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25 Cards in this Set
- Front
- Back
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What data do you need to collect in the acute phase (hospital)
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Current/medical condition (chart review)
Hypothesize potential impairments (based on SL and NL) Associated injuries Time course of INJ and mgt until now Precautions - spinal and medical Med list PMH and reason for referral |
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ROM restrictions for C and upper T-sp vertebral injury
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No PROM above 90 deg shoulder
No SLR above 60 deg (dural pulling and bridging) No ROM to trunk/neck |
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How should you do resisted ex during first 8 weeks?
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Within ROM restrictions, Bilaterally, and shoulders stabilized (supine)
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When can you progress a pt to ex sitting up after C-sp SCI?
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Once stable and in a hard collar (6-8 wks)
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When can you do B shoulder isometrics, B shoulder AROM < 90 deg, and B resistance ex in supine < 10 lbs?
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3 weeks
4 weeks 6-8 weeks |
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Spinal precautions for lower T-sp and L-sp vertebral injury (first 8 weeks)?
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Only log roll
Ex done in supine only Come up to sitting with NO ROTATION Once sitting, make sure hip/knee flex < 90 deg and SLR < 60 deg (body jacket usually stops this) |
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Hip precautions for lower T-sp and L-sp vertebral injury (first 8 weeks)?
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Hip/Knee flex < 90 deg
SLR < 60 deg No resistance ex first 6 weeks |
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Precauations for PT of UEs when recovering from a lower T-sp or L-sp vertebral injury?
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Bilateral resistance so you don't have asymmetrical forces pulling on the spine
Make sure ex are not too difficult to where pt would have to compensate with other mm groups (ie. arch back) |
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Precautions for incomplete and AMB SCI pts?
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No high impact activities
Use AD Avoid spinal rotation |
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How do you know if something is wrong with SCI pt during PT?
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Dec in neurological fxt (mo or sensory)
Pain at fx site with activities |
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What type of personal/social hx do you want to take from pt?
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Prior funcitonal status (work, home, community)
Home env and caregivers DME Anticipated D/C shiot Pt's goals |
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5 key areas to include in your initial examination
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1. Voluntary motor/MSK (ROM, MMT, tone, DTRs)
2. Sensory (pin prick, light touch) 3. Skin (integrity) 4. Respiratory 5. CV (vitals, tolerance for upright, DVT screen) |
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What type of functional activities will you have pt perform in initial examination?
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Sketeltal INJ: self positioning, pressure relief, Assisted transfers and bed mobility (maybe)
No Skeletal INJ: Defintatley transfers and other ADLs |
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What type of secondary shit do you have to keep in mind during your assessment and developing POC?
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Respiratory complications
Contractures Skin breakdown CV complications (ie. orthostatic hypotension) |
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What prevents a pt from going ot next level of care?
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Medical or skeletal instability
Dec tolerance for activities or upright Degree of dependence |
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2 things you develop from your prognosis?
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1. D/C planning
2. Goal setting: often driven by D/C env and assessment |
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What type of goals should you make for your pt?
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1. Participation - one overall goal
2. Activity - fxt skills needed to perform to meet participation goal 3. Impairment - impairments that you need to overcome/substitute for to meet activity and participation goals |
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Examples of impairment goals?
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Pt will be independent with giving caregiver instructions on how to apply ted hose prior to upright activity
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How often should pt be moved and do pressrue relief?
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Moved q2h
Pressure relief q 15 min |
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How do you build tolerance for upright activities?
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Vertical accomidation activity (tilt table), abdominal binders/ted hose
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Laundry list of interventions you will perform with SCI pt?
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Respiratory
Tolerance for upright activity TherEx within spinal precautions Fxt mobility trng Pt and caregiver education |
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What to look for as signs of skin breakdown?
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Redness that does not change in 30 mins
Abrasions Swelling Heat |
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What should you educate pt/caregiver on?
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Mobility (W/C, transfers)
PROM Assisted coughing/breathing tech Pressure relief Skin exam |
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What is different about your PT eval in Post-acute rehab compared to acute rehab?
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Social/personal hx is much longer
Current/medical condition still the same |
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Tests/measures you may want to use in post-acute rehab?
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ASIA
FIM or SCIM or QIF CHART or CHIEF SCATS |
