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36 Cards in this Set
- Front
- Back
In this section... |
ExaminationOutcome MeasuresTreatments
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What does into an examination |
1) Vital Signs - Edu pt on orthostatic hypo tension and autonomic dysreflexia 2) Resp Function- action of diaphragm, cough 3) Skin Integ - Edu pt on skin checks, Pressure Injuries* 4) Muscle Tone - speasticity 5) Reflexes 6) Sensation (ASIA) - sharp/dull, light touch 7) Motor function (ASIA) - MMT 8) Functional Mobility - Bed mobility, transfers, wheelchair mobility |
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C2 skeletal muscle innervation |
Head and neck movements --SCM and Trap |
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C3 skeletal muscle innervation |
Head and neck movements --SCM and Trap Breathing; Elevate Scap --Levator Scap, Diaphragm |
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C4 skeletal muscle innervation |
Breathing; Elevate Scap --Levator Scap, Diaphragm Shoulder Adduction --Rhomboids |
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C5 skeletal muscle innervation |
Breathing; Elevate Scap --Levator Scap, Diaphragm Shoulder Adduction --Rhomboids Elbow Flexion --Supraspin --Serratus Ant --Brachialis --Deltoid --Pec Major (Clavicular) |
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C6 skeletal muscle innervation |
Elbow Flexion --Supraspin --Serratus Ant --Brachialis --Deltoid --Pec Major (Clavicular) Wrist Extension --Supinator --Pronator teres --Lats --Long extensors of wrist and fingers --Pec major (Sternal) |
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C7 skeletal muscle innervation |
Elbow Flexion --Serratus Ant --Pec Major (Clavicular) Wrist Extension --Supinator--Pronator teres --Lats --Long extensors of wrist and fingers --Pec major (Sternal) Elbow Extension --Triceps |
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C8 skeletal muscle innervation |
Elbow Flexion --Serratus Ant Wrist Extension --Long extensors of wrist and fingers --Pec major (Sternal) Elbow Extension --Triceps Finger Flexion --Long flexors of wrist and fingers |
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T1 skeletal muscle innervation |
Wrist Extension --Pec major (Sternal) Elbow Extension --Triceps Finger Flexion --Long flexors of wrist and fingers Finger Abduction -Hand Intrinsics |
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T7-12 skeletal muscle innervation |
Move/Stabilize Trunk --Abdominals |
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L2 skeletal muscle innervation |
Hip Flexion and Adduction --Iliopsoas --Adductors |
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L3 skeletal muscle innervation |
Hip Flexion and Adduction --Iliopsoas --Adductors Knee Extension --Quad Femoris |
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L4 skeletal muscle innervation |
Hip Flexion and Adduction --Iliopsoas --Adductors Knee Extension --Quad Femoris Ankle Dorsiflexion --Tib Ant --Tib Pos --Glute med/min/TFL |
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L5 skeletal muscle innervation |
Hip Flexion and Adduction --Adductors Ankle Dorsiflexion --Tib Ant --Tib Pos --Glute med/min/TFL Long Toe Extensors --Glute Med --Hamstrings --Ext Dig Longus --Ext Hallucis Long --Peroneus |
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S1 skeletal muscle innervation |
Ankle Dorsiflexion --Glute med/min/TFLLong Toe Extensors --Glute Med --Hamstrings --Ext Dig Longus --Ext Hallucis Long --Peroneus Ankle Plantarflexion --Triceps surae (gastroc +soleus) --Foot Intrinsics |
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S2 skeletal muscle innervation |
Long Toe Extensor --Glute Maximus Ankle Plantarflexion --Triceps surae (gastroc +soleus) --Foot Intrinsics |
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S3 skeletal muscle innervation |
Ankle Plantar Flexion --Foot Intrinsics |
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Describe the Reintegration to Normal Living Index |
ICF: Participation Purpose: assessesthe degreeto which individuals who have experienced traumatic or incapacitatingconditions achieve reintegration into normal social activities Timetoadminister: 10 minutes Populationstested: stroke, TBI, SCI, MVA, amputation, Parkinson's, Guillain-Barre, femoralneck fracture, MS |
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DescribeCraigHandicap Assessment and Reporting Technique (CHART) |
ICF: activity,participation Purpose: Assessesthe degree of limitation and restriction in 6 areas (physicalindependence, cognitive independence, mobility, occupation, socialintegration, economic self-sufficiency) Timeto administer: approx 15minutes Populationstested: SCI, stroke, TBI, MS, burns, amputee |
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Describe Capabilitiesof Upper Extremity Functioning Instrument |
ICF: Bodyfunction Purpose: tomeasure upper extremity functional limitations in individuals with tetraplegia Timeto administer: approx 30minutes |
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Describe SpinalCord Independence Measure |
ICF:Activity Purpose: Assessestraumatic and non-traumatic, acute and chronic SCI Timeto administer: 30-45 min by observation; 10-15 min withinterview |
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Describe SCIFunctional Ambulation Inventory |
ICF:Activity Purpose: SCI-specificambulationmeasure focusing on gait abnormalities --Gaitparameters (weight shift, step width, step rhythm, step height, foot contact,step length) --Assistivedevices used (degree of assistance provided by each device; cane, walker,parallel bars) --Walkingmobility (distance, speed, frequency) –Canonlybe used with patients who can ambulate independently for up to 2 minutes withor without AD –Notedceilingaffects Timetoadminister: 5 min |
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DescribeWalkingIndex for SCI II (WISC II)F-8 |
ICF: Activity Purpose -–Assessestheamount of physical assistance needed as well as devices required for walkingfollowing paralysis that results from SCI -–Designedto bea more precise measure of walking ability specific to SCI Timeto administer: 5 minutes |
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Outcome measures for WalkingFunction |
--Six-minute walk test (6MWT) –endurance --10-meter walk test (10MWT) –gait speed --Timed-Up-and-Go (TUG) –Fall risk; may use task to assess quality of movement during transitionalmovements, walking, turning |
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Treatment in acute care and inpatient rehab |
1) Reorientto vertical –Tilttable or wheelchair –Abdominalbinder and stockings 2) Bedmobility –Independentrolling 3) Transfertraining –Improvesitting tolerance 4) Wheelchairmobility –Basicsof propulsion 5) Pressurerelief –30seconds every 15 min OR 2 min every hour –Moreoften with skin integrity issues 5) Generalizedstretching and strengthening 6) Balance –Sitting –Standingif able 7) Standingactivities –Ifstable enough |
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Rules for early strengthening and ROM |
ROM dialy but with caution --Too intense stresses vertebra --Pelvis in Neural --Tretaplegia - head/neck motion contraindication till cleared medically // Shoulder flexion/abd to 90 --Lumbar spine - SLR lmt to 60 // Hip fx lmt to 90 All innervated muscles can be strengthend maximally |
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Rules for Selective Stretching |
Preserve tightness --Lower Trunk: tight hip flexors may inc trunk stability --Long finger flexors facilitate grop Fully lengthen hamstrings --100 SLR to facilitate long sit for dressing |
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Progressing to Outpatient |
1) Bedmobility 2) Transfertraining –Addfloor transfers and Multipleheights 3) Wheelchairmobility 4) Pressurerelief 5) Generalizedstretching and strengthening 6) Corestability and balance 7) Cardiovascularprogram 8) Gaittraining 9) Communityre-entry |
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What should be assessed in the Chronic Phase |
1) Car training - getting in and out // driving 2) Generalized Exercise program - home to community gym 3) Scoliosis management 4) Gait training 5) Wheelchair assessment (repairs, new chair) 6) MSK asymmetries 7) Orthotics |
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Expectations for gait training in Chronic SCI |
Expectations --Speed (0.75-1.32m/s, 1.7-2.9mph) --Max sustainable load ( <35% BWS) --Upright and extended trunk and head --At least 30 min (3000-45000 steps) |
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Sensory cues in gait training Chronic SCI |
-Symmetry in stepping and interlimb coordination -Approximating normal hip, knee ankle kinematics -Minimize WB on UE and normal arm swing -Minimizingsensory stimulation that conflicts with sensory information |
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When to use Aquatic therapy |
Pre-gait and gait t raining Strengthening with gravity eliminated PNF that would be difficult land-based Core stability, balance training Decreased Spasticity Contraindicated - lack of bowel and bladder control |
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ACSM Guidelines for SCI |
•Followguidelines for general population •Aerobictraining •Tetraplegia- peripheral before central fatigue •Autonomicdysreflexia •Decreasedcapacity •Decreasedsensation, increased tolerance •Highercore temperatures |
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What are precautions to improving CV endurance in SCI patients? (i think thats what slide 89 is TRYING to say....) |
•Bluntedtachycardia •Lackof pressor response •Verylow blood pressure •Normsrange around 100-110/60 |
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Pt goals tetra vs paraplegia |
Tetra: -Hand function -Bladder -Bowel -Sexual -Walking Para: -Bladder -Bowel -Sexual -Walk |