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275 Cards in this Set
- Front
- Back
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Left CVA
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-slow movements
-aphasia -facial weakness, swallowing difficulty, trouble speaking -trouble with learning and memory -slow in activities |
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Right CVA
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-poor decision making
-short term memory loss -lack of insight into safety deficits/limitations -impulsivity -decreased attention span -facial weakness, difficulty speaking and swallowing |
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Homonymous Hemianopsia
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Visual field loss affecting both eyes; half of visual field is gone, such as right side of visual field being gone on both eyes.
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Barthel Index
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Measures functioning in feeding, bathing, grooming, dressing, bowel, bladder, toilet use, transfer, mobility, and stairs with score of 0 (unable), 5 (needs help) and 10 (independent)
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Functional Capacity Evaluation
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Set of tests and observations to determine one's ability to function in an objective manner, usually for employment purposes
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Rood: Inhibition techniques to quiet, relax, or dampen overactive muscle groups
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1. Gentle rocking
2. Slowing stroking over posterior rami of spine. 3. Slow rolling from supine to sidelying and back. 4. Tendinous pressure over muscle insertion. 5. Maintained stretch. 6. Neutral warmth such as blanket wrapping 7. Prolonged icing |
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Rood: Facilitation techniques to stimulation or maintain control of a muscle group
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1. Fast brushing via battery operated brush
2. Stretch/tendon tapping 3. High frequency vibration 4. Quick icing 5. Heavy joint compression applied manually and longitudinally through the joint in weight-bearing position 6. Resistance |
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Burn positioning
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Avoid the position of comfort, as it is often a position that is flexed, protective, and leads to contractures
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Dimensions to allow for a 360 degree turning radius using a wheelchair
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5x5 feet
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Is chickenpox an airborne, droplet, or other spread disease
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airborne
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Isotonic exercises
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the only type of exercises approved for those with cardiac conditions or precautions.
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Offset hinges
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can increase interior doorway width by 2 inches
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Manual muscle score of 5
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normal
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MMS 4
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Good
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MMS 3+
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Fair+
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MMS 3
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Fair
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MMS 3-
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Fair-
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MMS 2+
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Poor+
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MMS 2
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Poor
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MMS 2-
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Poor-
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MMS 1
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Trace
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Cardiac MET 1-3
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sponge bathing, grooming, light or seated housework, bedside mobility, lifting under 10 lbs
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Cardiac METs 3-4
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shower, climb stairs, heavy housework (laundry, mop, iron, vaccum), bowl, golf, archery, fishing, lifting under 20 lbs
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Cardiac METs 4-5
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sexual activity, heavy housework (gardening, shovel snow, rake leaves, mow, wash car, wax floor, move furniture), softball, fast walking, lifting under 50 lbs
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Uses radial palmar grasp
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6 months
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Rakes tiny objects
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7 months
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Transfers toys
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7 months
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Radial digital grasp
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9 months
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pad to pad grasp
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9 months
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pincer grasp
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10 months
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gives toy when asked
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11 months
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neat/superior pincer grasp
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12 months
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disk, cylindrical, and spherical grasp
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18-36 months
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palmer supinated grasp
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24 months
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digital pronate grasp
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24-36 months
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Static tripod grasp
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3 1/2- 4 years
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dynamic tripod grasp
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4-6 years
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Scribbles with marker
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9-12 months
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Releases 1-inch objects into container, stacks 2 to 6 one inch blocks, unscrews bottle tops
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1-2 years
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Stacks 10+ blocks
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6+ years
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Uses scissors to cut on a line
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3 years
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Uses scissors to cut simple shapes
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4 years
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imitates scribbling
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10-12 months
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scribbles spontaneously
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15 months
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Imitates vertical line
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24 months
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Imitates horizontal line and circle
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2 1/2 years
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Copies vertical line, horizontal line, circle
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3 years
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Copies a cross, square, left and right diagonal lines, some letters and numbers, may be able to write own name
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4-5 years
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Copies a triangle, prints own name, copies most uppercase and lowercase letters
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5-6 years
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Snips with scissors
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3 years
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Cuts a circle
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4 years and 1-2 months
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Cuts a square
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4 1/2 years
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mature use of scissors
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5-6
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Lifts head briefly in prone
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1 month
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props on forearms
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3 months
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rolls prone to supine
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3 1/2 months
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props on hands and pulls to sit
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4 1/2 months
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pivots in prone and prop sits
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5 1/2 months
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sits by self; rolls supine to prone; stands with hands held
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6 1/2 months
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bells crawls; pulls to stand
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8 1/2 months
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creeps on hands and knees
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9 1/2 months
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stands alone momentarily; pivots in sitting
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10 1/2 months
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walks 2-3 steps; stands alone well
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1 year (12 months)
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Opens mouth when spoon presented
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4-7 months
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takes baby food from spoon; puts objects in mouth;
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5-7 months
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drinks from cup held by adult
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6 months
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attempts to hold bottle; can anticipate spoon or bottle;
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6-8 months
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holds and tries to eat cracker; consumes soft foods that dissolve in mouth; grabs at spoon but bangs it or sucks at end; can do hand to mouth actions with objects
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6-9 months
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reaches for spoon when presented; bangs spoon; stirs in imitation
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9 months
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finger feeds self a portion of meal consisting of soft table foods
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9-13 months
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Dips spoon in food; brings spoonful of food to mouth; uses pronated grasp on spoon; holds cup and drinks with some spillage; drinks from a straw; recognizes tool function and uses appropriately
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12-14 months
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scoops food with spoon and brings to mouth; demonstrates precise movements
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15-18 months
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drinks from a cup
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18-24 months
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holds small cup in one hand
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20-22 months
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brings spoon/fork to mouth palm up
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24 months
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demonstrates interest in using a fork; may stab at food pieces; proficient at spoon use; pours from small cup; tolerates various textures in mouth
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24-30 months
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uses fork to stab food; self-feeding; little to no spillage
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36 months
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D-1 flexion
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Starts with arm crossing midline, ends with arm on same side
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D-1 extension
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Starts with arm crossing midline, ends with arm on same side (example: right arm stretched over left shoulder then ending extended on right side)
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D-2 flexion
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starts with arm on same side and ends with arm crossing midline
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D-2 extension
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Starts with arm on same side and end with arm crossing midline
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Finger DIP ROM
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0-80
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Finger PIP ROM
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0-100
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Finger MCP ROM
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(0-45 hyperextension)- 90
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Rancho Level 8
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-learns at a slower rate
-ready for driving, job training -poor judgement in new or stressful situations -may need guidance with decisions -begins to compensate for problems |
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Rancho Level 7
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-Follows a set schedule
-Can do a self-care routine without help -Problems planning, starting, and carrying through activities -Trouble paying attention in distracting or stressful situations -Not aware of deficits and impacts on future goals |
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Rancho Level 6
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-Confused, especially with details
-Follows a schedule with some assistance -Becomes confused by changes in routine -Pays attention for up to 30 minutes -Knows month and year -Trouble with multiple steps, noisy or distracting activities (i.e. outdoor activities near crowds or busy traffic) |
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Rancho Level 5
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-Pay attention for only a few minutes
-Can not start or complete self-care independently -Not oriented to date, time, or place -Unaware of deficits, injury -Overloaded/restless when tired, too many people or distractions present -Tries to fill memory gaps by making up things -Perseverates |
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Allen's Cognitive Level- 1
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Able to use protective responses; conscious responses to external environment are minimal
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Allen's cognitive level-2
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-Unable to imitate running stitch
-May assist caregiver with simple tasks, -Attends to large barriers in environment |
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Allen's Cognitive Level- 3
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-Able to perform Running stitch x3
-Able to handle objects -Follows 1-step cues -Performs activities with repetitive movement patterns |
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Allen's Cognitive Level-4
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-Able to perform whip stitch x3
-Able to complete a goal -Can perform established routines - |
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Allen's cognitive level-5
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-Able to perform single Cordovan stitch with overt trial and error
--No visual cues needed -Explores new actions -Makes fine motor adjustments |
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Allen's Cognitive Level-6
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-Able to perform single Cordovan stitch with mental trial and error
-Able to think about hypothetical situations -thinks before actions -can determine safety hazards |
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Areas innervated by the median nerve
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volar side: all but pinkie
dorsal side: all but thumb and pinkie |
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Population who would benefit most from task group approach.
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Individuals with substance abuse problems
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ROM limits for cervical rotation.
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0-60 degrees
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ROM limits for thoracic and lumbar spine flexion.
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0-80 degrees.
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ROM lateral flexion of the spine.
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0-40 degrees.
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Dystonia
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Neurologic condition; symptoms include twisting, repetitive movements and abnormal postures or positions
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Brown Sequard syndrome
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hemisection lesion of the spinal cord leading to same-side motor loss and opposite-side loss of sensitivity to pain and temperature
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Functionality: C-5 SCI
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-can use dorsal wrist splint with universal cuff
-may use suspension sling or mobile arm support -assistance with grooming, dressing, bathing, transfers, |
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Functionality: C-6 spinal cord injury
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-Wrist extension, elbow flexion
-IND transfer toilet to wheelchair -can bend forward -wrist tenodesis with splint |
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Functionality: C-7 spinal cord injury
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-Wrist flexion, elbow extension, finger extension
-Mod I for feeding, dressing, bathing, grooming, toileting -transfers IND |
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Functionality: T-6 spinal cord injury
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-Increased endurance and respiratory reserve
-IND ADLs -can ambulate with long leg braces but very hard and not likely |
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Functionality: T-12 spinal cord injury
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-IADLs IND
-Ambulates with long leg braces and crutches -wheelchair for energy conservation |
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Parietal lobe damage= deficits in...
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-touch
-proprioception -pain -temperature -self-perception and organization |
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Thalamus damage= deficits in..
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-communications regarding sensory information
-altered states of arousal -memory -speech -orientation -apathy |
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Hypothalamus damage= deficits in...
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-appetite
-thirst -circadian rhythem -emotion |
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Cerebellum damage= deficits in...
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-fine motor control
-coordination |
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Reticular formation damage=
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sleeping longer periods
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Cubital tunnel syndrome
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compression of ulner nerve at cubital tunnel at elbow
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Components of biomechanical activity analysis
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1. Activity
2. Steps 3. Precautions 4. Positions 5. Repetitions 6. ROM 7. Strength 8. Type of contractions |
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Loss of intrinsic plus grasp is associated with damage to what nerves
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median and ulnar combined
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Clinical signs, low level deep branch radial nerve injury.
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loss of finger and thumb extension, normal sensation
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Signs of high level median nerve injury.
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-Loss of wrist and thumb flexion.
-Loss of active pronation. -Loss of palmar abduction -Loss of opposition |
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Signs of low level median nerve injury
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-Flattened thenar eminence
-Loss of thumb flexion, opposition, and palmar abduction |
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Signs of a high-level ulnar nerve lesion.
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-Wrist flexion abnormal.
-Hyperextension of the MCP joint of ring and pinkie fingers (Bishop hand?) |
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Signs of low level ulnar nerve lesion.
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-Clawing of the MCP of the pinkie and ring fingers
-Flexion of the DIP and PIP of the pinkie -Wrist flexion normal |
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Splint for median nerve palsy.
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Splint to position thumb in palmar abduction and opposition.
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Splint for combined median and ulnar nerve injury
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figure of 8 or dynamic
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Ulnar nerve palsy splint
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Splint to prevent MCP hyperextension
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Radial nerve palsy splint
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dynamic wrist, finger and thumb extension
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Splint for median nerve injury
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C-bar or opponens
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Splint for tendinitis/tenosynovitis
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volar or dorsal, 20-30 degrees extension
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Splint for rheumatoid arthritis
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volar in up to 30 degrees extension or ulnar drift
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ADA- Title 3
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Public accommodations and accessible design
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Task group
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To increase participants' awareness of needs, ideas, feelings, feelings, and behaviors through engagement in group activities. This occurs through working through problems that arise through choosing and completing group tasks/activities
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Egocentric-cooperative groups
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Enable members to select and implement a long range activity which requires group interactions; enables members to identify and meet needs of themselves, others
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Cooperative group
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enables members to engage in group activities which facilitate free expression of ideas and feelings and which allow members to develop trust, bonds, and meet socio-emotional needs
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Thematic group
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-Assists members in acquiring knowledge or skills to perform a specific activity
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Developmental groups
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continuum made up of all the other social groups
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Instrumental group
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helps group members function at their highest level for as long as possible and meets mental health needs
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Cluster A personality disorders
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schizophrenia, paranoid, schizotypal, schizoid
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Symptoms of borderline personality disorder
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-impulsive
-suicidal -self mutilation -mood instability -fear of abandonment -inappropriate affect |
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Dyspraxia
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difficulty planning new motor tasks
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Domains of practice framework
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1. performance areas
2. Performance skills 3. context 4. Performance patterns 5. activity demands 6. client factors |
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Performance skills (practice framework)
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1. motor skills
2. process skills 3. communication |
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Process skills (practice framework)
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1. Energy
2. Knowledge 3. Time 4. Organizing space/objects |
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Activity demands (practice framework)
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1. objects used and their properties
2. space demands 3. social demands 4. sequencing and timing 5. required actions 6. required body functions 7. required body structures |
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Sensorimotor development in the neonatal period.
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1. Tactile, proprioceptive, and vestibular input needed for body scheme development.
2. vestibular input defines arousal. 3. visual system develops as infant focus on objects 10" or less from face |
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Sensorimotor integration development in first 6 months?
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1. -Infant movement patters progress from reflexive to voluntary and goal directed
2. Vestibular, proprioceptive, and visual integrate for postural control 3. Visual and tactile systems become integrated to lay foundation for eye-hand coordination |
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Sensorimotor development from 6-12 months
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-Fine motor and motor planning develop due to refinement of tactile and proprioceptive senses
-Midline skills and crossing midline -Primitive self-feeding |
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Dressing milestones 3 years
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-Puts on shirt w/ Min A
-Zips and unzips -Pulls down pants I -Buttons large buttons |
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Dressing milestones 3 1/2 years
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-Works snaps or hooks in front
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Dressing milestones 4 years
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-Removes pullover I
-Laces shoes -Identifies front and back |
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Disorganized type schizophrenia
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Primitive, disinhibited, and disorganized behavior
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Sensory retraining
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-Sensory Retraining- learn the meaning of new sensation
1. vigorous, generalized cutaneous stimulation (Ex: rub affected area briskly with terrycloth) 2. cognitive cueing (Ex: OT & pt. discuss stimuli) 3. feedback (Ex: visual feedback) -Compensatory Techniques: visual, thermometers |
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Reisburg stage 3
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-Beginning signs and deficits are noted
-difficulty negotiating directions to new location -difficulty completing complex tasks |
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Reisburg stage 4
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Deficits noted in all IADL
-Increasingly forgetful -Unable to follow/sequence written cues -unable to perform challenging, familiar activities -Cannot manage at home without assistance -Difficulty word finding |
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Reisburg stage 5
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Person cannot function independently
-poor judgement -Difficulty with all decision making -forgets to take care of hygiene |
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Moro reflex
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Onset Age: 28wks
Integration Age: 4-6mo Stimulus:Rapidly drop infant's head backward Response: First phase:arm extension/abduction, hand opening Second phase:arm flexion and adduction |
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Traction
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Onset Age: 28wks
Integration Age: 2-5mo Stimulus: Grasp infant's forearms and pull-to-sit Response:complete flexion of upper extremities |
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Plantar reflex
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Onset Age: 28wks
Integration Age: 9mo Stimulus:Apply pressure with thumb on the infant's ball of the foot Response:Toe flexion |
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Galant reflex
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Onset Age: 32wks
Integration Age: 2mo Stimulus: Hold infant in prone suspension, gently scratch or tap alongside the spine with finger, from shoulders to buttocks Response:lateral trunk flexion and wrinkling of the skin on the stimulated side |
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Asymmetric tonic neck reflex
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Onset Age: 37wks
Integration Age: 4-6mo Stimulus:Fully rotate infant's head and hold for 5 sec Response: extension of extremities on the face side, flexion of extremities on the skull side |
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Palmar grasp reflex
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Onset Age: 37wks
Integration Age: 4-6 mo Stimulus:Place examiner's finger in infant's palm Response: finger flexion;reflexive grasp |
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Tonic Labyrinthine-Prone
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Onset Age: >37wks
Integration Age: 6mo Stimulus:place infant in prone Response:increased flexor tone |
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Tonic Labyrinthine-Supine
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Onset Age: >37wks
Integration Age: 6mo Stimulus:place infant in supine Response:increased extensor tone |
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Labyrinthin/Optical (head) Righting Reflex
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Onset Age: birth-2mos
Integration Age: persists Stimulus:hold infant suspended vertically and tilt slowly (about 45 degrees) to the side, forward, or backward Response:upright positioning of the head |
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Landau reflex
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Onset Age: 3-4 mos
Integration Age: 12-24 mos Stimulus: Hold infant in horizontal prone suspension Response: complete extension of head, trunk, and extremities |
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Downward parachute
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Onset Age: 4mos
Integration Age: Persists Stimulus: Rapidly lower infant toward supporting surface while vertically suspended Response: extension of the lower extremities |
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Prone tilting
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Onset Age: 5mos
Integration Age: persists Stimulus:after positioning infant in prone, slowly raise one side of the supporting surface Response:Curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms and legs |
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Neck Righting
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Onset Age: 4-6 mos
Integration Age: 5yrs Stimulus: Place infant in supine and fully turn head to one side Response: Log rolling of the entire body to maintain alignment with the head |
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Body Righting
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Onset Age: 4-6 mos
Integration Age: 5yrs Stimulus: Place infant in supine, flex one hip and knee toward the chest and hold briefly Response: Segmental rolling of the upper trunk to maintain alignment |
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Symmetric tonic neck reflex
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Onset Age: 4-6mos
Integration Age: 8-12 mos Stimulus: Place infant in the crawling position and extend the head Response: flexion of hips and knees |
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Sideward Parachute
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Onset Age: 7mo
Integration Age: persists Stimulus: Quickly but firmly tip infant off balance to the side while in the sitting position Response: arm extension and abduction to the side |
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Supine and sitting tilting
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Onset Age: 7-8mos
Integration Age: persists Stimulus: after positioning infant in supine or sitting, slowly raise one side of the supporting surface Response: curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms and legs |
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Backward Parachute
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Onset Age: 9-10 mos
Integration Age: persists Stimulus: Quickly but firmly tip infant off-balance backward Response: backward arm extension or arm extension to one side |
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Quadruped tilting
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Onset Age: 9-12 mos
Integration Age: persists Stimulus:after positioning infant on all fours, slowly raise one side of the supporting surface Response:Curving of the spine toward the raised side (opposite to the pull of gravity) |
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Standing tilting
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Onset Age: 12-21mos
Integration Age:persists Stimulus: after positioning infant in standing, slowly raise one side of the supporting surface Response:Curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms and legs |
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Splint for spasticity
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cone splint or spasticity splint
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Multiple sclerosis types
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1. Relapsing remitting
2. Secondary progressive 3. Primary Progressive 4. Progressive relapsing |
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Home Health treatment guidelines
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-Presence of a medical OR psychiatric condition
-Homebound status due to functional limitation must be clearly described |
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Medicare reimbursement requirements for OT
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1. describe clearly the specific skilled care rendered (#1 cause for retroactive denial). Notes must show therapeutic intervention. Example: decreasing extensor tone to accomplish dressing rather than just dressing.
2. Care must match diagnosis and physician's order 3. Must be unique to OT and not sound like PT/SLP 4. Document honestly but in such a way that indicates the need for further care 5. practical improvement should be noted with functional change. If there is a reason for no change, document it, or discharge. 6. Demonstrate that patient is making functional improvement in reasonable and predictable period of time. 7. Medicare doesn't reimburse for maintenance 8. Must be reasonable and necessary (i.e. lessen staff care needed, increase independence, safety, function) |
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CVA position in sidelying for hemiplegia and subluxed shoulder
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Protracted with arm forward on pillow and the elbow extended or slightly flexed
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Direct oral motor intervention
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utilizes a bolus
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Indirect oral motor intervention
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does not include use of a bolus
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Akathisia
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restless, urgent need for movement
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Conduct disorder versus oppositional defiant disorder
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-Conduct disorder is diagnosed in teenage years, more criminal, chronic, dangerous behaviors, antisocial, bullying, set fires, steal, use drugs, lie, place blame,
-Oppositional defiant disorder is less criminal and occurs at a younger age. Very strong willed children who want control, defiant behaviors, benefit more from therapy |
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Associative play
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when children are playing the same game or activity, but not playing together
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Compression garment use for burns
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wear for 24 hours a day for 1-2 years or until scar has matured?
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Airborne precautions
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Wear mask
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Steps of activity or task analysis
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1. Specify exact task or activity to be analyzed
2. Identify and know procedures, tools, materials needed to complete activity/task 3. Analyze activity/task as it is typically performed under ordinary circumstances 4. Analyze activity/task to be certain that all client factors, performance skills and patterns, and activity/task performance components and contexts are considered 5. Select a frame of reference to determine which aspects of activity or task are to be emphasized in analysis |
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Medicare indicators for group membership- individual is able to..
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1. engage willingly in group
2. attend to group guidelines/procedures 3. actively participate in group process 4. benefit from group leadership input 5. Benefit from group membership/peer input 6. Respond appropriately through group process 7. Incorporate feedback 8. Complete activities toward goal attainment 9. Attain greater benefit from the group intervention than from 1 on 1 intervention |
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Close supervision
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daily, face to face contact at site of work
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routine supervision
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face to face contact at least every two weeks at the site of work with interim supervision occurring by other methods such as phone or written communication
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General supervision
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At least monthly face to face contact with supervision available as needed by other means
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Minimal supervision
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provided only on an as needed basis and may be less than monthly
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Who determines amount of supervision
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Supervising therapist
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Dupuytren's disease
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Abnormal thickening of the fascia leading to flexion contractures and sometimes knots or nodules
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Mosey's major types of activity groups
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1.Evaluation
2. Task oriented 3. developmental 4. Thematic 5. Topical 6. Instrumental |
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Dysmetria
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overshooting rom needed for a movement
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Foods for videofluoroscopy procedure
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-do not give foods the client currently has no difficulties eating, skip these
- start at the lowest level then progress to more difficult as possible -thick before thin liquids |
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Placement of materials for adult's with cataracts
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-Lose central vision first, then peripheral (side) gradually
-Individuals with cataracts have increased difficulty with glare -Present to side with no direct lighting to reduce glare if individual has residual vision. |
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Only adaptive equipment covered by Medicare
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3 in 1 commode
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Instrumental groups: activities
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-Reminiscence
-Arts and crafts -music -exercise -dance |
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Froment's sign
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Assesses motor function of the ulnar nerve.
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Akathisia
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urgent, restless need to move
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Akinesia
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loss of voluntary movement
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Wheelchair belt placement
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across the anterior hips
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Capital expenses
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Funds used by a company to acquire or upgrade physical assets such as property or equipment (i.e. driver rehab computer equipment)
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Executive functions
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Problem solving
Planning Memorizing Organizing Strategizing Remembering Time management |
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Presbycusis
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age related hearing loss
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Side effect of electro convulsive therapy (ECT)
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memory loss
Individual can engage in structured tasks 6 hours after session |
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FInger to palm translation emerges
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12-15 months
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palm to finger translation emerges
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2- 2 1/2 years
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Shift skills emerge
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3- 3 1/2 years
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Simple rotation skills emerge
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2-2 1/2 yeras
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Complex rotation skills emerge
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6-7 years
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In-hand manipulation skills with stabilization emerges
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6-7 years
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Denver developmental screen
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- screens areas of fine and gross motor, language, and personal skills
-population= 1 month to 6 years |
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Bayley Scales of Infant Development
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1 to 42 months (3 years 6 months)
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Miller Assessment of Preschoolers
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Sensory and motor abilities, cognitive
Population- 2 years, 9 months- 5 years, 8 months |
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Pediatric Evaluation of Disability Inventory
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6 months- 7 years
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Bruininks-Oseretsky Test of Motor Proficiency
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4-21 years
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Erhardt Developmental Prehension Assessment
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children of all ages
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Peabody Developmental Motor Scales
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birth to 6 years
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Beery-Buktenica Developmental Test of Visual Motor Integration (Beery VMI)
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Short form: 2-7 years
Regular: 2-18 years |
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Motor free visual perceptual test
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4-95 years
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Snaps front snaps
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3 1/2
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Imitates housework
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13 months
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Puts away toys
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2 years
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Carries things without dropping, dries dishes with help, dusts with help, puts away toys with reminders, wipes up spills
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3 years
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Fixes dry cereal/snacks, helps with sorting laundry
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4 years
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Puts toys away neatly, makes a sandwich, takes out trash, makes bed, puts dirty clothes in hamper, answer phone
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5 years
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Does simple errands, cleans sink, washes dishes with help, crosses street safely,
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6 years
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Begins to cook simple meals, puts clean clothes away, hangs up clothes, manages small amounts of money
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7-9 years
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Cooks simple meals with supervision, sets table, begins doing laundry, washes dishes, cares for pets with reminders
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10-12 years
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does laundry, cooks meals
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13-14
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Primary prevention services
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OT services for a population that does not currently have a diagnosis to prevent a diagnosis or problem.
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Secondary prevention
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OT services for a population that currently has a diagnosis or problem to prevent a secondary problem or co-morbidity, such as a fall, from occurring.
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Rotator cuff repair protocol: 0-6 weeks post-op
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-PROM; progress to assisted-active/active ROM
-decrease pain (begin with ice and progress to heat) |
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Rotator cuff repair protocol: 6+ weeks post op
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-Strengthening: begin with isometrics (joint angle and muscle length do not change), progress to isotonic (free weights, etc) below shoulder level
-activity modifications (light ADLs and meaningful role activities, progress as tol.) |
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Rotator cuff repair protocol: 8+ weeks post op
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leisure and work activities
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Ape hand
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due to injury of distal median nerve
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When to use angled/long handled utensils
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Significant ROM limitations
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PNF- rhythmic initiation
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utilized to improve movement initiation. Involves passive rhythmic movement followed by active participation in the same pattern
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PNF- rhythmic rotation
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Utilized when restriction is felt during ROM. When restriction is felt, therapist repeats rotation of all components of the pattern at the point of restriction slowly and gently. As relaxation occurs movement is continued through larger range.
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Cardiac monitoring
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Check pulse/BPM 1 minute before, during, and after and 5 minutes after therapy session/activity
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Heart disease: class 1
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- no limits to activity, no complaints
-max MET 6.5 |
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Heart disease: class 2
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- slight activity limit; comfort at rest; ordinary activity results in fatigue, pain, dyspnea, palpitations
-max MET 4.5 |
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Heart disease: class 3
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-Marked limitation; less than ordinary activity; fatigue, palpitations, dyspnea, and angina pain
-max MET 3.0 |
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Heart disease: class 4
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Inability to carry out physical activity without discomfort
-max MEt 1.5 |
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Terminal device training procedures
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1. Manually guide patient through motions.
2. For transhumeral prosthesis, keep elbow unit locked at 90 degree flexion. 3. Teach terminal device control first, then joint. |
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Joint training procedure
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1. Occurs after terminal device training
2. Manually guide patient through movements 3. Patient listens for click as lock activates (elbow) 4. Have patient exaggerate movements initially |
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SMART goals
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Specific, Measurable, Attainable, Relevant, and Time-Limited
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Wraparound armrest wheelchair
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reduces overall width of wheelchair by one inch, allowing to fit through a 31" door instead of a 32", and cheaper than a customized wheelchair (but not necessarily a standard narrow?)
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Diplegia
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paralysis affecting symmetric parts of the body
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Diplegic cerebral palsy
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characterized by mild lower extremity weakness and minimal to no upper extremity involvement.
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Emergence of diagonal jaw movements (eating)
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7 months
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emergence of rotary chewing and drinking from cup with firm jaw
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1 year
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effective mastification
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9 months
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When should you co-treat with another discipline
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When another discipline has greater knowledge and experience, and could contribute to both your knowledge and benefit your client more than working with you alone.
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Displacement
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Redirection of an emotion such as anger from one "object" (such as a person) to another (i.e. a plate that gets thrown)
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Precautions working with HIV populations
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-Wash hands before and after treatments
-Additional precautions needed only for other circumstances, such as bodily fluids or additional illness |
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Positioning children with hypotonia for feeding
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-neutral pelvic alignment
-avoid head extension -reclining or slightly tilting chair for extreme hyotonia |
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Thromboangitis obliterans (Buerger's disease)
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-Disease resulting in diminished temperature sense, paresthesia, pain, and cold extremities
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-spinal muscle atrophy
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group of inherited disease causing progressive muscle weakness eventually leading to death
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Mechanical principles for dynamic splinting
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-Use a 90 degree angle of pull from the joint
-use a wide, long splint base with rounded edges |
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-pronator teres syndrome (it is indicated by tinel's sign)
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-Compression of the median nerve at the elbow
-Indicated by positive Tinel's sign on forearm -Similar to Carpal Tunnel syndrome in symptoms but forearm is involved is major difference |
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Motor learning stages
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1. Cognitive Stage: learner develops understanding of task
2. Associated stage: learner practices movements, decreases errors 3. Autonomous stage: movements largely error free, vary environments to challenge learner |
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Tonic bite response
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-Provide firm downward pressure using a spoon on the middle aspect of the tongue
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Hyperactive gag reflex treatment
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-Press down firmly on the center of the tongue
-Apply pressure from distal to proximal |
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Intervention strategies for ideational apraxia
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-provide step by step instructions
--use hand over hand guiding techniques -provide opportunities for motor planning and motor execution |
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Neurofunctional approach to remediation of client deficits
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-Used for individuals with acquired neurological impairments
-Focuses on retraining real world skills -Utilizes an overall adaptive approach but incorporates remediation components -Treatment is focused on training-specific functional skills in true contexts |
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Remedial/restorative/transfer of training intervention approach
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-targets cause of symptoms
-assumes improvement in performance components will result in increased skill -Assumes cerebral cortex is malleable and can reorganize -Utilizes tabletop and computer activities such as memory drills, block designs, parquetry, as treatment modalities |
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Compensatory/Adaptive/Functional Intervention Approach
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-Involves repetitive practice of functional tasks
-emphasizes modifications, intact skill training -treats symptoms, not the cause -utilizes environmental adaptation, compensatory strategies, and functional tasks that the individual desires to perform at discharge as the basis of treatment |
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Information Processing Intervention Approach
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-Standard cues are given to determine their effect on performance
-investigative questions are used to provide insight to the underlying deficits -Cues are utilized to draw attention to relevant features of task |
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Dynamic Interactional Approach
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-Emphasizes transfer of info from one situation to the next
-Practice of a targeted strategy with varied tasks and situations (multi contextual) -Emphasizes self-awareness of strengths and deficits as basis of learning -Transfer of learning occurs through graded series of tasks that decrease in similarity -Therapist utilizes awareness questioning to help the individual detect errors, estimate task difficulty, and predict outcomes |
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Capital expense
|
permanent purchases above a fixed amount (i.e. 500-1000); separated from other business items because they depreciate
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Direct expense
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costs related to OT service provision such as salaries, benefits, vacation/sick time, office supplies, and treatment equipment
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Indirect expenses
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costs shared by the setting as a whole such as utilities, house-keeping, and marketing
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Fixed expenses
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Stay the same even when there are changes in the services provided (i.e. rent)
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Variable expenses
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change in direct proportion to the amount of services provided (i.e. splinting materials)
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