Key terms Introduction Overview and pathogenesis Overview of neural tube formation Neural tube defects Types of spina bifida Incidence, etiology, prevention, and economic impact Incidence Etiology Prevention Economic impact Clinical manifestations Weakness and paralysis Muscle tone abnormalities Sensory impairment Hydrocephalus Chiari malformation Association pathways Hydromyelia Tethered cord Orthopedic deformities Osteoporosis Bowel and bladder dysfunction Cognitive impairment and learning issues Integumentary impairment Latex allergy Pressure ulcers Growth nutrition and obesity Dysphagia and swallowing Anthropometrics Psychosocial and emotional issues Medical management Prenatal testing and diagnosis Prenatal care Neurosurgical management Urological management Orthopedic management Hip dislocation Knee valgus stress Rotational deformities Scoliosis Back pain Foot deformity Osteoporosis, osteopenia, and fracture Postoperative management Evaluation Assessing muscle strength Muscle tone assessment Sensory testing Range of motion assessment Reflex testing Development and functional assessment Gait analysis Perceptual and cognitive evaluations Physical therapy management Before closure of myelomeningocele After surgery, during hospitalization, and transitioning to home Newborn through early infancy Range of motion exercises Handling and positioning Sensorimotor training Facilitation of normal development Infant to toddler (preambulatory) Toddler through preschool (ambulatory phase) Primary school through adolescence Transitions to adolescence Transition to adulthood Sexuality and reproductive issues Psychosocial adjustment to spina bifida References 14. Traumatic spinal cord injury 14 Traumatic spinal cord injury Keywords: Objectives Key terms Spinal cord lesions Tetraplegia Paraplegia Complete, discomplete, and incomplete lesions Demographics Sequelae of traumatic spinal cord injury Clinical syndromes Central cord syndrome Brown–séquard syndrome Anterior cord syndrome Posterior cord syndrome Cauda equina syndrome Conus medullaris syndrome Dual diagnosis: Co-occurring brain and spinal cord injury Medical management Immobilization/transportation Surgical stabilization Cervical spine Thoracolumbar spine Clinical trials and ongoing research Therapeutic rehabilitation continuum of care Inpatient (acute care and rehabilitation) Postacute rehabilitation Examination and evaluation of body function and structure History Systems review Tests and measures Neurological examination American spinal cord injury association examination Functional examination for activity Goal setting for activity and participation skills Early rehabilitation and complication prevention Preventing and managing pressure injury and skin compromise Prevention and management of joint contractures Adaptive shortening or adaptive lengthening of muscles Splinting to prevent joint deformity Treatment for joint deformity Prevention and management of respiratory complications Inspiratory muscle training Diaphragm and phrenic nerve pacing Glossopharyngeal breathing Secretion clearance Urinary tract infection Early mobilization Rehabilitation: Achieving functional outcomes Activities of daily living and instrumental activities of daily living Feeding Grooming Bathing Dressing Bladder management Bowel management Sexual health Home management Parenting Assistive technology Additive manufacturing Mobility Bed mobility and coming to sit Pressure relief in the upright position Wheelchair transfers Wheelchair mobility skills Equipment Seating principles Return to walking Locomotor and gait training Orthotics: Traditional and powered Exoskeletons for rehabilitation Exoskeletons for personal use Recovery and restoration Principles of neuroplasticity Upper-extremity restoration Health promotion and wellness Physical activity and exercise interventions Education Psychosocial issues Discharge planning Architectural modifications Community reintegration Conclusion References 15. Neuromuscular diseases 15 Neuromuscular diseases Keywords: Objectives Key terms Amyotrophic lateral sclerosis Etiology, incidence, and medical diagnosis Clinical presentation Medical prognosis Medical management Muscle spasms and pain Dysphagia Dysarthria Respiratory management Therapeutic management of movement dysfunction associated with amyotrophic lateral sclerosis Assessment Primary deficits. Initial examination. Goals of therapeutic intervention Therapeutic considerations Disuse atrophy. Exercise intolerance or overwork damage. Evidence of the benefits of exercise. Therapeutic interventions Independent: Phase I, stages 1 to 3. Partially independent: Phase II, stages 4 and 5. Dependent: Phase III, stage 6. Psychosocial issues in amyotrophic lateral sclerosis From the clinicians’ perspective Patients’ attitudes and fears Depression. Family members as caregivers in amyotrophic lateral sclerosis Guillain-barré syndrome Pathology, incidence, and medical diagnosis Clinical presentation Onset Respiration Guillain-barré syndrome disability scale Weakness Fatigue Other signs and symptoms Secondary complications and residual deficits. Medical prognosis Medical management Life support Psychological support Immunotherapy Pharmacotherapy for pain Other supportive management Therapeutic management of movement dysfunction associated with guillain-barré syndrome Examination Intervention goals Therapeutic interventions Respiratory dysfunction, communication difficulties, dysphagia. Pain. Contractures, decubitus ulcers, and injury to weakened or denervated muscles Positioning. Range of motion. Injury prevention. Optimizing strength and endurance while monitoring for overuse and fatigue Exercise from onset through the plateau. Beginning of recovery. Activity progression during active recovery. Documenting relapses. Addressing residual deficits in later stages of recovery. Adaptive equipment and orthoses Psychosocial roles and quality of life Psychosocial issue. Psychosocial issues, continued. Summary of therapeutic management in guillain-barré syndrome Chapter summary Acknowledgments References 16. Beyond the central nervous system - Neurovascular entrapment syndromes 16 Beyond the central nervous system: Neurovascular entrapment syndromes Keywords: Overview Peripheral neuroanatomy Mobility of the peripheral nervous system Peripheral nerve entrapment Pathogenesis of neurovascular entrapment Adaptive responses to pain Clinical examination and treatment of neurovascular entrapment Objective examination Symptom patterns characteristic of neurovascular entrapment Common signs of neurovascular entrapment Neurovascular entrapment interventions Core components of treatment Acknowledgments References 17. Multiple sclerosis 17 Multiple sclerosis Keywords: Objectives Key terms Overview of multiple sclerosis Incidence and prevalence Subtypes of multiple sclerosis Pathology Brief description of the common clinical manifestations Medical management Diagnosis Quantifying disease severity Medical management of disease Disease-modifying therapeutics Management of acute relapses (antiinflammatory medications) Prognosis Multidisciplinary management of clinical manifestations Overview Assessment Special dysfunctions associated with multiple sclerosis Assessing impairments and activity Spasticity. Ataxia and incoordination. Vestibular dysfunction. Fatigue. Cognition. Balance. Gait. Upper-extremity tests of function. Assessing quality of life and participation. Interventions Benefits of exercise in multiple sclerosis Multidisciplinary management of multiple sclerosis symptoms Fatigue. Spasticity. Pain. Balance and postural control. Mobility. Tremor. Bowel and bladder management. Cognitive impairments. Dysarthria and dysphagia. Special considerations. Summary Resources References 18. Disorders of the basal nuclei 18 Disorders of the basal nuclei Abstract: Objectives Key terms The basal nuclei Anatomy Afferent pathways Efferent pathways Pathways to the motor system Physiology Relationship of the basal nuclei to movement and posture Automatic movement Motor problems in animals Movement initiation and preparation Postural adjustments Perceptual and cognitive functions Neurotransmitters Specific clinical problems arising from basal nuclei dysfunction Parkinson disease Symptoms Bradykinesia, akinesia, and complex motor planning. Rigidity. Tremor. Postural instability. Gait. Perception, attention, and cognitive deficits. Nonmotor symptoms. Stages of Parkinson disease Pharmacological considerations and medical management Examination of the patient with Parkinson disease General prognosis, treatment principles, and rationale Therapeutic programs and approaches. Strengthening. Use of cues for improving gait. Balance. Dual task performance. Activities of daily living. Differences between Parkinson disease and atypical Parkinsonisms: Theoretical and practical considerations Huntington disease Symptoms Stages of Huntington disease Pharmacological considerations and medical management Examination of the patient with huntington disease General treatment goals and rationale Treatment procedures Wilson disease Symptoms Stages of the disease Medical management Examination and treatment intervention Tardive Dyskinesia Symptoms Etiology Pharmacological and medical management Evaluation and treatment interventions for Dyskinesia Other considerations Dystonia General information Generalized Dystonia Symptoms. Etiology. Pharmacological and medical management. Evaluation and treatment intervention. Other considerations. Focal dystonias Symptoms. Etiology. Pharmacological and medical management. Evaluation and treatment. Other considerations. Metabolic diseases affecting other regions of the brain Summary Websites Acknowledgment References 19. Cerebellar dysfunction 19 Cerebellar dysfunction Keywords: Objectives Key terms Overview Types of cerebellar damage Cerebellar anatomy and physiology Anatomical divisions Functional divisions and their afferent and efferent projections Physiology of cerebellar neuronal circuits Cerebellar function in adapting and controlling movement Theories of cerebellar function Clinical manifestations of cerebellar lesions Dysmetria Dyssynergia Dysdiadochokinesia Decomposition Lack of check Cerebellar tremor Hypotonia Imbalance Gait ataxia Oculomotor deficits Speech impairments Impaired motor learning Nonmotor impairments Clinical signs by functional division Medical management of cerebellar damage Physical therapy management of cerebellar movement dysfunction Physical therapy examination Tests of impairments of body functions or structures Tests of activity limitations Standardized clinical scales Diagnosis, prognosis, and plan of care Physical therapy interventions for patients with cerebellar dysfunction Gait and balance interventions Aerobic exercise and resistance training Consider more intensive, longer duration interventions Compensatory strategies The controversy of weighting Summary Acknowledgments References APPENDIX 19.A International Cooperative Ataxia Rating Scale I. Posture and gait disturbances II. Kinetic functions III. Speech disorders IV. Oculomotor disorders APPENDIX 19.B Scale for Assessment and Rating of Ataxia 20. Balance dysfunction 20 Balance dysfunction Keywords: Objectives Key terms Balance Definitions of balance Environmental context Human control of balance The systems approach Peripheral sensory reception Central sensory perception Central motor planning and control Peripheral motor execution Influence of other systems Constant cyclic nature Motor components of balance Reflexes Automatic postural responses Anticipatory postural adjustments Volitional postural movements Clinical assessment of balance Objectives of testing Types of balance tests Quiet standing Active standing Sensory manipulation Vestibular system tests Active transitions and stepping Functional scales Combination test batteries Dual-task tests Balance confidence tests Tests recommended by expert consensus or systematic review for specific populations Considerations in the selection of balance tests Problem identification, goal setting, and treatment planning Clinical decision making Using the systems model to identify postural control impairments Writing goals on the basis of body structure and function impairments, balance skill deficits, and activity limitations Developing an intervention plan Balance retraining techniques Motor learning concepts Individual Task Environment Intervention Sensory systems Multisensory and motor control dysfunction Control of the center of gravity Sitting balance. Standing balance. Balance during gait. Sitting to standing and transfer balance. Standing balance. Strategy training. Gait training. Other considerations Treatment tools Safety education and environmental modifications Home programs Concurrent tasks Fall prevention Conclusion Acknowledgment References 21. Vestibular dysfunction 21 Vestibular dysfunction Keywords: Objectives Key terms Overview: The role of the vestibular system Top down postural control Bottom up reference for postural control Visual reference for postural control Gait dysfunction Recovery of function: Adaptation versus substitution Importance of taking the history Determining the adaptation status through examination that guides intervention Sensation of motion at rest Gaze stability Head impulse testing paradigm Suppression head impulse testing paradigm Rotary chair testing Dynamic visual acuity Vestibulo-ocular reflex cancelation (VOR cancel) Head motion dizziness Sensory substitution for postural control Visual dependency Somatosensory dependency Head-righting responses Central maladaptation Head position dizziness Vertical canals Horizontal canals Feedback Acknowledgment APPENDIX 21.A Common Vestibular Disorders Benign paroxysmal positional vertigo Infection Endolymphatic hydrops Perilymph fistula Superior semicircular canal dehiscence syndrome Vestibular migraine Vascular disorders Neoplasia Ototoxicity Traumatic brain injury and concussion Metabolic disorders Autoimmune ear disease Autonomic nervous system dysregulation Mal de Debarquement (disembarkment syndrome) Persistent postural-perceptual dizziness References 22. Traumatic brain injury 22 Traumatic brain injury Objectives Key terms Section i—overview of traumatic brain injury Epidemiology of traumatic brain injury Mechanisms of injury Pathophysiology of injury Primary damage Secondary damage or insult Clinical features of traumatic brain injury Disorders of consciousness Autonomic nervous system changes Motor, sensory, perceptual, and functional changes Cognitive, personality, and behavioral changes Other complications Types and classifications of traumatic brain injury Section ii—medical management of traumatic brain injury Initial care and acute management Common neurosurgical interventions Common pharmacological interventions Medications that decrease intracranial pressure Medications that control blood pressure and cerebral perfusion pressure Medications that decrease intracranial bleeding Medications to control seizure Medications for prevention of brain cell death Medications for prevention of infections Medications that affect behavioral and cognitive functions (also see chapter 36) Medications that affect motor functions (see chapter 36) Regenerative medicine and management of traumatic brain injury Section iii—rehabilitation management of traumatic brain injury Terminology and structure for patient management Examination Evaluation Diagnosis Prognosis and outcomes Examination for people with traumatic brain injury Task analysis of activity limitations Assessing underlying impairments Impaired consciousness and cognition. Autonomic dysfunctions. Impaired strength or force production. Impaired muscle length and joint range of motion. Abnormal muscle tone and reflexes. Impaired coordination. Impaired sensory function. Impaired vision and visual perception. Deficits in the vestibular system. Impaired cardiovascular endurance (deconditioning). Impaired communication. Emotional and behavioral problems. Assessing activity limitations Basic functional mobility. Sitting balance. Standing balance. Gait and dual-task gait ability. Upper extremity function. Assessing participation restrictions Interventions for people with traumatic brain injury Roles and responsibilities of the interprofessional rehabilitation team Physical therapy interventions through the care continuum Interventions for disorders of consciousness (levels of cognitive functioning i–iii) Physical therapy considerations for persons with levels of cognitive functioning iv-vi Interventions to improve motor performance and physical function after traumatic brain injury Treadmill training. Virtual reality. Interventions to improve vestibular function. Interventions to improve endurance and benefits of aerobic exercise. Interventions to improve dual-task performance. Emerging technology for the rehabilitation of moderate to severe traumatic brain injury. Section iv—prognosis and outcomes after traumatic brain injury Prognostic models and indicators Age Clinical severity Abnormalities on computed tomography scan Secondary insults Biomarkers Genetic factors Laboratory values Duration of coma and posttraumatic amnesia Outcomes after traumatic brain injury References APPENDIX 22.A Family Guide to the Rancho Los Amigos Levels of Cognitive Functioning Cognitive level I No response Cognitive level II Generalized response Cognitive level III Localized response Cognitive level IV Confused and agitated Cognitive level V Confused and inappropriate Cognitive level VI Confused and appropriate Cognitive level VII Automatic and appropriate Cognitive level VIII Purposeful and appropriate Level ix—purposeful, appropriate: Stand-by assistance on request Level x—purposeful, appropriate: Modified independent 23. Concussion Concussion* Objectives Key terms Introduction Epidemiology Pathophysiology Persistent symptoms/prolonged recovery Examination of the acute concussion Recognize Remove Evaluate Neurocognitive assessment Oculomotor assessment The King-Devick concussion screening test. Vestibular/ocular motor screening Balance assessment Balance Error Scoring System. Symptom complaint Postconcussion symptom inventory. Post concussion symptom scale. Rivermead Post-Concussion Symptoms Questionnaire. Health and Behavior Inventory. Graded Symptom Checklist. Reevaluate Determination of diagnosis of concussion Medical management Risk reduction/prevention of sports-related concussion Potential long-term effects associated with sports-related concussion Retirement from sports Considerations for rest and return to play/learn following SRC What is the evidence for physical and cognitive activity in acute concussion? What criteria should be used to determine recovery? Recommendations for return to play and return to school/learn Recommendations for return to play Recommendations for return to school/learn Prognosis and outcomes following concussion Prognosis and outcomes following sports-related concussion Prognosis and outcome following non–sports-related concussion in adults Prognosis and outcomes following mild traumatic brain injury in military personnel Attention. Memory. Executive functions. Word retrieval. Social language/pragmatic skills. Clinical examination for persistent postconcussion symptoms Symptom complaint Tests and measures to evaluate persistent postconcussion symptom complaint Cognitive/neuropsychological dysfunction Cognitive/neuropsychological assessment Exercise intolerance Assessment of exercise intolerance: Subsymptom exercise tolerance test Vestibular system impairment Positional vertigo Impaired dynamic gaze stabilization Dynamic gaze stabilization assessment. Ocular motor impairment Ocular motor assessment Motion sensitivity Sensation of motion at rest. Balance and gait impairment Balance and gait assessment Functional gait assessment. Dependency patterns Cervical spine function and dysfunction Movement, stability, and somatosensory components of the cervical spine. Mechanisms of cervical injury in concussion events. Cervical spine assessment Craniocervical ligament tests. Vertebral artery dissection and vertebral basilar insufficiency. Somatosensory testing. Posture. Sensation of motion at rest (seated without support, eyes closed). Active range of motion (standing or seated, caution if patient complains of dizziness). Palpation (seated or supine). Passive accessory intervertebral motion (seated or supine). The cervical flexion rotation test (in supine). Joint position error test (seated, 90 CM from a wall). Kinesthetic sense. Smooth pursuit neck torsion test (performed seated or standing). Eye-head coordination, changes in neck recruitment and gaze in whiplash-associated disorder. Head righting response (seated). Body rotation under a stable head. Strength and endurance tests. Balance and gait. Cervicogenic dizziness Cervicogenic headache Prognosis in cervical spine dysfunction following concussion Mood and psychological disorders Headaches Posttraumatic headache Posttraumatic migraine Tension-type headache Headache attributed to whiplash Cervicogenic headache Headache, intracranial hypotension, and cerebral spinal fluid leaks Sleep disturbances Intervention Education Active training intervention Cognitive rehabilitation Attention training Memory Executive functions Word retrieval Social language/pragmatic skills Aerobic exercise training Vestibular rehabilitation Eye-head coordination exercises Balance exercises Vision therapy Management of cervical spine dysfunction Multidisciplinary care Acute concussion Education and recommendations from sports medicine physician Recommendation for return to learn Reevaluation at 14 days following injury Education and recommendations from sports medicine physician Recommendation for return to learn Recommendation for return to play Reevaluation at 30 days References 24. Movement dysfunction associated with hemiplegia 24 Movement dysfunction associated with hemiplegia Keywords: Objectives Key terms Overview Definition General medical assessment Epidemiology Outcome Pathoneurological and pathophysiological aspects classification Thrombotic infarction. Embolic infarction. Hemorrhage. Clinical findings Medical management and pharmacological considerations Acute medical care Evaluation. Ischemic stroke. Hemorrhagic stroke. Medical management of associated problems Spasticity. Seizures. Respiratory involvement. Stroke fatigue syndrome. Cardiovascular health. Fractures. Thrombophlebitis. Complex regional pain syndrome. Pain. Sequential stages of recovery from acute to adaptive phase Evolution of recovery process Recovery of motor function Predictors of recovery Classification of atypical movement patterns Impairments contributing to activity and participation limitations Primary and secondary impairments. Composite impairments. Physical therapy evaluation of general neurological function Mental status evaluation Levels of consciousness Mental, emotional, and affective states Communication Perception Cranial nerves Tone Reflexes and spasticity Spasticity. Spasticity versus hypertonicity. Sensation Evaluation of functional movement Postural control Anticipatory postural adjustments Compensatory postural adjustments Trunk control Levels of trunk control. Extremity control Objective outcome measures Objective measures of participation, activity, motor function, balance, quality of life Descriptors of gait patterns Evaluation of movement control Assisted movement Example. Developing a physical therapy assessment Primary impairments Neurological weakness Muscle activation deficits Impaired initiation/cessation. Impaired sequencing. Inappropriate timing. Altered force production. Equilibrium and protective reactions Evaluation of secondary impairments Changes in joint alignment Shoulder subluxation. Inferior subluxation. Anterior subluxation. Superior subluxation. Changes in muscle and tissue length Pain Joint pain. Muscle and tendon pain. Complex regional pain syndrome: Shoulder-hand syndrome. Objective measures of pain. Edema Aberrant extremity movement Underlying causes of aberrant movement Insufficient postural stability and trunk control. Altered biomechanical alignment. Example 2a: Lower extremity. Example 2b: Upper extremity. Inappropriate voluntary muscle activation. Conclusions Motor evaluation forms Recognizing needs Clinical decision making and problem solving Analyzing evaluation material Common combinations of primary and secondary impairments Acute recovery Inpatient/subacute recovery Chronic recovery Distal and proximal relationships Example Developing hypotheses for significant impairments Goal setting Functional goals Long-term goals Examples. Functional goal. Long-term goals. Short-term goals Choosing intervention techniques Intervention strategies for functional recovery General considerations Supine Rolling Trunk and extremity linked patterns. Impairments that interfere. Clinical observations. Feeding and swallowing Impairments that interfere Clinical observations Sitting Trunk and arm linked patterns (representative examples) Trunk and leg linked patterns (representative examples) Impairments that interfere Clinical observations Transfers Sitting to standing Standing Standing control Trunk and arm linked patterns Trunk and leg linked patterns in weight bearing Trunk and leg linked patterns as the leg moves in space Impairments that interfere Clinical observations Walking Clinical observations Cardiovascular health Clinical considerations Equipment Example Bedside equipment Wheelchairs Slings Canes Orthotics Polypropylene orthotics Carbon fiber orthoses Wireless FES systems Toe curling/clawing AIDS Movable surfaces Hand splints Design considerations Psychosocial aspects and adjustments Sexuality Summary References APPENDIX 24.A Product Manufacturers APPENDIX 24.B Resources for One-Handed Adaptations One-handed in a two-handed world Adaptive resources: A guide to products and services APPENDIX 24.C Stroke Survivor Resources Internet links Audiovisual and literary resources Films and videotapes Inner world of aphasia, 35-minute film Candidate for stroke, 35-minute film I had a stroke, 35-minute film Living with stroke Books Children Adult 25. Brain tumors 25 Brain tumors Keywords: Objectives Key terms An overview of brain tumors Incidence and etiology Classification of tumors Primary brain tumors Secondary brain tumors: Metastatic brain tumors Signs and symptoms General signs and symptoms Specific signs and symptoms Medical diagnosis of disease or pathology Conventional imaging Advanced imaging Diffusion-weighted imaging Functional magnetic resonance imaging Magnetic resonance spectroscopy Perfusion weighted imaging Molecular imaging Biopsy Molecular diagnosis Medical and surgical management Traditional surgery Chemotherapy Radiation therapy Stereotactic radiosurgery Research trends Rehabilitation Overview Evaluation Goal setting Functional assessment Side effects and considerations Intervention Discharge planning Palliative care and hospice Psychosocial care Summary References 26. Inflammatory and infectious disorders of the brain 26 Inflammatory and infectious disorders of the brain Keywords: Objectives Key terms Overview of inflammatory disorders in the brain Categorization of inflammatory disorders Brain abscess Meningitis Bacterial meningitis. Clinical problems. Medical management. Prevention. Potential neurological sequelae. Aseptic meningitis. Encephalitis Clinical problems. Medical management. Clinical picture of the individual with inflammatory disorders of the brain Examination and evaluation process Observation of current functional status Evaluation of physiological responses to therapeutic activities Evaluation of cognitive status Examination of functional abilities Evaluation of sensory channel integrity and processing Examination of movement abilities Diagnosis, prognosis, and goal setting General goals for the intervention process General therapeutic intervention procedures in relation to intervention goals Interaction with other professionals Summary Acknowledgment References 27. Aging, dementia, and disorders of cognition 27 Aging, dementia, and disorders of cognition Key words: Objectives Key terms The starting point with older persons in physical or occupational therapy Paradigm for aging, the brain, and learning Framework for clinical problem solving Definition of terms Epidemiology Physiology of aging: Relevance for symptomatology and diagnosis of delirium and dementias The normal brain Arndt-Schulz principle Law of initial values Biorhythms Cognitive changes in normal aging Stress and intellectual capacity Strategies for assessing, preventing, and minimizing distortions in information processing Screening tests for cognitive impairment Sensory and perceptual changes with dementia Older adult learning styles and communication Interference Pacing Organization Communication Environmental considerations Hypothermia Transplantation shock Delirium and reversible dementia: Evaluation and treatment Irreversible dementia Alzheimer’s disease Selected outcome measures for older adults with dementia Strategies for treatment and care Supporting families and caregivers with their own sense of loss, frustration, and helplessness Epstein: Stages of healing for caregivers Nonlinear learning Role of the clinician: Development of interventions and caregiver training170,171 Emerging interventions and future trends on the role of rehabilitation therapists in dementia care Summary References APPENDIX 27.A Rating Guidelines for Barthel Index 28. Disorders of vision and visual-perceptual dysfunction 28 Disorders of vision and visual-perceptual dysfunction Keywords: Objectives Key terms Anatomy of the eye Eye chamber and lens Iris Exercise 28.1: Observation of pupillary constriction and dilation Lens Vitreous chamber Retina Exercise 28.2: Blind spot Visual pathway Exercise 28.3: Peripheral central awareness Eye movement system Exercise 28.4: Pursuits, saccades, convergence Pursuits. Saccades. Convergence. Functional visual skills Refractive error Accommodation Exercise 28.5: Accommodation Vergence Exercise 28.6: Vergence Pursuits and saccades Symptoms of visual dysfunction History Near point blur Distance blur Phoria and strabismus Oculomotor dysfunction Visual field defects—hemianopsia and quadrantanopsia Summary of disorders of vision Eye diseases Pediatric conditions Retinopathy of prematurity Retinoblastoma Mental retardation Cerebral palsy Hydrocephalus Fetal alcohol syndrome Conditions of aging Cataracts Age-related macular degeneration Arteriosclerosis Hypertension Diabetes Glaucoma Eye muscle dysfunctions Visual field loss Environmental implications for functional performance Lighting Glare Low-vision AIDS Hand and stand magnifiers. Telescopes. Microscopes. Electronic digital magnifiers. Nonoptical aids. Visual field expansion. Current research. Visual screening Observations during testing Distance acuities Equipment Setup Procedure Record Implications Near acuities Equipment Procedure Record Interpretation and referral Pursuits Equipment Setup Procedure Record Saccades Equipment Setup Procedure Record Near point of convergence Procedure Record Interpretation and referral Implications Cover tests Purpose Equipment Setup Procedure Near cover tests Cover-uncover test. Alternate cover test. Far cover tests Interpretation and referral. Stereopsis (depth perception) Equipment Procedure Record Interpretation and referral Implications Visual field screening Equipment Setup Procedure Record Interpretation and referral Implications Referral considerations Rehabilitation optometric evaluation Visual intervention Documentation Therapeutic considerations Accommodative dysfunction Eye alignment dysfunction Visual dysfunction and balance disorders Visual-perceptual dysfunction Problems of unilateral spatial inattention Identification of clinical problems General category. Unilateral spatial inattention with homonymous hemianopsia. Unilateral visual, auditory, and tactile inattention. Unilateral spatial inattention and body image. Behavioral manifestations of unilateral spatial inattention. Assessment Interventions Problems of cortical blindness, color imperception, and visual agnosia Identification of clinical problems Cortical blindness. Color imperception. Visual agnosia. Visual object agnosia. Simultanagnosia. Facial agnosia. Color agnosia. Assessment Interventions Problems of visual-spatial disorders Identification of clinical problems Assessment Interventions Problems of visual-constructive disorders Identification of clinical problems Assessment Interventions Problems of visual analysis and synthesis disorders Identification of clinical problems Assessment Interventions Perceptual retraining with computers Summary of visual-perceptual dysfunction References APPENDIX 28.A Resources Helpful websites Vision therapy information and referrals 29. Cardiovascular and pulmonary system health in populations with neurological disorders 29 Cardiovascular and pulmonary system health in populations with neurological disorders Keywords: Objectives Key terms Physiological responses to exercise Measurement of cardiopulmonary fitness Testing modality Predicting maximal oxygen consumption with use of submaximal exercise tests Fitness levels in populations with neurological disorders Impact of low fitness levels on health of people with neurological disorders Factors affecting fitness levels in people with neurological disorders Personal and environmental contextual factors Age Sex Race Lifestyle factors Environmental factors Health condition Neuromuscular system Cardiovascular system Pulmonary system Adaptive responses to aerobic training in populations with neurological disorders Mechanism of improved exercise capacity in neurological disorders Additional benefits of aerobic training Cardiopulmonary function Cardiovascular risk factor reduction Impairments in body structure and function Emotional well-being Activity, participation, and quality of life Aerobic exercise prescription to optimize fitness of people with neurological disabilities Safety and screening Training environment Preparation of participants Scheduling of sessions Duration of program Frequency and duration of sessions Mode of training Muscle strengthening Intensity of training Progression of training program Laboratory outcome measures Clinical outcome measures Six-minute walk test. Shuttle walk test. Adherence to program Conclusion References APPENDIX 29.A Abbreviations Commonly Used When Discussing Cardiovascular and Pulmonary Problems and Their Effect on Function 30. Pain management 30 Pain management Keywords: Objectives Key terms Defining pain Pain anatomy Pain transmission Pain modulation The gate control theory Descending pain modulation system Categorizing pain Examination of the patient with pain Pain history Pain outcome measurement Measuring pain intensity Visual analog scale. Simple descriptive pain scale. Pain estimate. Faces Pain Scale. Localizing pain symptoms Pain drawings. Describing pain quality Mcgill Pain Questionnaire. Pediatric verbal descriptor scale. Caregiver checklist. Psychosocial assessment Examination of the patient Rehabilitation management of the patient with pain Physical interventions Thermotherapy Cryotherapy Transcutaneous electrical nerve stimulation Iontophoresis Massage Myofascial release Joint mobilization Light therapy Therapeutic touch Point stimulation Cognitive strategies, including cognitive behavioral therapy Relaxation exercises Body scanning Humor General conditioning through exercise Operant conditioning Hypnosis Biofeedback General treatment guidelines Case studies Acknowledgments References 31. Electrophysiological testing and electrical stimulation in neurological rehabilitation 31 Electrophysiological testing and electrical stimulation in neurological rehabilitation Keywords: Objectives Key terms Electrophysiological testing Anatomical review At the cellular level At the anatomical level Nerve conduction tests Motor nerve conduction Sensory nerve conduction F-wave latency H-reflex response Repetitive stimulation tests Blink reflex Clinical evoked potentials Needle electromyography Summary of clinical electroneuromyographic and nerve conduction studies Single-fiber electromyography Macroelectromyography Kinesiological electromyography Recording instrumentation Needle or fine wire electrodes (indwelling or intramuscular). Surface electrodes. Instrumentation for kinesiological electromyography acquisition Signal processing. Normalization. Interpretation of kinesiological electromyography Kinesiological electromyography and strength. Muscle tone versus spasticity. Electrical stimulation and electromyographic biofeedback Neuromuscular electrical stimulation Parameters of stimulation Waveform Duration Frequency Amplitude Additional parameters: Ramp time and on-off time ratio On time and off time. Ramping. Duty cycle. Muscle reeducation Functional electrical stimulation Electromyographic biofeedback Reduction of hypertonicity Muscle reeducation Feedback considerations Integrating neuromuscular electrical stimulation and electromyographic biofeedback Applications Upper-extremity management Electromyographic biofeedback Neuromuscular electrical stimulation Lower-extremity management Electromyographic biofeedback Neuromuscular electrical stimulation Evidence-based practice Stroke Traumatic spinal cord injury Upper-extremity management Lower-extremity management Standing. Cycling. Ambulation. Traumatic brain injury Guillain-Barré syndrome Multiple sclerosis Pediatric applications Cerebral palsy Spina bifida Spinal muscular atrophy Scoliosis Contraindications and precautions Summary Case studies Part 1: Electrodiagnosis Part 2: Neuromuscular electrical stimulation and electromyographic biofeedback References APPENDIX 31.A Key to Abbreviations 32. Orthotics - Evaluation, intervention, and prescription 32 Orthotics: Evaluation, intervention, and prescription Keywords: Objectives Key terms Overview Basic orthotic functions Alignment Stability Contracture reduction Evaluation Evaluation of the spine Evaluation of the upper extremities Evaluation of the lower extremities Orthotic evaluation Orthotic intervention Clinical examples Paraplegia Hemiplegia Paralytic spine Spastic diplegic cerebral palsy Multiple sclerosis Summary Acknowledgment References 33. Integrating health promotion and wellness into neurorehabilitation 33 Integrating health promotion and wellness into neurorehabilitation Keywords: Objectives Key terms Definitions and relationships among terms A paradigm shift to wellness Theories of behavior change Social cognitive theory Resilience theory Transtheoretical model Self-determination theory Measurement of wellness Merging wellness into rehabilitation—the role of physical and occupational therapists in health promotion and wellness Communication strategies to implement behavior change theory Application to individuals with neurological conditions Conclusion References 34. Human immunodeficiency virus infection - Living with a chronic illness 34 Human immunodeficiency virus infection: Living with a chronic illness Keywords: Objectives Key terms Identification of the clinical problem Epidemiology Normal immunity Acquired immunity Pathogenesis of human immunodeficiency virus disease Medical management CD4 cell counts Viral load measurement Vaccines for other antigens Vaccines and functional cures for human immunodeficiency virus Prevention Nutrition Systemic manifestations Integumentary system and neoplasms Musculoskeletal system Cardiopulmonary system Neurological system Autonomic nervous system Central nervous system Peripheral nervous system Balance and postural mechanisms Pain Psychopathology Pediatric human immunodeficiency virus infection Rehabilitation interventions Rehabilitation process Exercise Precautions and concerns during exercise Psychoneuroimmunology: Prevention and wellness in human immunodeficiency virus infection Complementary and integrative therapies in human immunodeficiency virus infection Social interactions and the association with disease management Summary Future directions for research Case studies References 35. Aging with chronic nervous system conditions and impairments 35 Aging with chronic nervous system conditions and impairments Keywords: Objectives Key terms Diagnoses with underlying chronic consequences Developmental conditions Acquired neurological conditions: Spinal cord injury, traumatic brain injury, postpolio syndrome Spinal cord injury and traumatic brain injury Examination of individuals with chronic impairments Examination: Systems model Challenges of examination of individuals with chronic conditions Health history Systems review Tests and measures Fatigue Pain Strength Weakness and Postpolio syndrome. Range of motion and muscle length Tone Cognitive function Mobility and posture Balance and coordination Environmental temperature intolerance Sleep disturbances Life-threatening conditions Functional assessment Psychosocial considerations Postpolio syndrome Coping strategies Response to new diagnosis. Compliance. Health-related disparities in aging adults with chronic disabilities Management of chronic impairments Aging with chronic impairments Multisystem approach Health promotion Health promotion with chronic conditions Shift to health promotion Community-based programs Health promotion interventions: Evidence and challenges Intervention strategies Therapeutic exercise Strengthening and conditioning Physical activity Cardiopulmonary conditioning Pulmonary status Fatigue management Sleep disturbance Decreasing the workload of muscles Energy conservation techniques Orthotics and assistive devices Changes in locomotion Management of postural deviations Limitations in range of motion Weight management Pain management Alternative pain management Cold and heat intolerance Other interventions Key points References 36. Impact of drug therapy on patients receiving neurological rehabilitation 36 Impact of drug therapy on patients receiving neurological rehabilitation Key words: Objectives Key terms Clinical pharmacology Disease perspective Parkinson disease Cancer Seizure disorders (epilepsy) Stroke, hypertension, and related disorders Anxiety and depression Arthritis and autoimmune disorders Infectious diseases Diabetes Pulmonary diseases Gastrointestinal disorders127,128 An impairment perspective Sensory impairment Cognitive and central motor control impairment Vertigo, dizziness, balance, and coordination Cardiovascular impairment Spasticity and muscle tone Neuroplasticity Research and development prospects Summary References 37. Use of neuroimaging in rehabilitation 37 Use of neuroimaging in rehabilitation Keywords: Objectives Key terms Visualizing the central nervous system Imaging of the central nervous system Clinical decisions regarding the need for imaging studies General guidelines for reviewing medical images Radiodensity Step 1 Gather all pertinent information regarding the patient’s neuroimaging studies Step 2 Familiarize with patient background information and identify image type and orientation Step 3 Quick scan followed by thorough image examination Step 4 Establish relationships between the structures involved and the presenting impairments, movement dysfunctions, and activit ... Future of neuroimaging in rehabilitation References 38. Integrating technology in neurological rehabilitation 38 Integrating technology in neurological rehabilitation Keywords: Objectives Key terms Types of robotic rehabilitation and their applications Service robotics Nonwearable assistive robotic devices Wearable assistive robotic devices Robotic system mechanisms for operation General screening considerations Specific screening of patients for wearable assistive devices Patient simulator robotics Purpose Introduction Technology Features Size. Limb and chest mobility. Physiological features. Cerebrovascular system features. Cardiovascular and pulmonary system features. Programmability of patient simulators Costs of establishing a simulation laboratory Summary Wearable inertial sensors Introduction What are wearable inertial sensors? Can wearable sensors improve our assessment of balance and gait in the neurological population? Measure impairment Detect subtle deficits Home monitoring Can wearable sensors improve treatment for balance and gait in the neurological population? Impairment-focused rehabilitation Biofeedback rehabilitation Important considerations in wearable inertial sensors for balance and gait rehabilitation Future direction/conclusions Virtual reality technology Introduction The rationale for virtual reality in rehabilitation Clinical application of virtual reality Noninvasive brain stimulation in neurological rehabilitation Introduction Transcranial magnetic stimulation Using transcranial magnetic stimulation in rehabilitation Mechanism of cortical plasticity following transcranial magnetic stimulation Transcranial direct current stimulation Applying transcranial direct current stimulation in neurorehabilitation Mechanism of change Clinical application of noninvasive brain stimulation Acknowledgments References 39. Complementary and integrative therapies - Beyond traditional approaches to intervention in neurological diseases and movement disorders 39 Complementary and integrative therapies: Beyond traditional approaches to intervention in neurological diseases and movement disorders Keywords: Objectives Key terms Alternative integrative models Movement therapy approaches Equine-assisted therapy Introduction to hippotherapy and therapeutic riding Benefits, indications, and precautions. Regulations. Evidence and clinical implications. Feldenkrais method of somatic education Development of the Feldenkrais method. Background theory—dynamical systems theory. Approaches to the Feldenkrais method. Research Evidence of effectiveness. Pain. Balance mobility and function. Multiple sclerosis. Cerebrovascular accident. Other neurological diagnoses Cerebral palsy Spinal cord injury Parkinson disease Dementia Other areas of research Conclusion The pilates method Pilates principles Breathing. Trunk control and axial elongation. Mobility. Efficiency of movement. Alignment and weight bearing of extremities. Movement integration. Clinical application Summary Tai Chi styles and forms Characteristics of Tai Chi movement Effects of tai chi practice on movement science Yin-Yang philosophy in Tai Chi theory and practice Mechanism of Tai Chi effect Tai Chi for neurological disorders Stroke Parkinson disease Traumatic brain injury Multiple sclerosis Spinal cord injury Vestibular dysfunction Summary Yoga Galantino Carpal tunnel syndrome. Stroke and hemiparesis. Multiple sclerosis. Epilepsy. Human immunodeficiency virus. Fear of falling and insufficient balance. Conclusion. Energy therapy approaches Reiki: Feng Shui, Chakras What is reiki?298–307 The seen and unseen influences of energy around and within US Feng shui: The art of arranging your outer world to enhance your inner world Chakra: Internal energy wheels Five reiki principles and self-cultivation Methods and tools Future of healing and interaction with patients Therapeutic touch Assumptions. Procedure. Scientific literature. Anxiety. Pain. Disruptive behaviors. Conclusion. Physical body systems approaches Craniosacral therapy Structure of the craniosacral system. Technique. Outcomes. Use in treatment intervention. Training. Myofascial release (barnes method) Models of health care belief systems American Indian healing traditions of North and South America Contemporary American Indian health care and traditional healing: North and South American Indian or indigenous perspectives. A lakota centric perspective on health. Ayahuasca: A spiritual pathway to consciousness and healing. Health risks associated with ayahuasca. Shamanic mythology in palliative care: New frontiers Traditional acupuncture History. Methods. Examination and evaluation. The law of five elements. Intervention. Benefits of intervention. Future treatments. Summary. Allopathic links to models of health care belief systems Aquatic therapy: A link between traditional therapy and the community Electroacupuncture and dry needling Therapeutic effects of electroacupuncture. Research Lymphedema management for patients with neurological movement disorders Integrating lymphedema therapy in neurorehabilitation Music therapy History of music therapy. Specialization. Music therapy in neurological rehabilitation. Music therapy as a complementary modality. Conclusion References
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