Neurologic Physical Therapy Rehabilitation of brain and spinal cord (Part II) Shout Out Quiz What is this called? Stroke CVA (cerebrovascular accident) What is another name for stroke? Brain and spinal cord What makes up the central nervous system? Right If someone has a left side stroke, which side of their body may be paralyzed? Left If someone has problems with speech and language, which side of the brain had a stroke? Right If someone is impulsive and unaware, which side of the brain had a stroke? Left If someone is slow and cautious, which side of the brain had a stroke? Right If someone has problems with spatial relationships, which side of the brain had a stroke? Cerebellum If someone has abnormal reflexes of the head and torso and has problems with coordination, which part of the brain had a stroke? Cerebellum If someone has abnormal reflexes of the head and torso and has problems with coordination, which part of the brain had a stroke? Today’s Agenda Learn about multiple sclerosis Learn about traumatic brain injury Learn about vestibular disorders Journal MoveWell The Pain-Free Corporate Solution Multiple Sclerosis (MS) • • • • An autoimmune disorder (body attacks itself) Involves the myelin (the fatty substance that surrounds the nerve tissue) Scar tissue distorts or disrupts nerve impulses to the muscle More common in people ages 20-35. Twice as common in women as in men. Symptoms of MS • • • • • • Muscle weakness Sometimes paralysis Slurred speech Problems with posture Involuntary jerking and twitching Wasting of muscles PT for MS • • • • • Gait training: assistive devices Transfer training Balance training Muscle strength: focus on core stabilization and control Exercise in the a.m. to avoid fatigue. Break up tasks into smaller steps. Traumatic Brain Injury • • • • Injury to the brain from an external force Open - penetration through skull Closed - brain contacts the skull suddenly and violently Major cause of death and disability TBI Statistics (cdc.gov) • • • • 1.4 million TBI/year in the US Causes: Falls (28%), Motor vehicle-traffic crashes (20%), struck by/against events (19%), assaults (11%) Males 1.5 times as likely as females Highest risk: 0-4 year olds and 15-19, military personnel TBI Classification Severity of brain injury measured by: • • • Glasgow Coma Scale Post-traumatic amnesia Loss of Consciousness Glasgow Coma Scale The most widely used clinical scale to measure the level of consciousness and helps define and classify the brain injury. Post-traumatic Amnesia: A series of standardized questions related to orientation and the ability to recall events before and after the injury. Severity PTA Very mild < 5 minutes Mild 5-60 mins Moderate 1-24 hours Severe 1-7 days Very severe 1-4 weeks Extremely severe > 4 weeks Loss of Consciousness Severity Post-traumatic amnesia (PTA) Mild <30 minutes Moderate 1-24 hours Severe >24 hours Physical Therapy for TBI: A Team Approach Physician Speech-Language Pathologist Occupational Therapist Rehabilitation Nurse Case Manager/Team Coordinator Medical Social Worker Neuropsychologist Family PT Focus • Gait training and transfers • Strength, muscle control and posture • Movement quality and coordination • Pain management • Family training • Equipment needs Vestibular Disorders • • • If disease or injury of the vestibular system (inner ear and brain that control balance and eye movements Caused by genetic or environmental conditions, or occur for unknown reasons. Symptoms may be mild, lasting only seconds or minutes; or they may be severe, resulting in total disability. Physical Therapy for Vestibular Disorders • • Gaze and postural stability exercises Help restore balance Symptoms • • • Dizziness is a sensation of lightheadedness, faintness, or unsteadiness. Vertigo is a perception of spinning movement or whirling, either of the self or surrounding objects. Disequilibrium is unsteadiness, imbalance, or loss of equilibrium and spatial disorientation (Not knowing where your body is in space.) Quote of the Day... When was the last time you had a real, face-to-face conversation?