Clinical Decision Making In Therapeutic Exercise

Question 1

ultimate goal of PT

Answer 1

improve fxn

Question 2

evaluating fxn

Answer 2

pt/caregiver interview

outcome measures

Question 3

outcome measures –> evaluating fxn

Answer 3

FIM - fxnal independence measure

FAM –> fxnal assessment measure

barthel index

berg balance score

disability specific measures for CVA, TBI, PD, MS

Question 4

ICF model

Answer 4

international classification of fxning, disability and health

Question 5

what does ICF describe

Answer 5

how a person fxns in daily life

Question 6

what doesnt the ICF do

Answer 6

focus on dx or diability

Question 7

what does the ICF encourage

Answer 7

health care personnel to look at the entire person to decide on POC

Question 8

general principles

Answer 8

evaluate the pt’s fxnal ability

pt’s abilities

environmental demands and/or restrictions

Question 9

general principles –> changes occur through

Answer 9

natural recovery

intervention

Question 10

general principles –> changes occur through intervention

Answer 10

intervention must address both primary and secondary impairments

Question 11

how could improved fxnal outcomes be obtained

Answer 11

by interventions which help the pt to change if it is a possibility

Question 12

help the pt to change –> improved fxnal outcomes

Answer 12

if the change is possible and appropriate

Question 13

what if change is not possible or appropriate

Answer 13

we can teach pt compensatory techniques and use compensatory aides

Question 14

compensatory aides –> change isnt possible or appropriate

Answer 14

modify the pt’s environment to accommodate the pt’s ability

Question 15

looking at the pt as a whole

Answer 15

consider the pts extrinsic, intrinsic, physical and combined factors

Question 16

extrinsic factors

Answer 16

physical environment

social environment

cultural environment

Question 17

physical environment –> extrinsic factors

Answer 17

private home

apartment

assisted living

etc.

Question 18

social environment –> extrinsic factors

Answer 18

family/friends

occupation

recreation

education

Question 19

cultural environment –> extrinsic factors

Answer 19

religious beliefs

cultural belief

nutrition

Question 20

intrinsic (inherent) factors

Answer 20

psychological

medical

Question 21

psychological –> intrinsic factors

Answer 21

self-esteem

sense of control

happiness

life satisfaction

Question 22

medical –> intrinsic factors

Answer 22

PMH/PSH

health habits

meds

contraindications

Question 23

physical factors

Answer 23

results of your systems review

cardio/pulmonary, MSK, neuromuscular

Question 24

combined factors

Answer 24

all previous factors influence health to create either

-positive coping manner or
-negative strain leading to stress responses

Question 25

stress responses --> combined factors

Answer 25

depression anxiety ulcers LBP chronic pain syndrome

Question 26

examination

Answer 26

mobility skill pt's capacity learning variables

Question 27

mobility --> examination

Answer 27

passive ROM active ROM stability mobility control in fxn

Question 28

passive ROM --> mobility

Answer 28

normal/limited tx

Question 29

limited passive ROM

Answer 29

joint soft tissue muscle tightness muscle hypertonicity

Question 30

active ROM --> mobility

Answer 30

initiation and throughout range

Question 31

stability --> mobility

Answer 31

muscle synergy for stability postural stability

Question 32

mobility control in fxn --> mobility

Answer 32

weight shifting transitional movements

Question 33

skill --> examination

Answer 33

normal timing and sequencing for locomotion and manipulation

Question 34

what is patient's capacity

Answer 34

ability to do work

Question 35

what is pt's capacity a combination of

Answer 35

physiological stress

Question 36

physiological stress --> pt's capacity

Answer 36

HR BP respiratory rate intensity duration frequency speed of movement

Question 37

learning variables --> exam

Answer 37

intensity of the stimuli task repetition variability of the procedure and environment to improve generalization

Question 38

what should be identified in the evaluation process

Answer 38

pt's fxnal needs and desired outcomes

Question 39

what should the evaluation process assess

Answer 39

the physical impairments and environmental constraints to determine each one's contribution to the limitation of fxn

Question 40

what should we examine in the evaluation process

Answer 40

limitations or impairments to try and find a cause

Question 41

what does the evaluation process include

Answer 41

determining the appropriate PT goals and interventions re-assess after a specific period of time change/modify interventions as necessary refer to other practitioners if necessary document accurately and appropriately

Question 42

interventions should be directed towards

Answer 42

the patient

Question 43

how many components of intervention

Answer 43

3

Question 44

3 components of intervention

Answer 44

activities techniques parameters

Question 45

activities --> interventions

Answer 45

postures movements

Question 46

techniques --> interventions

Answer 46

to achieve movement control (mobility, stability, controlled mobility and skill)

Question 47

parameters --> interventions

Answer 47

to determine dosage of intensity, duration, frequency and variables of learning

Question 48

how does tx always start w/

Answer 48

activities the pt can perform and progress in difficulty to the fxnal outcome

Question 49

what could be varied by changing any component in tx

Answer 49

challenge/difficulty

Question 50

what happens if a pt's status cannot change --> intervention

Answer 50

try to change the home, work or community environment to decrease architectural barriers

Question 51

what do we need to look at relative to the environment --> intervention

Answer 51

postures needed for the activity type of movement required repetition, speed and duration requirements

Question 52

classification of pt's impairments

Answer 52

primary and secondary

Question 53

primary impairments

Answer 53

direct result of pathology

Question 54

secondary impairments

Answer 54

secondary effect of pathology or result of improper care

Question 55

how should we plan interventions

Answer 55

to change those impairments that are changeable pick and choose interventions from a variety of sources cross systems

Question 56

what should we do throughout tx

Answer 56

provide compensatory aids and strategies as appropriate for safety and fxn modify environmental constraints educate pt, family and caregivers for carryover

Question 57

reassessment

Answer 57

formal and informal

Question 58

informal reassessment

Answer 58

constantly modify/change intervention as necessary

Question 59

formal reassessment

Answer 59

as your facility requires