TBI - Ranchos VII - IX (higher level rehab)

Question 1

What is the characteristic name for a ranchos level VII?

Answer 1

Automatic - Appropriate

Question 2

What are the characteristics to be placed in ranchos level VII?

Answer 2

• pt is oriented with the environment
• follows daily schedule and routine in a robot like way
• unable to recall all details of daily events
• new learning possible (with extra time)
• continued safety concerns

Question 3

What is the characteristic name for a ranchos level VIII?

Answer 3

purposeful - appropriate

Question 4

What are the characteristics to be placed in ranchos level VIII?

Answer 4

• able to recall and integrate past and recent events
• aware of and responsive to environment
• independent in the home
• developing community reentry skills
• shows carryover with new skills and no supervision required once skill is learned

Question 5

What will a patient in a ranchos level VIII still demonstrate a decreased ability to complete?

Answer 5

• novel problem solving
• stress management
• speed of reactions/responses
• abstract reasoning
• maintaining social relationships
• judgement in emergencies or unusual situations

Question 6

Where is the most common setting for a ranchos level VII or VIII exam to take?

Answer 6

Outpatient rehab

Question 7

How is the orientation of a ranchos level VII patient described?

Answer 7

robot like, impaired judgement

Question 8

How is the orientation of a ranchos level VIII patient described?

Answer 8

responsive to movement, does not required supervision once activities learned, struggles with new situation

Question 9

What are the rehab goals for ranchos level VII and VIII?

Answer 9

• help patient function with less structure
• improving independent problem solving
• increasing safety awareness
• decreasing supervision
• integrating cognitive, emotional, and social skills needed to function in community

Question 10

What are the goals of cognitive rehab programs?

Answer 10

• promote community reintegration
• return to work/school
• address behavioral, psychosocial, and cognitive impairments

Question 11

List 4 cognitive intervention strategies for a ranchos level VII and VIII?

Answer 11

1) high level balance and walking skills
2) dual task
3) provide opportunities for problem solving
4) enhancing social skills

Question 12

What type of practice is important for a patient in ranchos IV-VI?

Answer 12

• blocked
• distributed

Question 13

What type of feedback is necessary for a patient in ranchos LOCF IV-VI?

Answer 13

extrinsic feedback

Question 14

What type of practice is important for a patient in ranchos level VII-VIII?

Answer 14

• massed

Question 15

What type of feedback is important for a ranchos level VII-VIII?

Answer 15

Intrinsic feedback

Question 16

What should you look for to identify patient physical and mental fatigue?

Answer 16

• increased irritability
• decreased attention and concentration
• deterioration in performance of the physical skill
• delayed initiation

Question 17

List the main strategies to maximize outcome in patients of all levels of cognitive functions

Answer 17

• beware of overstimulating the patient
• gradually increase cognitive complexity when appropriate
• use a structured organizational system that contains a daily journal, calendar, and frequent communication with family

Question 18

What SOMS do you use to measure balance in ranchos level VII and VIII patients?

Answer 18

• community balance and mobility scale
• HiMAT

Question 19

What SOMS do you use to measure gait in ranchos level VII and VIII patients?

Answer 19

• 6MWT
  -10MWT
• FGA
• rancho los amigos observational gait analysis

Question 20

What SOMS do you use to measure QOL in ranchos level VII and VIII patients?

Answer 20

• quality of life after brain injury scale
• community integration questionnaire

Question 21

What SOMS do you use to measure overall function in ranchos level VII and VIII patients?

Answer 21

Functional assessment measure/quality indicators

Question 22

What is the community balance and mobility scale made to measure?

Answer 22

• high level balance skills (unilat stance, hop, look and carry, stairs, etc)

Question 23

What is the HiMAT skill made to measure?

Answer 23

high level balance items (return to sport, physically demanding vocational role)

Question 24

What is the community integration questionnaire made to measure?

Answer 24

readiness to return to work

Question 25

What is the functional assessment measure made to measure?

Answer 25

focuses on community functioning and behavior (swallowing, car transfer, reading, writing, employability, etc)

Question 26

What is the compensatory intervention approach?

Answer 26

• improve functional skills by compensating for the lost ability.
• use brain activation in areas formerly not used for a given task

Question 27

what is the restorative (recovery) intervention approach?

Answer 27

restore the normal use of the movement pattern. reactivate areas of the brain, or penumbra, typically responsible for the task

Question 28

What are the 5 considerations for the compensatory intervention approach?

Answer 28

1) safety
2) impairments
3) cognitive and behavioral barriers
4) financial resources
5) discharge destination

Question 29

What two principles of neuroplasticity are most important in a restorative intervention approach?

Answer 29

• specificity
• intensity matters