BOOK
Physical Management for Neurological Conditions E-Book
Sheila Lennon | Gita Ramdharry | Geert Verheyden
(2018)
Additional Information
Book Details
Abstract
The second edition of the Neurological Physiotherapy Pocketbook is the only book for physiotherapists that provides essential evidence-based information in a unique and easy-to-use format, applicable to clinical settings.
Written by new international editors and contributors, this pocketbook provides quick and easy access to essential clinical information.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| Physical Management for Neurological Conditions | i | ||
| Series Page | ii | ||
| Physical Management for Neurological Conditions | iii | ||
| Copyight | iv | ||
| CONTENTS | v | ||
| PREFACE | vii | ||
| ACKNOWLEDGEMENTS | ix | ||
| CONTRIBUTORS | xi | ||
| 1 - Background Knowledge | 1 | ||
| 1 - Guiding Principles in Neurological Rehabilitation | 3 | ||
| WHY IS A CONCEPTUAL FRAMEWORK IMPORTANT? | 4 | ||
| GUIDING PRINCIPLES FOR NEUROLOGICAL REHABILITATION | 5 | ||
| Principle 1: The ICF | 5 | ||
| The Value of Participation | 6 | ||
| Principle 2: Team Work | 7 | ||
| Principle 3: Person-Centred Care | 7 | ||
| Principle 4: Prediction | 9 | ||
| Principle 5: Neural Plasticity | 10 | ||
| What Type of Training Drives Neural Plasticity and Recovery of Function? | 10 | ||
| Principle 6: Motor Control: A Systems Model | 11 | ||
| Principle 7: Functional Movement Reeducation | 11 | ||
| Principle 8: Skill Acquisition | 12 | ||
| Task Practice Issues | 12 | ||
| Role of Feedback | 14 | ||
| Amount of Practice | 14 | ||
| The Optimal Theory of Motor Learning | 14 | ||
| Principle 9: Self-Management (Self-Efficacy) | 15 | ||
| Principle 10: Health Promotion | 15 | ||
| CONCLUSION | 16 | ||
| REFERENCES | 16 | ||
| 2 - Common Impairments and the Impact on Activity | 21 | ||
| INTRODUCTION | 21 | ||
| WEAKNESS | 22 | ||
| Upper Motor Neurone Weakness | 22 | ||
| Lower Motor Neurone Weakness | 22 | ||
| FATIGUE | 23 | ||
| General Fatigue | 23 | ||
| Motor Fatigue | 23 | ||
| DISORDERS OF MUSCLE TONE | 23 | ||
| Hypertonus | 23 | ||
| Hypotonus | 24 | ||
| Dystonia | 25 | ||
| Involuntary Muscle Spasms | 25 | ||
| Dyskinesias | 25 | ||
| Rigidity | 26 | ||
| DISORDERS OF COORDINATION | 26 | ||
| Cerebellar Ataxia | 26 | ||
| Sensory Ataxia | 26 | ||
| Resting Tremor | 26 | ||
| Intention Tremor | 27 | ||
| Loss of Dexterity | 27 | ||
| DISORDERS OF MOTOR PLANNING | 28 | ||
| Apraxia | 28 | ||
| Bradykinesia/Akinesia | 28 | ||
| Freezing of Gait | 28 | ||
| VESTIBULAR DISORDERS | 28 | ||
| Peripheral Vestibular Disorders | 28 | ||
| Central Vestibular Disorders | 29 | ||
| Unilateral Spatial Neglect | 29 | ||
| Contraversive Pushing | 29 | ||
| Paraesthesia and Dysaesthesia | 30 | ||
| Pain | 30 | ||
| SECONDARY COMPLICATIONS | 30 | ||
| Contracture | 30 | ||
| Physical Inactivity and Deconditioning | 31 | ||
| Learned Non-Use | 31 | ||
| CONCLUSION | 32 | ||
| REFERENCES | 32 | ||
| 3 - Observation and Analysis of Movement | 37 | ||
| WALKING | 37 | ||
| The Gait Cycle | 38 | ||
| Walking Kinematics and Muscle Activity | 38 | ||
| Walking Kinetics | 42 | ||
| Spatiotemporal Characteristics | 43 | ||
| Clinical Focus: Walking for People with Parkinson’s | 43 | ||
| SIT TO STAND | 43 | ||
| Typical Phases of Sit to Stand | 44 | ||
| Muscle Action During Sit to Stand | 44 | ||
| Contextual Factors Influencing Sit to Stand | 44 | ||
| Clinical Focus on Sit to Stand for People Following Stroke | 45 | ||
| ROLLING AND GETTING OUT OF BED | 45 | ||
| Clinical Focus on Getting Out of Bed for People with Parkinson’s | 47 | ||
| REACH AND GRASP | 51 | ||
| Essential Components of Reach and Grasp | 51 | ||
| Kinematics | 53 | ||
| Muscle Activity | 53 | ||
| Clinical Focus on Reach and Grasp for People with Stroke | 55 | ||
| POSTURE AND BALANCE | 55 | ||
| Sensorimotor Control of Balance | 57 | ||
| Movement Analysis Strategies to Quantify Posture | 59 | ||
| Movement Analysis Strategies to Quantify Balance | 60 | ||
| Clinical Foci of Posture and Balance (Ataxia, Parkinson’s and Hemiplegic Stroke) | 61 | ||
| KEY MESSAGES | 65 | ||
| REFERENCES | 66 | ||
| 4 - Measurement Tools | 77 | ||
| INTRODUCTION | 77 | ||
| Impairments (Problems in Body Functions or Structures) | 78 | ||
| Activity Limitations | 79 | ||
| TYPES OF MEASUREMENT TOOLS | 79 | ||
| PSYCHOMETRIC PROPERTIES | 82 | ||
| Reliability | 82 | ||
| Assessing Reliability for Nominal and Ordinal Data with Two Scoring Categories | 83 | ||
| Assessing Reliability for Ordinal Data with Three or More Categories | 83 | ||
| Assessing Reliability for Interval and Ratio Data | 84 | ||
| Validity | 85 | ||
| Content Validity | 85 | ||
| Construct Validity | 85 | ||
| Criterion-Related Validity | 86 | ||
| Responsiveness | 87 | ||
| APPLIED MEASUREMENT SCIENCE: TOWARDS CLINICAL IMPLEMENTATION | 88 | ||
| CONCLUSIONS | 88 | ||
| REFERENCES | 89 | ||
| 5 - Goal Setting in Rehabilitation | 91 | ||
| INTRODUCTION | 91 | ||
| DEFINITIONS AND ASSUMPTIONS | 92 | ||
| Rehabilitation Goals and Goal Setting | 92 | ||
| Activities to Enhance Goal Pursuit | 92 | ||
| PRAGMATIC PERSON-CENTRED GOAL SETTING | 93 | ||
| Family Involvement in Goal Setting | 94 | ||
| Should Goals Be Measurable? | 95 | ||
| GOAL SETTING IN STROKE REHABILITATION – ADDRESSING THE CHANGING NEEDS FROM ACUTE CARE TO COMMUNITY LIFE | 96 | ||
| Acute Rehabilitation | 96 | ||
| Postacute Inpatient Rehabilitation | 98 | ||
| Postacute Community-Based Rehabilitation | 99 | ||
| Long-Term Recovery Following Stroke | 101 | ||
| GOAL ACHIEVEMENT AS AN OUTCOME MEASURE – CHALLENGING CURRENT ASSUMPTIONS | 102 | ||
| The Appeal of Goal Attainment as an Outcome | 102 | ||
| An Overview of Goal Attainment Scaling | 103 | ||
| Problems with Goal Attainment as an Outcome | 103 | ||
| CONCLUSION | 105 | ||
| REFERENCES | 106 | ||
| 6 - Respiratory Management | 111 | ||
| INTRODUCTION | 111 | ||
| CENTRAL NERVOUS CONTROL OF BREATHING | 112 | ||
| RESPIRATORY ASSESSMENT OF THE NEUROLOGICAL PATIENT | 112 | ||
| Lung Function | 113 | ||
| Peak Cough Flow | 113 | ||
| Arterial Blood Gases | 114 | ||
| Chest Radiographs | 115 | ||
| Respiratory Pattern | 115 | ||
| Respiratory Reserve (PaO2/FiO2 Ratio) | 115 | ||
| EARLY MOBILISATION | 116 | ||
| RESPIRATORY TREATMENT AND MANAGEMENT | 116 | ||
| Maximal Insufflation Capacity | 116 | ||
| Manual Cough | 118 | ||
| Mechanical Insufflation and Exsufflation | 118 | ||
| Other Considerations | 119 | ||
| Respiratory Muscle Training | 119 | ||
| Management of Acute Respiratory Failure | 120 | ||
| Tracheostomy and Weaning | 120 | ||
| RESPIRATORY FUNCTION IN NEUROLOGICAL CONDITIONS | 120 | ||
| Central Conditions | 120 | ||
| Subarachnoid Haemorrhage | 120 | ||
| Spinal Cord Injury and Disease | 121 | ||
| Anterior Horn Cell Conditions | 121 | ||
| Neuropathy | 122 | ||
| Neuromuscular Junction | 122 | ||
| Muscle Conditions | 122 | ||
| MANAGEMENT OF TRAUMATIC BRAIN INJURY | 123 | ||
| CONCLUSION | 126 | ||
| REFERENCES | 127 | ||
| 2- Management of Specific Conditions | 129 | ||
| 7 - Stroke | 131 | ||
| INTRODUCTION | 131 | ||
| EPIDEMIOLOGY | 132 | ||
| PATHOPHYSIOLOGY | 132 | ||
| DIAGNOSIS | 132 | ||
| MEDICAL MANAGEMENT | 133 | ||
| SETTING | 133 | ||
| INTERDISCIPLINARY TEAM | 133 | ||
| CLINICAL PRESENTATION | 134 | ||
| ASSESSMENT | 134 | ||
| Hyperacute Phase | 136 | ||
| Rehabilitation Phase | 136 | ||
| Chronic Phase | 137 | ||
| Prognosis and Time Course of Recovery | 138 | ||
| INTERVENTIONS | 139 | ||
| General Therapy Principles | 140 | ||
| Lower Limb and Locomotor Recovery | 141 | ||
| Gait Training | 142 | ||
| Overground Walking | 142 | ||
| Speed-Dependent Treadmill Training | 142 | ||
| Body Weight Supported Treadmill Training | 143 | ||
| Robot-Assisted Gait Training | 143 | ||
| Circuit Class Training | 143 | ||
| Electrostimulation of the Paretic Lower Limb | 144 | ||
| Upper Limb Recovery | 144 | ||
| Constraint-Induced Movement Therapy | 144 | ||
| Bilateral Arm Training (With Rhythmic Auditory Cueing) | 144 | ||
| Virtual Reality, Including Interactive Video Gaming | 145 | ||
| Electrostimulation of the Paretic Arm and Hand | 145 | ||
| Robot-Assisted Therapy for the Upper Limb | 145 | ||
| Therapy Delivery | 146 | ||
| CONCLUSIONS | 146 | ||
| CASE STUDY | 146 | ||
| REFERENCES | 149 | ||
| 8 - Traumatic Brain Injury | 153 | ||
| INTRODUCTION | 153 | ||
| EPIDEMIOLOGY | 154 | ||
| PATHOPHYSIOLOGY | 154 | ||
| Primary Brain Injury | 154 | ||
| Secondary Brain Injury | 155 | ||
| Associated Injuries | 155 | ||
| DIAGNOSIS | 155 | ||
| Coma | 156 | ||
| Posttraumatic Amnesia | 156 | ||
| MEDICAL MANAGEMENT | 156 | ||
| Intracranial Pressure | 157 | ||
| Multidisciplinary Care | 157 | ||
| CLINICAL PRESENTATION | 158 | ||
| ASSESSMENT | 158 | ||
| Abnormal Tone | 159 | ||
| Muscle Paresis | 159 | ||
| Disorders of Movement | 159 | ||
| Balance and Vestibular Function | 159 | ||
| Muscle and Joint Range of Motion | 160 | ||
| Concurrent Musculoskeletal Injuries | 160 | ||
| Pain | 160 | ||
| Function | 160 | ||
| Summary | 161 | ||
| PROGNOSIS/TIME COURSE | 161 | ||
| INTERVENTIONS | 162 | ||
| Hypertonicity and Spasticity | 162 | ||
| Muscle Paresis | 162 | ||
| Disorders of Movement | 162 | ||
| Balance and Vestibular Function | 163 | ||
| Muscle and Joint Range of Motion | 163 | ||
| Concurrent Musculoskeletal Injuries | 163 | ||
| Pain | 164 | ||
| Function | 164 | ||
| OTHER CONSIDERATIONS | 164 | ||
| CONCLUSION | 164 | ||
| CASE STUDY | 165 | ||
| REFERENCES | 168 | ||
| 9 - Spinal Cord Injury | 171 | ||
| INTRODUCTION | 171 | ||
| EPIDEMIOLOGY | 172 | ||
| Incidence Data | 172 | ||
| AETIOLOGY | 172 | ||
| PATHOPHYSIOLOGY | 173 | ||
| DIAGNOSIS | 173 | ||
| PROGNOSIS | 176 | ||
| INCOMPLETE SYNDROMES | 176 | ||
| EARLY ACUTE MANAGEMENT | 176 | ||
| Breaking the News | 179 | ||
| Physical Management | 179 | ||
| Facilitation of Range, Length and Movement | 180 | ||
| Mobilisation | 182 | ||
| RESPIRATORY ASSESSMENT | 182 | ||
| RESPIRATORY TREATMENT | 184 | ||
| Weaning From Ventilatory Support (RISCI 2017) | 184 | ||
| Long-Term Respiratory Management | 185 | ||
| CLINICAL PRESENTATION | 185 | ||
| Spinal Shock | 185 | ||
| Autonomic Dysfunction | 185 | ||
| Cardiovascular | 185 | ||
| Thermoregulation | 186 | ||
| Autonomic Dysreflexia | 186 | ||
| Bladder, Bowels and Sexual Dysfunction | 186 | ||
| Weakness | 186 | ||
| Sensory Changes | 187 | ||
| Balance | 187 | ||
| Pain | 187 | ||
| Spasticity | 187 | ||
| ASSESSMENT | 187 | ||
| PHYSICAL MANAGEMENT | 187 | ||
| Strength Training | 189 | ||
| Aquatic Therapy | 189 | ||
| Facilitation of Movement | 189 | ||
| Splinting | 190 | ||
| Seating | 190 | ||
| Functional Mobility | 191 | ||
| Standing | 191 | ||
| Gait Training | 192 | ||
| Cardiovascular Fitness | 193 | ||
| Other Modalities | 194 | ||
| Loss of Range of Movement and Postural Deformity | 194 | ||
| Shoulder Pain | 194 | ||
| Tissue Viability | 195 | ||
| Heterotropic Ossification | 195 | ||
| Syrinx and Syringomyelia | 195 | ||
| PAEDIATRIC CONSIDERATIONS | 195 | ||
| DISCHARGE PLANNING AND LIFELONG CARE | 196 | ||
| CONCLUSION | 196 | ||
| CASE STUDY | 196 | ||
| Progress With Rehabilitation | 196 | ||
| ACKNOWLEDGEMENT | 200 | ||
| REFERENCES | 200 | ||
| 10 - Multiple Sclerosis | 205 | ||
| INTRODUCTION | 205 | ||
| EPIDEMIOLOGY | 205 | ||
| PATHOPHYSIOLOGY | 206 | ||
| DIAGNOSIS | 206 | ||
| CLASSIFICATION | 207 | ||
| MEDICAL MANAGEMENT | 208 | ||
| Disease-Modifying Therapies | 208 | ||
| Lifestyle Modifications and Comorbidities | 209 | ||
| PROGNOSIS | 209 | ||
| CLINICAL PRESENTATION | 209 | ||
| ASSESSMENT | 210 | ||
| MANAGEMENT | 212 | ||
| Health Promotion | 212 | ||
| Restorative Rehabilitation | 213 | ||
| Maintenance Rehabilitation | 213 | ||
| INTERVENTIONS | 213 | ||
| Impaired Mobility, Balance and Falls | 213 | ||
| Sedentary Behaviour, Weakness and Deconditioning | 215 | ||
| Upper Limb Impairment | 216 | ||
| Ataxia | 216 | ||
| Spasticity | 216 | ||
| Fatigue | 218 | ||
| Pain | 218 | ||
| Respiratory Dysfunction | 218 | ||
| Bladder and Bowel | 219 | ||
| Cognitive Impairment | 219 | ||
| Anxiety and Depression | 219 | ||
| Pressure Ulcers | 220 | ||
| CONCLUSION | 220 | ||
| Key Assessment Findings | 221 | ||
| Treatment Plan | 221 | ||
| Initial Outpatient Physiotherapy Session | 221 | ||
| Progress Review at 3 Months | 222 | ||
| REFERENCES | 223 | ||
| 11 - Parkinson’s | 227 | ||
| INTRODUCTION | 227 | ||
| EPIDEMIOLOGY AND AETIOLOGY | 228 | ||
| NEUROANATOMY AND PATHOPHYSIOLOGY | 229 | ||
| Pharmacological Management | 232 | ||
| Surgical Management | 232 | ||
| TEAM MANAGEMENT | 233 | ||
| Time Course From Diagnosis of Parkinson’s and Communication | 235 | ||
| PHYSIOTHERAPY MANAGEMENT | 236 | ||
| Framework for Physiotherapy Intervention | 237 | ||
| Referral to Physiotherapy | 237 | ||
| Physiotherapy History Taking | 238 | ||
| Physical Assessment | 238 | ||
| Goal Setting and Choosing Treatments | 241 | ||
| Exercise | 241 | ||
| Practice | 243 | ||
| Movement Strategies Training | 244 | ||
| CONCLUSION | 244 | ||
| CASE STUDY: MAIN ISSUE OF SIT-TO-STAND TASK | 246 | ||
| Quick Reference Card 1: History Taking | 246 | ||
| Quick Reference Card 2: Physical Examination | 247 | ||
| Quick Reference Card 3: Treatment Goal and Quick Reference Card 4: GRADE-Based Recommendations | 247 | ||
| REFERENCES | 248 | ||
| 12 - Inherited Neurological Conditions | 253 | ||
| INTRODUCTION | 254 | ||
| HUNTINGTON’S DISEASE | 254 | ||
| Epidemiology | 254 | ||
| Genetics | 254 | ||
| Anatomy and Pathophysiology | 255 | ||
| Clinical Presentation | 255 | ||
| Medical Management | 256 | ||
| A Standard of Care for Huntington’s Disease | 257 | ||
| Physiotherapy Assessment and Prognosis | 257 | ||
| Time Course and Corresponding Physiotherapy Management | 260 | ||
| Treatment Selection and Secondary Complications/Special Problems | 260 | ||
| HEREDITARY ATAXIAS | 264 | ||
| Epidemiology and Genetics | 264 | ||
| Autosomal Dominant Cerebellar Ataxias | 264 | ||
| Autosomal Recessive Ataxias | 264 | ||
| Friedreich’s Ataxia | 266 | ||
| Diagnosis and Genetic Testing | 266 | ||
| Spasticity and Dystonia | 266 | ||
| Scoliosis and Orthotic Management | 266 | ||
| Cardiac Symptoms | 266 | ||
| Pharmacological and Surgical Management of Ataxia | 267 | ||
| Coenzyme Q and Idebenone in Friedreich’s Ataxia | 267 | ||
| Physiotherapy Assessment | 267 | ||
| Disease-Specific Scales | 268 | ||
| Time Course and Corresponding Management | 268 | ||
| Balance, Walking and Mobility | 269 | ||
| Anatomy, Pathophysiology and Clinical Presentation | 271 | ||
| Diagnosis | 271 | ||
| Physiotherapy Assessment | 272 | ||
| Disease-Specific Scales | 272 | ||
| Time Course and Corresponding Management | 272 | ||
| Treatment Selection, Secondary Complications and Special Problems | 273 | ||
| SUMMARY | 273 | ||
| Classification | 275 | ||
| Examination | 276 | ||
| History | 276 | ||
| Body Structures and Function | 276 | ||
| Activities | 277 | ||
| Prognosis | 277 | ||
| Intervention | 277 | ||
| Outcomes (8 months) | 277 | ||
| ACKNOWLEDGEMENTS | 278 | ||
| REFERENCES | 278 | ||
| 13 - Motor Neurone Disease | 285 | ||
| INTRODUCTION | 285 | ||
| EPIDEMIOLOGY | 285 | ||
| ANATOMY AND PATHOPHYSIOLOGY | 286 | ||
| GENETIC FACTORS | 286 | ||
| GEOGRAPHICAL AND ENVIRONMENTAL FACTORS | 286 | ||
| CLINICAL PHENOTYPES | 287 | ||
| DIAGNOSIS | 287 | ||
| (EARLY) MEDICAL MANAGEMENT | 289 | ||
| SIGNS, SYMPTOMS AND CLINICAL PRESENTATION | 289 | ||
| ASSESSMENT AND PROGNOSIS | 290 | ||
| Disease-Specific Measures | 292 | ||
| Prognosis | 293 | ||
| TIME COURSE AND CORRESPONDING MANAGEMENT | 293 | ||
| TREATMENT SELECTION AND SECONDARY COMPLICATIONS AND SPECIAL PROBLEMS | 294 | ||
| Assistive Devices and Orthoses | 296 | ||
| Exercise in Motor Neurone Disease | 296 | ||
| Overwork Damage Versus Disuse Atrophy | 296 | ||
| Types of Exercise | 297 | ||
| Evolving Wheelchair Needs | 298 | ||
| Respiratory Issues | 299 | ||
| CONCLUSION | 302 | ||
| CASE STUDY | 302 | ||
| REFERENCES | 305 | ||
| 14 - Polyneuropathies | 309 | ||
| INTRODUCTION | 309 | ||
| ANATOMY AND PHYSIOLOGY | 310 | ||
| CAUSES OF NEUROPATHY | 310 | ||
| SPECIFIC TYPES OF NEUROPATHY | 311 | ||
| Acquired Neuropathies | 311 | ||
| Guillain–Barré Syndrome | 312 | ||
| Chronic Demyelinating Polyradiculoneuropathy | 314 | ||
| Diabetic Neuropathy | 315 | ||
| ASSESSMENT OF PEOPLE WITH POLYNEUROPATHIES | 318 | ||
| PHYSICAL MANAGEMENT AND REHABILITATION APPROACHES FOR PEOPLE WITH POLYNEUROPATHIES | 319 | ||
| Acute Rehabilitation of Acquired Polyneuropathies | 320 | ||
| Long-Term Physical Management and Rehabilitation | 321 | ||
| Self-Management | 321 | ||
| Exercise and Physical Activity Interventions in Polyneuropathy | 321 | ||
| Balance Interventions | 322 | ||
| Orthotic Management | 322 | ||
| Pain and Fatigue Management | 323 | ||
| CASE STUDY | 323 | ||
| Presenting Impairments | 323 | ||
| Muscle Strength and Sensation | 324 | ||
| Gait | 324 | ||
| Balance | 324 | ||
| Pain | 325 | ||
| Physiotherapy Options for Mr V | 325 | ||
| Orthotic Prescription | 325 | ||
| Range of Movement | 325 | ||
| Muscle Strength and Aerobic Exercise | 325 | ||
| Balance | 325 | ||
| Outcome | 325 | ||
| Management of Upper Limb Function | 326 | ||
| Orthotics and Equipment | 326 | ||
| Stretches | 326 | ||
| 3 - Specific Aspects ofManagement | 377 | ||
| 17 - Self-Management | 379 | ||
| INTRODUCTION | 379 | ||
| SELF-MANAGEMENT: WHAT IS IT AND WHY NOW? | 380 | ||
| Defining Self-Management | 381 | ||
| Self-Management Is Not New | 383 | ||
| SELF-MANAGEMENT PROGRAMMES: THEORY AND RESEARCH | 383 | ||
| Understanding Responses to Neurological Disability | 383 | ||
| Social Cognitive Theory and Self-Efficacy – a Critical Factor in Self-Management | 384 | ||
| Stress Coping Model | 385 | ||
| Transtheoretical Model of Behaviour Change and Motivational Interviewing | 385 | ||
| Components of Self-Management Programmes | 386 | ||
| SELF-MANAGEMENT PROGRAMMES: THE EVIDENCE BASE FOR NEUROLOGICAL CONDITIONS | 387 | ||
| Adapting the Self-Management Approach to Neurological Conditions | 387 | ||
| Issues in Self-Management Research | 388 | ||
| Self-Management and Stroke | 389 | ||
| Measurement of Self-Management | 390 | ||
| SUPPORTING SELF-MANAGEMENT: PROVIDING INFORMATION ALONE IS NOT ENOUGH | 391 | ||
| CONCLUSION | 392 | ||
| REFERENCES | 394 | ||
| 18 - Virtual Rehabilitation: Virtual Reality and Interactive Gaming Technologies in Neurorehabilitation | 397 | ||
| INTRODUCTION | 397 | ||
| ROLE OF VIRTUAL REALITY TECHNOLOGIES IN NEUROLOGICAL REHABILITATION | 398 | ||
| VIRTUAL REALITY TECHNOLOGIES WITH POTENTIAL FOR USE IN THE REHABILITATION SETTING | 399 | ||
| Nintendo Wii and Nintendo Wii Fit | 400 | ||
| Microsoft Xbox with Kinect Sensor | 401 | ||
| PlayStation2 EyeToy, PlayStation3 Eye and PlayStation MOVE | 402 | ||
| Head-Mounted Displays | 402 | ||
| Smartphones, Tablets and Apps | 403 | ||
| Customised Software for Rehabilitation | 403 | ||
| Current Evidence | 404 | ||
| PRACTICAL TIPS FOR CHOOSING VIRTUAL REALITY TECHNOLOGIES | 405 | ||
| Choosing Technology | 405 | ||
| Choosing a Virtual Reality Task/Game | 406 | ||
| Client Considerations | 406 | ||
| Resources for Clinicians | 407 | ||
| CONCLUSION | 407 | ||
| CASE HISTORY | 407 | ||
| REFERENCES | 408 | ||
| 19 - Falls and Their Management | 411 | ||
| INTRODUCTION | 411 | ||
| FALLS AND FALLING | 411 | ||
| Extent of the Problem | 413 | ||
| Causes of Falling | 413 | ||
| Consequences of Falling | 414 | ||
| ASSESSING PEOPLE WHO HAVE FALLEN | 414 | ||
| Interviewing Patients and Carers | 416 | ||
| Falls Diaries | 416 | ||
| Observing Fall-Related Activities | 417 | ||
| Video | 418 | ||
| Standard Tests and Outcome Measures | 418 | ||
| PREVENTING FALLS AND MANAGING PEOPLE WHO HAVE FALLEN | 419 | ||
| The Person at Risk for Falling | 419 | ||
| Exercise and Other Training Programmes | 419 | ||
| Continued Physical Activity | 421 | ||
| Movement Strategies | 422 | ||
| External Environment | 424 | ||
| Engagement With Fall Prevention | 424 | ||
| Not Every Fall is Preventable | 425 | ||
| EFFECTIVE FALLS SERVICES AND TEAMS | 425 | ||
| Service Models | 425 | ||
| A Multifactorial Approach | 425 | ||
| CONCLUSION | 425 | ||
| REFERENCES | 426 | ||
| 20 - Physical Activity and Exercise in Neurological Rehabilitation | 433 | ||
| NEUROLOGICAL CONDITIONS | 433 | ||
| PHYSICAL ACTIVITY | 434 | ||
| Exercise | 435 | ||
| Fitness | 435 | ||
| Physical Activity, Exercise and Fitness in Long-Term Neurological Conditions | 435 | ||
| Considerations for Prescribing Neurological Conditions | 436 | ||
| Stage/Severity of Disease | 436 | ||
| Condition Progression | 436 | ||
| Neurological Symptoms | 436 | ||
| Likelihood of Secondary Conditions | 436 | ||
| Exercise Response/Recovery | 436 | ||
| ASSESSMENT AND MONITORING OF EXERCISE | 437 | ||
| Safety | 437 | ||
| International Classification of Function Model and Exercise, Physical Activity and Fitness | 437 | ||
| Assessment of Key Body Functioning Fitness Components | 437 | ||
| Assessment and Monitoring of Health | 438 | ||
| Monitoring Symptoms | 438 | ||
| Monitoring Participation, Health and Well-being | 438 | ||
| Monitoring Exercise and Physical Activity Levels | 438 | ||
| Wider Assessment | 439 | ||
| Exercise Prescription | 439 | ||
| Exercise Prescription Setting | 439 | ||
| Exercise Prescription Content | 439 | ||
| Limit to Capacity | 439 | ||
| Exercise Response and Recovery | 439 | ||
| Frequency | 439 | ||
| Intensity | 439 | ||
| Timing | 440 | ||
| Type | 440 | ||
| Reducing Sedentary Time | 440 | ||
| Barriers and Facilitators | 440 | ||
| Changing Behaviour | 440 | ||
| Conclusion | 441 | ||
| Summary of Exercise Prescription Guidance | 442 | ||
| REFERENCES | 442 | ||
| 21 - Vestibular Rehabilitation | 445 | ||
| INTRODUCTION | 445 | ||
| EPIDEMIOLOGY | 446 | ||
| ANATOMY AND PHYSIOLOGY OF THE VESTIBULAR SYSTEM | 446 | ||
| VESTIBULAR OCULAR REFLEX AND VESTIBULOSPINAL REFLEX | 449 | ||
| PATHOPHYSIOLOGY | 449 | ||
| PERIPHERAL DISORDERS | 449 | ||
| CENTRAL DISORDERS | 451 | ||
| Vestibular Migraine | 451 | ||
| PERSISTENT POSTURAL PERCEPTUAL DIZZINESS | 451 | ||
| DIAGNOSIS | 452 | ||
| MEDICAL AND SURGICAL MANAGEMENT | 452 | ||
| Ménière’s Disease | 454 | ||
| Persistent Benign Paroxysmal Positional Vertigo | 454 | ||
| Acoustic Neuromas | 454 | ||
| ASSESSMENT | 455 | ||
| Physical Impairments | 455 | ||
| Functional Ability | 455 | ||
| Outcome Measures | 456 | ||
| PROGNOSIS | 457 | ||
| INTERVENTIONS | 460 | ||
| Vestibular Paresis/Hypofunction | 460 | ||
| Balance and Gait Reeducation | 462 | ||
| Management of Benign Paroxysmal Positional Vertigo | 464 | ||
| Secondary Problems | 464 | ||
| OTHER CONSIDERATIONS | 464 | ||
| Multidisciplinary Team | 464 | ||
| Specialist Centres and Support Groups | 464 | ||
| Support Groups | 466 | ||
| CONCLUSION | 466 | ||
| CASE STUDIES | 466 | ||
| Case 1: Peripheral Vestibular Neuritis | 466 | ||
| Case 2: Benign Paroxysmal Positional Vertigo | 467 | ||
| REFERENCES | 467 | ||
| 22 - Pain Management | 473 | ||
| INTRODUCTION | 474 | ||
| Contemporary Views on Pain | 474 | ||
| Patient Experience of Pain | 474 | ||
| Types of Pain | 474 | ||
| Epidemiology of Pain Associated with Neurological Conditions | 475 | ||
| ANATOMY AND PATHOPHYSIOLOGY OF PAIN | 475 | ||
| SIGNS AND SYMPTOMS AND CLINICAL PRESENTATION | 477 | ||
| Musculoskeletal Pain | 477 | ||
| Neuropathic Pain | 478 | ||
| Peripheral Neuropathic Pain | 478 | ||
| Central Neuropathic Pain | 478 | ||
| Progressive Neurological Conditions | 478 | ||
| Multiple Sclerosis | 478 | ||
| Parkinson’s | 479 | ||
| Huntington’s Disease | 479 | ||
| Amyotrophic Lateral Sclerosis: Motor Neurone Disease | 479 | ||
| Other Neurological Diseases | 479 | ||
| Central Nervous System Damage | 479 | ||
| Stroke | 479 | ||
| Traumatic Brain Injuries | 480 | ||
| Spinal Cord Injuries | 480 | ||
| DIAGNOSIS, ASSESSMENT AND PROGNOSIS | 481 | ||
| Subjective Assessment | 481 | ||
| Red and Yellow Flags | 482 | ||
| Factors that Influence the Reliability of Subjective Pain Report | 482 | ||
| Objective Assessment | 482 | ||
| PRINCIPLES OF PAIN MANAGEMENT | 482 | ||
| Pharmacological Management of Pain | 483 | ||
| Surgical Management of Pain | 485 | ||
| Electrophysical Techniques | 485 | ||
| Manual Therapy | 485 | ||
| Physical Activity and Exercise | 486 | ||
| Splinting, Casting and Bracing | 486 | ||
| Invasive Electrical Stimulation Techniques | 486 | ||
| Noninvasive Electrical Brain Stimulation Techniques | 487 | ||
| Transcutaneous Electrical Nerve Stimulation | 487 | ||
| Acupuncture | 487 | ||
| Therapeutic Ultrasound | 487 | ||
| Thermal Therapies | 488 | ||
| Low-Level Laser Therapy | 488 | ||
| Visual Feedback, Motor Imagery and Body Illusions | 488 | ||
| Psychological Approaches | 488 | ||
| Self-Management | 489 | ||
| Setting Treatment Goals | 490 | ||
| Evaluating Response to Treatment | 490 | ||
| Strategies to Improve Treatment Effect | 490 | ||
| CONCLUSIONS | 491 | ||
| CASE STUDIES | 491 | ||
| Case 1: Diabetic Neuropathic Pain | 491 | ||
| Case 2: Phantom Limb Pain | 492 | ||
| REFERENCES | 493 | ||
| 23 - Clinical Neuropsychology in Rehabilitation | 499 | ||
| INTRODUCTION | 499 | ||
| NEUROPSYCHOLOGICAL ASSESSMENT | 500 | ||
| Cognitive Functions | 500 | ||
| Assessment of Emotional and Behavioural Adjustment | 501 | ||
| Affective and Mediating Factors | 501 | ||
| Assessment of Outcomes and Quality of Life | 502 | ||
| NEUROPSYCHOLOGICAL INTERVENTIONS | 502 | ||
| Cognitive Interventions | 503 | ||
| Behavioural Interventions | 503 | ||
| Psychotherapy: Staff, Team and Organisational Support and Research | 504 | ||
| NEUROPSYCHOLOGICAL CONSEQUENCES OF NEUROLOGICAL DISORDERS | 504 | ||
| Age of Acquisition and Neuroplasticity | 504 | ||
| Focal Versus Diffuse | 504 | ||
| Acute Versus Chronic | 504 | ||
| Progressive Versus Static | 505 | ||
| Site and Lateralisation | 505 | ||
| Traumatic Brain Injury | 505 | ||
| Stroke | 505 | ||
| Hypoxic Brain Injury | 505 | ||
| Degenerative Conditions | 506 | ||
| Spinal Injuries | 506 | ||
| Neuropsychological Disorders of Movement | 506 | ||
| Apraxia | 509 | ||
| Neglect | 509 | ||
| Functional Disorders | 509 | ||
| PROCESS OF REHABILITATION | 510 | ||
| CONCLUSIONS | 510 | ||
| Psychological Adjustment | 510 | ||
| ACKNOWLEDGEMENTS | 510 | ||
| REFERENCES | 511 | ||
| 24 - Complex Case Management | 513 | ||
| INTRODUCTION | 513 | ||
| MUSCULOSKELETAL INTEGRATION IN NEUROLOGICAL UPPER LIMB APPROACH -MOVEMENT AND MUSCLE ACTIVATION OF THE SHOULDER COMPLEX AFTER STROKE: A MUSCULOSKELETAL VIEW ON POSTSTROKE SHOULDER ASSESSMENT AND REHABILITATION | 514 | ||
| Evaluation of the Shoulder Complex from a Musculoskeletal Viewpoint | 514 | ||
| Musculoskeletal Management of Shoulder Complex Dysfunctions After Stroke | 520 | ||
| Illustration by Means of a Case Presentation | 521 | ||
| Summary | 522 | ||
| SPASTICITY: WHEN AND HOW TO TREAT THE CLINICAL PROBLEM IN NEUROLOGICAL REHABILITATION | 522 | ||
| Upper Motor Neurone Syndrome | 523 | ||
| Spasticity | 523 | ||
| Principles of Management | 524 | ||
| Physical and Pharmacological Treatment | 524 | ||
| Evaluation of Outcome | 526 | ||
| Summary | 528 | ||
| ON THE ROAD WITH MULTIPLE SCLEROSIS - CHALLENGES IN SCREENING, ASSESSMENT AND TRAINING OF DRIVING | 528 | ||
| Driving as an Important Instrumental Activity ofDaily Living | 528 | ||
| Aspects of the Driving Evaluation Process | 529 | ||
| Case Presentation | 531 | ||
| REFERENCES | 534 | ||
| Answers to Self-Assessment Questions | 539 | ||
| CHAPTER 1 | 539 | ||
| CHAPTER 2 | 540 | ||
| Sit to Stand | 540 | ||
| Rolling and Getting Out of Bed | 540 | ||
| Reach and Grasp | 540 | ||
| Posture and Balance | 541 | ||
| CHAPTER 4 | 541 | ||
| CHAPTER 5 | 542 | ||
| CHAPTER 6 | 543 | ||
| CHAPTER 7 | 543 | ||
| CHAPTER 8 | 543 | ||
| CHAPTER 9 | 544 | ||
| CHAPTER 10 | 544 | ||
| CHAPTER 11 | 545 | ||
| Hereditary Ataxia | 546 | ||
| HSP (Henoch-Schonlein Purpura) | 546 | ||
| CHAPTER 13 | 547 | ||
| CHAPTER 14 | 547 | ||
| CHAPTER 15 | 547 | ||
| CHAPTER 16 | 548 | ||
| CHAPTER 17 | 548 | ||
| CHAPTER 18 | 549 | ||
| CHAPTER 19 | 550 | ||
| CHAPTER 20 | 550 | ||
| CHAPTER 21 | 551 | ||
| CHAPTER 22 | 551 | ||
| CHAPTER 23 | 552 | ||
| CHAPTER 24 | 552 | ||
| Abbreviations | 555 | ||
| INDEX | 559 | ||
| A | 559 | ||
| B | 560 | ||
| C | 561 | ||
| D | 562 | ||
| E | 562 | ||
| F | 563 | ||
| G | 564 | ||
| H | 564 | ||
| I | 565 | ||
| J | 566 | ||
| K | 566 | ||
| L | 566 | ||
| M | 566 | ||
| N | 568 | ||
| O | 569 | ||
| P | 569 | ||
| Q | 571 | ||
| R | 571 | ||
| S | 572 | ||
| T | 575 | ||
| U | 576 | ||
| V | 576 | ||
| W | 576 | ||
| IBC | ES2 |