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20 Cards in this Set

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Inpatient rehabilitation is recommended for patients with stroke who are _
Too disabled to return home but who have adequate cognition and fitness to participate in therapy 3 hours a day, who need ongoing supervision by nurses and physicians for medical care and education and who have sufficient social support to return home
The most common disability that leads to referral of patient to inpatient rehabilitation is _
Inability to walk safely without physical help
On the basis of Medicare coverage policies, current median stay in inpatient rehab facility is _
16 days
Which percentage of people who undergo inpatient rehab are discharged to their homes
80%
After patient is discharged from inpatient facility does Medicare pay for anything else
Home based rehabilitation for next few weeks if patients are too weak to travel and treatment 2-3 times a week in outpatient facility for period of 1-3 months until patient reaches plateau in terms of gains in activities of daily living
Do the studies show that stroke patients significantly benefit from inpatient stroke unit
YES - results of meta analysis indicate that care in inpatient stroke unit that provides multidisciplinary services, coordinates disability-related medical care and trains caregivers results in fewer deaths, less disability and less need for nursing home placement as compared to hospital care on general wards - may enable extra 5 patients out of 100 to return home
How does inpatient rehabilitation compares to community-based care designed to permit earlier hospital discharge of patients who only need intermittent assistance?
Studies show that patients who are discharged earlier cause greater stress for caregivers but functional outcomes are equal.
What are the goals in training caregivers?
It improves their mood and quality of life, reduces short term financial costs, specifically helpful in caregivers to assist patients in safe swallowing, speech and walking for exercise and in finding solutions for managing daily activities - therapists can monitor and advance this home training
What is the percentage of people whi have impaired expression and comprehension of language after stroke and should receive speech therapy
20%
What is the optimal time to begin speech therapy after stroke
3 months after stroke - smaller but also positive effect when between 3-12 months and even after a year
Do patients benefit more from speech therapists or tranined volunteers
Speech therapists
In speech therapy what correlates directly with magnitude of improvement primarily among patients whose stroke occured less than 6 months previously
Greater intensity of treatment - ranging from 40 to 100 hours (5 hours or more weekly) of treatment targeted to specific impairments
Improvements in targeted language impairments have been associated with _
Changes in activity in cortical regions of the brain associated with language skills
For patients with hemiplegia, initial functional training emphasizes _
compensatory strategies - learn to transfer from bed to wheelchair for mobility and self care is performed one-handed with unaffected arm, overnight splinting maintains wrist and finger extension but may not improve range of motion in affected hand but may not improve ROM or reduce pain.
Initial interventions for affected arm are aimed at _
Eliciting small voluntary or reflexive involuntary movements
Training the arm for functional activities can start when _
Arm and hand begin to overcome gravity
If no hand dexterity is apparent by 6 weeks after stroke, further rehabilitation should emphasize _
Maintaining comfortably mobile arm
Protocols for constraint induced movement therapy are based on the theory that _
Nonuse of arm can result from great effort reuqired to perform tasks with affected hand
The key requirement and the primary limitation to arm therapy is _
Patients must have at least 10 degrees of finger and wrist extension which equates to rather good motor control in order to benefit from therapy
Is acupuncture helpful for arm therapy -
Was not shown effective