Rehabilitation Flashcards
(29 cards)
What is rehabilitation practice based around concepts of?
Impairment
Disability (activity limitation)
Handicap (Participation restriction)
What is impairment?
Problems in body function or structure such as a significant deviation or loss
What is disability / activity limitation?
Difficulties an individual may have in executing activities
What is handicap/ participation restriction?
Problems individual may have in involvement in life situations
What is rehabilitation?
The restoration of patients to their fullest physical, mental and social capability
“Getting back to work, sex and golf, not necessarily in that order”
What is the conceptual definition of rehabilitation?
A process of active change by which a person who has become disabled acquires the knowledge and skills needed for optimal physical, psychological and social function
What is the service definition of rehabilitation?
The use of all means to minimise the impact of disabling conditions and to assist people with activity limitaion to achieve their desired level of autonomy and participation in society
Describe the speciality of rehabilitation medicine
Involved with the prevention and reduction of activity limitation and participation arising from impairments, and the management of disability from a physical, psychological and vocational point of view
What are Long-term Neurological Conditions (LTNC) defined as?
Disease of, injury or damage to the nervous system whuch will affect the individual and their family in one way or another for the rest of their life
How do Long-term Neurological Conditions usually occur?
Sudden onset:
- Acquired brain injury
- Spinal cord injury
- Stroke
Intermittent/ Inpredictable
- Epilepsy
- Early MS lead to marked variation in the care need
Progressive conditions:
- Motor Neurone Disease
- Parkinson’s Disease
- Later stages of MS
Stable conditions:
- Post-polio syndrome
- Cerebral palsy in adults
- Spina bifida in adolescence/ adults
What are the physical problems from LTNC?
- Weakness (hemiparesis/paraparesis)
- Loss of/ abnormal sensation
- Increased or decreased ton/ spasticity
- Visual disturbance, e.g. homonymous hemianopia
- Loss of hearing
- Loss of smell and taste
- Swallowing and communication difficulties
- Bladder and bowel difficulties
- Pain syndrome
- Seizures/ Epilepsy
What cognitive proiblems may result from brain injury?
- Post-traumatic amnesia
- Confusion/ disorientation
- Severe memory problems (especially with recent events/ working memory)
- Poor cencentration/ attention
- Slowed thinking
- Poor “executive functioning”
What psychiatric/ behavioural problems may result after brain injury?
- Depression
- Anxiety
- Personal change
- Irritability
- “Childishness, selfishness, laziness”
- Behabioural problems, including aggression disinhibition, apathy
What is the assesment you would do in rehab?
- History and examination
- Mobility
- Activities of Daily living
- Mood and cognition
- Bladder and bowels
- Communication and swallow
- Skin, Vision and hearing
What is the process of rehabilitation?
- Problem lists
- Set goals
- Identify barrier issues
- Formulate management plan
- Draw upon all relevant disciplines
- Involve patient (family carers)
What are “SMART Goals”?
Specific Measurable Achievable Relevant Time limited
Describe the use of multidisciplinary teams in rehabilitation?
Most effectively delivered by a coordinated team of professionals
Work together towards same goal
Interventions may run parallel
Interdisciplinary: more integrated including joint sessions
What is the multidisciplinary ethos in rehabilitation?
- A team process
- Patient, family and/or carers the focus
- Active partnership with others
- Physicians: clear and important role
- Role not always be paramount
What is spasticity?
Motor disorder characterised by a velocity dependent increase in tonic stretch reflexes with exaggerated tendon jerks.
Disordered sensorimotor control resulting from an upper motor neurone syndrome (UMN) lesion, presenting as intermittent or sustained involuntary activation of muscles
What are some of the complications of spasticity?
- Poor seating and lying positions
- Sleep difficulties and fatigue
- Dressing and hygiene issues
- Pain, spasms and associated reactions
- Communication and feeding problems
- Pressure sores and contracture
- Poor self-image and relationship issues
How do you manage spasticity?
- Prevention, prevention and prevention!
- Multidisciplinary team approach
- Physical therapy
- Exclude exacerbating factors
- Oral antispasticity agents
- Focal treatment with Botulinum toxin
- Drug treatment not always necessary
Where does rehabilitation take place?
- Acute hospital
- Rehabilitation ward
- Outpatient centre
- Community facilities (e.g. local sports hall
- Vocational rehabilitation service
- In the patients home
What are the benefits of rehabilitation?
- Greater independence
- Greater chance of getting home or remaining at home
- Increased comfort and dignity
- Increased chance of remaining in/ returning to work
- Improved quality of life
- Reduced need for care/ assistance
What secondary complications should you try to prevent?
- Pressure sores
- Chest infections
- Deep venous thrombosis
- Malnutrition
- Constipation
- Musculoskeletal pain
- Contractures
- Low morale and depression
