Physical Therapy in

Neuromuscular Conditions
 General Description

 Neuromuscular System Conditions

– Focus is on patient’s function/functional
abilities
– Causes may be:
• Inherited
• Acquired
 General Description

 Neuromuscular System Conditions

– Can affect any age
– Conditions may be:
• Lifelong
• Temporary
– Effects may be:
• Reversible
• Static
• Progressive
 Common Conditions

 Stroke / Cerebrovascular Accident (CVA)

 Traumatic Brain Injury (TBI)
 Spinal Cord Injury (SCI)
 Vestibular Disorders
 Multiple Sclerosis (MS)
 Parkinson’s Disease (PD) /Parkinsonian
Syndromes
 Amyotrophic Lateral Sclerosis (ALS)
 Examination

 Patient History
– Usually, patients have been seen by physician
specialists first
• Review all pertinent medical records
• Review and understand results of ancillary
diagnostic tests
– Radiographs (X-rays)
– Computed (Axial) Tomography (CAT) scans
– Magnetic Resonance Imaging (MRI)
– Angiography
– Lumbar Puncture (LP)
– Electrodiagnostic tests (EMG/NCV)
 Examination

 Patient History
– Interview can be focused on:
• Premorbid (pre-disease) lifestyle and functional
level
• Cognitive / communicative abilities
• Prioritize / concerns regarding patient’s goals
 Examination

 Systems Review
– Evaluate role, if any, problems in other systems
that may affect overall functional limitations
 Examination

 Tests and Measures

– Cognition
– Communication
– Functional activities
– Motor control
– Tone
– Sensation and perception
– Range of motion
 Evaluation

 Based on evaluation of findings from a

comprehensive examination, identify:
– Impairments
– Activity limitations
– Participation restrictions
 Diagnosis and Prognosis

 Diagnosis
– Based on identifying a pattern from the
identified problems in evaluation and
classifying to identified pattern(s)
 Diagnosis and Prognosis

 Prognosis
– Based on identified problems, develop goals to
address each problem
 Diagnosis and Prognosis

 Plan of Care
– Based on goals formulated
– Interventions are identified by Evidenced Based
Practice
 Procedural Interventions

 Nervous System
– Previously believed that:
• Once damaged/affected, regeneration, and thus
return of function, were very poor
 Procedural Interventions

 Nervous System
– Currently, belief is that:
• Because of its plasticity and redundancy, it is
capable of adaptation and modification after injury
or disease, and
• Peripheral nervous system also has additional
capacity to regenerate
– Thus, creative treatment approaches are
necessary to accommodate these characteristics
of the nervous system
 Traditional Approaches

 Rood’s Approach
 Proprioceptive Neuromuscular Facilitation
(PNF)
 Brunnstrom Approach
 Neurodevelopmental Approach
 Current Approaches

 Motor Control and Motor Learning

 Constraint-Induced Movement Therapy
 Locomotor Training