Conceptual frame work for Neurologic Physical THerapy Clinical Practice

Question 1

Introduction

Answer 1

• Conceptual framework is a logical structure that helps organize clinical practices into a cohesive and comprehensive plan
• It provides context in which information is gathered and interpreted
• It provides guidelines for clinical intervention

Question 2

Four key concepts or elements that contribute to a comprehensive conceptual framework for clinical practice

Answer 2

models of practice
models of disablement
HOAC
Theory of motor control

Question 3

Models of practice

Answer 3

Process used to gather information design an intervention program is similar for all patients

Question 4

APTA model of practice

Answer 4

Examination

• -History
• -systems review
• -tests and measurements
• evaluations
• diagnosis
• prognosis and plan of care
• intervention

Question 5

Diagnosis

Answer 5

both the process and the end result of evaluating information obtained from the examination, which the physical therapist then organizes into defined clusters, syndromes, or categories to help determine the most appropriate intervention strategies

Question 6

Prognosis

Answer 6

determination of the level of optimal improvement that maight be attained tr

Question 7

Intervention

Answer 7

1

Question 8

Outcomes

Answer 8

1

Question 9

Examination

Answer 9

1

Question 10

Evaluation

Answer 10

1

Question 11

Examination

Answer 11

1

Question 12

Evaluation

Answer 12

dynamic proves in which the PT makes clinical judgments based on data gathered during the examination

Question 13

Diagnosis

Answer 13

• both the process and the end result of evaluating information obtained from the examination
• Which the PT then organized into defined clusters, syndromes, or categories to help determine the most appropriate treatment strategies.

Question 14

Neurologic Physical Therapy Diagnosis

Answer 14

• movement pattern coordination deficit
• force production deficit
• sensory detection deficit
• sensory selection and weighting deficit
• perceptual deficit (pushers)
• fractionated movement deficit (can’t isolate movements)
• hypermetria (all big movements) cerebellar
• hypokinesia (small movements–Parkinson’s)

Question 15

The essential components of diagnosis

Answer 15

organizing relevant information into defined clusters, syndromes or categories to help determine the most appropriate treatment strategies.

Question 16

Prognosis

Answer 16

determining the level of optimal improvement that might be attained through intervention

• as well as, the amount of time required to reach that level
• prognostic statements are important
• Goals also explicitly represents the prognosis that the PT has determined

Question 17

Essential Components of a well-written functional goal

Answer 17

Actor
Behavior
Condition
Degree
Expected Time

Question 18

Writing Goals

Answer 18

• in addition to being well written, goals should address 3 outcome levels:
• -disability (LEFS)
• -function (walk 300 feet w/I 2 min Independent on uneven surface in two weeks.)
• -Impairment (mostly ST) ( increase ROM-connect it with the function)

Question 19

Goals

Answer 19

goals should apply to the episode of care under your direction: write goals for your setting
ACUTE care with estimated 5 day LOS example
-NO STG
-LTG to be achieved by D/C from hospital
-Recommendations: continue with HHPT 2X/week for 4 weeks to achieve modified independence in all transfer and safe, modified independent gait including stair climbing.

Question 20

Components of PT intervention

Answer 20

• coordination, communication and documentation
• patient/client-related instruction
• procedural interventions

Question 21

Models of Disablement

Answer 21

framework for structuring the effects of disease on the individual
describe the path from disease to disability

Question 22

WHO international classification functioning, disability, and health

Answer 22

• body function and structure
• activities
• participation
• contextual factors: environmental factors and personal factors

Question 23

Environmental Factors?modifiers

Answer 23

external influences on functioning and disability; facilitating or hindering impact of features of the physical, social, and attitudinal world; barriers

Question 24

Personal Factors/modifiers:

Answer 24

internal influences on functioning and disability; impact of attributes

Question 25

Posture, Balance, and Gait: Functional Activity or Underlying Impairments

Answer 25

controlled by multiple systems; | Posture and Balance problems are not easily defined as solely functions activity or body structure/function impairments

Question 26

Hypothesis-Oriented Clinical Practice

Answer 26

1. generate alternative hypothesis about potential causes 2. determine crucial tests and expected outcomes to rule out one or more hypothesis 3. Carry out tests 4. continue the process of generating and testing hypothesis, refining understanding of the causes of the problem.

Question 27

Evidence-Based Clinical Practice

Answer 27

1

Question 28

Theories of Motor Control

Answer 28

theories of motor control lead to development of clinical practices

Question 29

Applying

Answer 29

1

Question 30

Task-Oriented Approach to Examination

Answer 30

- quantification of functional abilities - description of the strategies used to accomplish functional skills - quantification of underlying sensory, motor, ad cognitive impairments that constrain functional movement

Question 31

Examination at the Functional Level

Answer 31

- performance-based versus self-reported functional measures - -some agencies may not accept self-report - Task-specific tests and measures - Age-specific tests and measures - diagnosis-specific tests and measures - measuring disability--function in a social and physical context.