Week 6 - Fxnal mobility, FES and ABI

Question 1

Functional mobility

Answer 1

ability to move from one place to another to complete an activity or task

Question 2

Purpose of fxnal assessment

Answer 2

measures functional abilities
info base for goal setting

Question 3

Components of functional mobility

Answer 3

moving in bed (assist level - min, mod, or max?)
transitional movements
transfers
ambulation
stairs

Question 4

How to increase patient participation

Answer 4

decrease hands-on by PT/PTA
decrease need for cueing/prompting

Question 5

Progressive decrease in need for aids

Answer 5

2ww -> 4ww -> cane -> no aid

Question 6

FES

Answer 6

Functional Electrical Stimulation

Question 7

What does an FES do?

Answer 7

A neurological Tx. approach for flaccid/weak muscles that uses and EMS to retrain/perform a functional activity
Putting the pads on two parts of a muscle to activate it.

Question 8

What is an ABI?

Answer 8

Acquired Brain Injury
Damage to brain, which occurs after birth and not related to a congenital or degenerative disease

Question 9

ABI includes

Answer 9

TBI (car accident, falls)
Non-traumatic (tumor, stroke)

Question 10

severe ABI’s can cause deficits in…

Answer 10

thought
behaviour
motivation
personal traits
talents
movement
cognition
social skills

Question 11

ABI - Coup injury

Answer 11

1 direction hit injury

Question 12

contrecoup injury

Answer 12

2 direction hit (whiplash in a car)

Question 13

Cerebral Herniation

Answer 13

when brain tissue, blood and CSP shift from normal position in skull

Question 14

Cerebral Herniation charactizations

Answer 14

decreased level of consciousness - can lead to coma
progressive motor dysfunction
vegetative disturbances
abnormal posturing

Question 15

CSP

Answer 15

Cerebrospinal fluid

Question 16

Diffuse brain injury

Answer 16

rotational and shaking forces on brain (car roll over) - brain being injured in every part of skull
worst one
Diffuse axonal Injury (DAI)

Question 17

DAI

Answer 17

resulting in severe widespread degeneration of white matter, microscopic structural disruption

Question 18

DAI clinical picture

Answer 18

Coma
person cannot wake up, but knows and hears everything people are saying

Question 19

ABI - abnormal posturing

Answer 19

Decorticate
Decerebrate

Question 20

Decorticate

Answer 20

feet in plantar flexion
arms at core

Question 21

Decerebrate

Answer 21

arms held in extension
wrists held internal rotation and flexion
feet in plantar flexion

Question 22

Coma emergence

Answer 22

patient may experience significant agitation, anxiousness and aggression during time after coming out of coma

Question 23

Coma: structured Tx. sessions should be

Answer 23

in quiet areas to reduce distractions
broken up into multiple shorter sessions

Question 24

Coma emergence Tx.

Answer 24

pt. may be progressively mobilized through tilt table or standing frame activities
vital signs monitored for changes and adverse physiological responses to positional changes

Question 25

secondary brain damage

Answer 25

results from initial injury - raised intracranial pressure - arterial hypoxia and brain ischemia - cerebral edema - arterial hypotension - impaired salt and water balance - intracranial infection - hydrocephalus (swelling of brain

Question 26

ABI recovery factors

Answer 26

age size of lesion(s) extent of diffuse injury premorbid skills, intelligence, behaviours genetic inheritance neural plasticity nutritional history environment medical management, rehab, family involvement availability of support services

Question 27

ABI - PT management considerations

Answer 27

Behavioural management motor learning motivation attention memory motor control family education

Question 28

ABI - managing impulsivity

Answer 28

stay aware at all times give patients 1 command at a time

Question 29

ABI - How to get pt. up and going!

Answer 29

give choices - want to go to the bathroom first, or go straight to walking

Question 30

ABI - emotional liability

Answer 30

reassure patients this is not unusual and carry on

Question 31

ABI - decreased memory

Answer 31

use memory aids repetition

Question 32

Managing comm issues - Apraxia

Answer 32

Hard to get message out - speech muscles are affected encourage breath control and pauses clarify words

Question 33

Managing communication issues - Dysarthria

Answer 33

speech muscles are damaged, paralyzed or weakened breath control clarify words

Question 34

Dysphasia - managing comm issues

Answer 34

partial loss of ability to produce and understand spoken language use tools/diagrams liaise with SLP and follow recommendations

Question 35

Paraphasia - managing comm issues

Answer 35

production of unintended syllables, words or phrases while speaking breath control clarify words

Question 36

Dysphagia - managing comm issues

Answer 36

difficulty/painful swallowing encourage to follow recommendations from SLP and dietician

Question 37

Mild TBI means what?

Answer 37

concussion