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Neuromuscular > Eval, Assessment and Management of Brain Injury > Flashcards

Eval, Assessment and Management of Brain Injury Flashcards

1
Q

Model of Clinical Practice

A

-Exam: measuring
-Eval: taking the exam and implications (ICF)
-Diagnosis
-Prognosis: ICF, co-morbidities, environment
-Intervention: treat, education
-Outcomes

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2
Q

Internal Classification of Function

A

Health Condition: Stoke

Body Function and Structure: weakness, sensory, pain, location, tone, apraxia, executive function, BS issues

Activity: walking, sitting, speech, ADLs, IADLs

Participation: job, hobbies, ADLs, social

Environmental: home, stairs, bathroom, kitchen access

Personal Factors: insurance, support, money, depression

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3
Q

ANPT Neuro Core Measures

A

-Berg Balance
-Functional Gait Assessment
-Activities-Specific Balance Confidence Scale
- 6MWT
-10 Metter Walk Test
-5STS

-not always great for non-ambulatory
-should observe score and quality/compensations
-score on the lowest

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4
Q

ANTP Stroke Outcome Measure Recs

A

-StrokEDGE Recs: FIM, Fugl-Meyer, Postural Ass Scale for Stroke, Stoke Impact Scale, Trunk Impairment Scale
-Traumatic Brain Injury EDGE Recs

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5
Q

Stroke Impact Scale

A

-SIS
-subjective experience of stroke impact on life
-quality of life, impairments, activity limitation

-strength, memory, mood, communication, ADLS. mobility, hobbies, work

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6
Q

Postural Assessment Scale for Stroke Patients

A

-PASS
-maintaining and changing posture

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7
Q

Functional Independence/Assessment Measure

A

-FIM/FAM
-general rehabilitation
-not specifically post stoke
-Activities Supine to transfers to locomotion
-Assistance or not

7:Complete Independence
6: Modified Independence
5: Supervision or Set up No hands on
4: Min Assist= >75%
3: Moderate Assist= 50-74%
2: Max Assist= 25-49%
1:Total Assist=0-24%

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8
Q

Stroke Rehabilitation Assessment of Movement

A

-STREAM
-progressive
-voluntary mmt of limb
-measure the quality of movement
-measures impairment and activity level

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9
Q

Fugl-Meyer Test

A

-sensory and motor function, function and limitations
-synergies, reflexes

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10
Q

Glasgow Coma Scale

A

-GCS
-3-15, Eyes, Motor, Verbal
-used at scene of accident, ER, acute care
-predictor of future outcomes

3-8: severe injury, 44%, coma
9-12: moderate injury, 15%
13-15: mild injury, 41%

Limitations:
-language barriers
-prexisting conditions
-alcohol

Eyes: 1-4, none, pain, speech, spontaneous

Verbal: 1-5, None, incomprehensible, inappropriate, confused, oriented

Motor: 1-6, None, extension, flexion, withdraws, localizes, obeys

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11
Q

Rancho Los Amigos Level of Cognitive Functioning Scale
1-3

A
  1. No response (no sleep/wake cycles)
  2. Generalized Response
    -limited, inconsistent responses
    -general reflexes to pain
  3. Localized Response
    -purposeful responses, follow simple commands

-lots of tubes
-asleep or awake
-high risk for skin breakdown and seizures
-NPO
-unstable vitals
-extreme hypertonicity
-GCS 3-8
-disordered consiousness

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12
Q

Rancho Los Amigos Level of Cognitive Functioning Scale
4

A
  1. Confused, Agitated
    -heightened state of activity, confusion, disorientation, agressive behavior
    -internal confusion
    -violence
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13
Q

Rancho Los Amigos Level of Cognitive Functioning Scale
5-6

A
  1. Confused, Inappropriate, non-agitated
    -alet, distractable, verbally or sexually inappropriate
    -doesnt learn new info
  2. Confused, appropriate
    -good directed behavior**
    - needs cueing but can relearn**
    -memory problems
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14
Q

Rancho Los Amigos Level of Cognitive Functioning Scale
7

A
  1. Automatic, Appropriate
    -out of PTA
    -robot like
    -minimal confusion
    -shallow recall
    -needa structure
    -problem solving
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15
Q

Rancho Los Amigos Level of Cognitive Functioning Scale
8

A
  1. Purposeful, Appropriate
    -alert, oriented
    -cognitively independent
    -function at reduced levels in society
    -integrates past events
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16
Q

Rancho Los Amigos Level of Cognitive Functioning Scale
9-10

A
  1. Purposeful and Appropriate- Stand by Assistance on Request
  2. Purposeful and Appropriate- Modified Independent
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17
Q

Trunk Impairment Scale

A

-Static Sitting Balance
-Dynamic Sitting Balance
-Co-Ordination

18
Q

Function in Sitting Test

A

-reactive and anticipatory balance
-Nudge, EO/EC, picking up behind, lat, forward, scooting

19
Q

Movement System Diagnoses

A
  1. Movement Pattern Coordination Deficit
  2. Force Production Deficit
  3. Fractionated Movement Deficit
  4. Postural Vertical Deficit
  5. Sensory Selection & Weighting Deficit
  6. Sensory
20
Q

Prognostic Measures

A

-Orpington Prognostic Scale
-Clinical Signs of Poor Prognosis post Stroke

21
Q

CPG for Locomotion for Chronic Stroke, TBI, InSCI

A

-to improve WALKING

  1. Walking mod to high intensity (post stroke and SCI)
  2. VR Walking Training following acute onset (post stroke and SCI)
  3. Strength train >70% 1RM
  4. Stepping/circuit/cycling 75-85% HRmax
  5. NO static/sitting balance
  6. NO robot ass gait training
  7. Can use static of dynamic balance with VRf
22
Q

CPG for Use of AFOs and FES (E-Stim) Post Stroke

A

FES and AFO: Quality of life, chronic walking endurance, other mobility, Dynamic Balance, Gait speed, Chronic Muscle Strength/Activation (may provide AFO)

May Provide FES and AFO: Acute walking endurance

Should Not provide FES and AFO: Tone/Spasticity

23
Q

Types of Activities

A

Functional Activities: work directly toward functional goals

Contrived Activities: work towards functional activities but not directly to goals

Education

24
Q

Predictors of Poor Rehab Outcome

A

Dementia
Global Aphasia
Previous Stroke
Older Age
Incontinence
Severe Visuospatial deficits
Persistent Sensory Defifits

25
Q

Core Tasks

A
  1. Sitting
  2. Sit to Stand
  3. Standing
  4. Walk and Turn
  5. Step up/down
  6. Reach, Grasp, manipulate
26
Q

Movement Pattern Coordination

A

-inability to coordinate an intersegmental task because of a deficit wih timing and sequency
-improves with practice and instruction

S/s: Fractionated mmt, little to no ataxia

27
Q

Force Production Deficit

A

-flaccid tone
-weakness and fatigue

S/s: fracionated mmt, little postural control

28
Q

Fractionated Movement Deficit

A

-inability to fractionate movement
-hypertonic tone restricting

S/s: stiffness, extensor tone

29
Q

Postural Vertical Deficit

A

-inaccurate perception of vertical orientation
-resist pushing
-backward disquilibrium behavior

S/s: difficulty planing, sensation issues, impulsiveness

30
Q

Sensory Selection and Weighting Deficit

A

-inability to maintain posture or motor performance difficulty sreening for and attending to sensory input
-do not resist pushing
-sensitivity to sensory stimuli

S/s: fractionated mmt, self stimulation

31
Q

Sensory Detection Deficit

A

-inability to execute intersegmental movement due to lack of join position sense
-sensation deficits
-proprioception deficits

S/s: poor timing, slow movements

32
Q

Hypokinesia

A

-slow movements (initiatting and executing)
-stopping ongoing movement

S/s: rigid movement, undershooting movement, delayed reflexes

33
Q

Dysmetria

A

-inability to grade forces appropriattely for task
-worse with higher speeds
-non equilibrium coordination

S/s: standing issues

34
Q

Cognitive Deficit

A

-lack of aroussal, attention, or abiliity to apply meaning to a situation
-could be a modifier

35
Q

UE Flexion Synergy

A

-Scapular Elevation
-Scapular Retraction*
-Shoulder Abd & ER
-Elbow flexion*
-Forearm Supination
-Wrist flexion*
-Finger Flexion*

36
Q

UE Extension Synergy

A

-Scapular Depression*
-Scapular Protraction
-Shoulder extension*
-Shoulder add*
-Shoulder IR*
-Elbow Extension
-Forearm Pronation*
-Wrist Extension
-Finger flexion*

37
Q

UE Resting Synergy

A

-Scapular Depression
-Scapular Retraction
-Shoulder extension
-Shoulder add
-Shoulder IR
-Elbow flexion
-Forearm Pronation
-Wrist flexion
-Finger Flexion

38
Q

LE Flexion Synergy

A

-Pelvic elevation*
-Pelvic retraction*
-Hip Flexion*
-Hip Abd
-Hip ER
-Knee Flexion
-Ankle DF
-Foot Inversion*

39
Q

LE Extension Synergy

A

-Pelvic depression
-Pelvic protraction
-Hip extension
-Hip Add*
-Hip IR*
-Knee Extension*
-Ankle PF*
-Foot Inversion*

40
Q

LE Resting Synergy

A

-Pelvic elevation
-Pelvic retraction
-Hip Flexion
-Hip Add
-Hip IR
-Knee Extension
-Ankle PF
-Foot Inversion

Neuromuscular (21 decks)

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