exam revision Flashcards
what is a person’s physical capacity?
musculoskeletal capacity
what are the concepts associated with bones, joints, and muscle?
-joint ROM
-strength
endurance
what is joint ROM?
amount of motion available
what is the strength of muscle?
the ability of muscles to produce tension for maintaining postural control and moving body parts
what is endurance?
ability to sustain effort overtime required
does AROM client lead?
yes
does PROM client lead?
no
is AROM greater than PROM?
yes
what are some biomechanical influences on ROM?
- muscle weakness
- tendon ruptures
- adhesions
what are some personal causes that influence ROM?
- pain
- fear of injury
- fatigue
- time of day
what is an environmental influence on ROM?
temp
when is ROM affected?
- trauma
- oedema
- immobilization
- muscle weakness
- pain
what are some intervention strategies when ROM is decreased?
- if due to tightness: stretching
- if oedema: compression/elevation
- splinting may help contracture
what is an intervention strategy when there is weakness in muscle groups?
increase stress through resistance, duration, rate/speed, and frequency
what is work hardening?
individualised approach aimed at returning people to work, simulated work tasks
what is the worker role interview based on?
MOHO
what type of interview is the worker role interview?
semi-structured interview with 16 item rating scale
how are the 16 items of the WRI rated?
implications of each for the likelihood of work success
what is the WRIs use in practice?
assess impacts of personal causation, values, interests, roles, habits, and perception of enviro on the potential of a return to work
what is the 4 point rating scale for the 16 items of WRI?
- strongly supports
- supports
- interferes
- significantly interferes
how long does the WRI approximately take?
30-60mins
what is the work environment impact scale (WEIS) designed to gather information on?
info on people with physical/psychosocial disability in work enviros
what is WEIS based on?
MOHO
what is the WEISs use in practice?
assess features that support/impede performance, satisfaction, and wellbeing
how many topics is the WEIS organized around?
17 enviro factors
what 4 point scale ratings does the WEIS use?
SS, S, I, SI,
how long approx does the WEIS take to administer?
30-60mins
what is the assessment of work performance based on?
MOHO
what does the assessment of work performance measure?
individuals observable work-related skills
what 3 domains are the 14 skills assessed by the AWP?
motor, process, communication/interaction skills
what are motor skills related to?
- posture
- mobility
- coordination
- strength
- energy use
what are process skills related to?
- knowledge
- temporal organisation
- space and objects
- energy
- adaption
what are communication and interaction skills related to?
- physicality
- language
- relations
- information
- exchange
what is the AWPs use in practice?
assesses the performance of motor, process, and communication/interaction skills in work activity
what does occupational analysis explore the relationship between?
- occupation itself
- person
- contexts surrounding occupational participation
what does activity analysis not consider?
all aspects and contexts of person, groups/communities
what does the top-down approach first focus on?
outcome or overall goal first
what is the process involved in a top-down approach?
- identify abilities
- understand strengths/weaknesses
- assessment of capacities that support performance
what is the process involved in the bottom-up approach?
- start with underlying capacities
- goal to improve those
what is occupation-as-means activity related to restoring?
capabilities
what does occupation-as-end activity enable?
independent performance to fulfil life roles
what is grading activities?
sequentially increasing/decreasing activity demands for improvement
what may adapting information involve?
- modifying
- reducing/increasing demands
- use of assistive devices
- changing physical/social demands
what are some reasons for adapting activity?
- modify to make therapeutic
- graduate exercise to accomplish goals
- enable person to do what they usually do
- prevent trauma injury
what are some guidelines for managing fatigue?
- pacing
- planning ahead
- use correct equip
- use efficient methods and posture
what is acquired brain injury occurred due to?
occurs when the brain becomes damaged through trauma, stroke, infection, tumor, lack of oxygen, substance abuse, degenerative neurological disease
what is traumatic brain injury induced by?
induced by structural injury and/or physiological disruption of brain function as result of external force
what is ABI?
permanent change to bran structure/function
what is the mild form of ABI?
cerebral contusions that manifest as concussion
what does mild form of ABI result in?
mild problems with memory and self regulation
what occurs in severe ABI?
coma with non recovery
what is motor control?
ability to regulate or direct mechanisms essential to movement
what does cortical damage lead to?
tonal change
what does subcortical damage affect?
quality of movement (dystonias)
what can cerebellar lesions result in?
- ataxia
- hyptonia
- disequiillibrum
- dysmetria
what is ataxia?
wide based gate, poorly controlled movement, intention tremor
what is hypotonia?
low tone
what is dysmetria?
target accuracy
what is disdiaokinesia?
poorly coordinated rapid alternating movement
what is disequilibrium?
reduced balance
what can result from basal ganglia lesions?
- bradykineasia
- resting tremor
- dystonia including rigidity
- ballistic movement
what is bradykineasia?
slowness in carrying out movement
what is spasticity?
motor disorder characterised by velocity-dependent increase in tonic stretch reflexes
what is contracture?
shortening of soft tissue results in joint ROM
what is muscle tone?
resistance of muscle to passive elongation or stretching
what is hypertonia?
more than normal resistance of muscle to passive elongation
what is hypertonicity?
increase in tone/more than normal resistance of muscle to elongation
what is the glascow coma scale?
gauge severity of acute brain injury
what is the severe score in glascow coma scale?
8 or less
what is the moderate score in glascow coma scale?
9-12
what is the mild score in glascow coma scale?
13-15
what does PTA effect?
- disorientation
- disinterested/distractible
- difficulty with thinking, concentration and memory
- anxiety, agitation and rapid mood changes
when is PTA usually over?
when patient begins to retain info and continuous memory returns
what does a 0 on the modified ashworth scale represent for muscle tone?
no increase in muscle tone
what does a 1 on the modified ashworth scale represent for muscle tone?
slight increase, manifested by minimal resistance at end of ROM in flexion/extension
what does a 1+ on the modified ashworth scale represent for muscle tone?
a slight increase, manifested by minimal resistance throughout remainder of ROM
what does a 2 on the modified ashworth scale represent for muscle tone?
more marked increase, throughout most ROM, easily moved
what does a 3 on the modified ashworth scale represent for muscle tone?
considerable increase, passive movement difficult
what does a 4 on the modified ashworth scale represent for muscle tone?
affected part rigid in flexion/extension
what items are assessed by Tardieu scale?
- intensity of resistance to muscle strength
- angle at which catch is first appreciated
- differences noted when muscle is stretched at different velocities
what does neuroplasticity mean?
brain continues to respond to changes in behavioural demands over time
what areas should be assessed for cognitive impairments following PTA?
- attention
- visuospatial
- executive function
- langauge, social communication
- social cognition
- learning/memory
- awareness of impairments
- expression of emotion
what are some common and challenging behaviours associated with brain injury?
- verbal/physical aggression
- inappropriate sexual behaviour
- wandering
- risk-taking
what are five principles for effective behavior management of brain injury??
- manage: day to day rather than fix
- structure and routine
- consistency
- add positives
- seek assistance
why should OTs measure muscle strength?
- impacts daily occupations
- communication
- detection of change
- motivation
- justify role
what can impairment in cognition result from?
- developmental; or learning disorders
- brain injury
- psychiatric dysfunction
- socio-cultural conditions
what are some higher level functions of cognition?
awareness and executive functions
what are basic cognitive functions
- attention
- concentration
- memory
- perception of spatial relations
- visual attention
- thinking
what areas of cognition are impaired in dementia?
-language
-memory
-perception
-personality
cognitive skills
what are the most common forms of dementia?
- alzheimer’s
- vascular dementia
- dementia with Lewy bodies
- front temporal dementia
what are some risk factors for dementia?
- TIA/stroke
- repeated head trauma
- prolonged hypertension
- uncontrolled diabetes
- atrial fibrillation
what are some early indications of dementia?
- forgetfulness
- language problems
- mood swings/behavioural changes
- loss of initiative
what are the areas that must have decline in one or more for diagnosis of dementia on DSM-5?
- complex attention
- executive functions
- learning and memory
- language
- perceptual-motor
- social
what is Alzheimer’s categorised by the presence of?
plaques and tangles
what are the second stage characteristics of dementia?
- behavioural disturbances
- repetitive
- confused
- behave inappropriate
what are the third and last stage characteristics of dementia?
- loss of independence
- altered perception and social relationships
- physical problems
what are some demands of dementia on carers?
- exhaustion
- sadness
- mental health issues
- role changes
what makes a good team?
- shared load
- collaboration
- flexibility
- trust
- team decision making
what makes a poor team?
- difficulty speaking up
- differing level of effort
- reliance on self discipline
- no space to learn, lack of reinforcement
what are the five stages of Tuckman’s model of team development?
- forming
- storming
- norming
- performing
- adjourning
what are some factors that inhibit group decision-making?
- lack of maturity
- social loafing
- free riding
- group think
- poor conflict management
- inappropriate group size
how can social loafing be reduced?
- member’s contributions are identifiable
- strong incentive
- cohesiveness
- goals meaningful and challenging
what professionals make up a stroke unit team?
- neurologist
- nurse
- OT
- physio
- speech pathologist
- social worker
- dietician
what are the OTs role in acute stroke management?
- assessment
- intervention
- discharge planning
what time frame is an initial assessment conducted with stroke?
1 day
what does stroke initial assessment involve?
allied health pre-morbid and OT initial assessment
what aspects are involved in an allied health pre-morbid assessment for stroke?
- previous health status
- home enviro
- previous function/ADLs
- social history
what aspects are involved in an OT initial assessment for stroke?
- current physical status
- plan
- goals
- cognition/perception/behaviour
- OPIs
what are the guidelines for vision screening assessment of stroke?
those with difficulty recognising objects should be screened and if deficit is found refer to comprehensive assessment
what visual screening assessment should all stroke survivors have?
- assessment of visual acuity to see newspaper and distant objects
- presence of visual filed and eye movement deficits
what are the guidelines for upper limb assessment for stroke?
upper limb training should commence early
what is the none hole peg test for stroke developed to measure?
finger dexterity
what sensations should be tested in a hand assessment for stroke?
- cutaneous
- hot/cold discrimination
- proprioception
- coordination
how can cutaneous sensation be assessed?
- random tactile stimuli to forearm and hand patient indicate when recognized
- localisation tested by closing eyes and pointing to the area being touched
how is proprioception of hand assessed?
- demonstrate thumb up/down
- patient distinguishes between thumb positions
how is digit opposition coordination assessed for stroke?
each finger touching in succession
how are rapid alternating movements of coordination assessed for stroke?
position hand on knee, rapid alternating supination/pronation
what is sustained attention?
maintain focus on relevant info without interference from irrelevant stimuli
what is selective attention?
maintains attention in presence of conflicting sensory info
what is alternating attention?
moves attention flexibly between tasks and respond to demands of task
what is divided attention?
responds simultaneously to two or more tasks
what are some conditions that may impair attention?
- hypoxic brain damage
- TBI
- stroke
- cerebral tumour
- dementia
- mental health issues
how does the midbrain reticular activating system affect attention?
- arousal
- mood
- motivation
- sustained attention
- vigilance
how does the parieto-temporo-occipital area affect attention?
-orientating
-engaging/disengaging
object recognition
how does the frontal lobes, anterior cingulate gyrus and basal ganglia affect attention?
- response selection
- intentional control
- active switching/inhibiting
- strategies for manipulating info
how does the right hemisphere affect attention?
- mediates alertness and sustained attention
- detecting/interpreting full visual field
how does the left hemisphere affect attention?
selective or focused attention
what are the primary areas of each lobe associated with?
PSC processes primary sensory and motor input
what are the secondary areas of each lobe associated with?
integration of incoming stimuli with adjacent areas
what are the tertiary areas of each lobe associated with?
complex integration of sensory input with other modalities and lobes
what is unilateral neglect?
lateral disorder of spatial cognition and space-related behaviour
what do people with uni-lateral neglect usually fail to respond to?
stimuli occurring on side of space opposite to lesioned hemisphere
what occurs in neglect of the primary area of parietal lobe?
self and personal self
what occurs in neglect of the secondary area of parietal lobe?
immediate enviro and less complex reactions
what occurs in neglect of the tertiary area of parietal lobe?
interpretation of complex enviro input
what are the levels of assessment OTs must attend to for unilateral neglect?
- personal (self and sensations)
- peripersonal (reaching)
- extrapersonal (locomotor space)
what are some subtests of the Behavioural Inattention Test?
- star cancellation
- line crossing and bisection
what are some implications of neglect on mobility?
- does not symmetrically weight-bear while standing
- difficulty initiating movement on left
- difficulty completing left turns
what are some implications of neglect on daily activities?
- fail to dress/groom left half of body
- ignores food on left side
- may complete activity in half space available
- overly attentive to items on right
what is the aim if the cognistat?
assess intellectual function
what domains are assessed by cognistat?
- attention, level of consciousness, orientation
- language
- constructions
- memory
- calculations
- reasoning
what is the aim of the RBMT-II?
detect impairment of everyday memory functioning and to monitor treatment
what domains are assessed by the RBMT-II?
- short-term
- long-term
- prospective
- semantic memory
what are the aims of LOTCA?
assess cognitive performance as baseline
what are the domains assessed by the LOTCA?
- orientation
- visual/spatial perception
- motor praxis
- visuo-motor organisation
- thinking
what functional impairment is affected by in tetraplegia?
arms, trunk and legs
what is a complete spinal cord injury?
absence of sensory or motor function in lowest sacral segments
what is an incomplete spinal cord injury?
only used when there is a partial preservation of sensory or motor function below neurological level and including sacral segment
what is central cord syndrome?
incomplete injury, centre cord damaged, more weakness in upper limbs
what is brown-sequard syndrome?
half of cord damaged causing ipsilateral loss of proprioception and motor function; contralateral loss of pain and temp
what is anterior cord syndrome?
front of cord damaged resulting in variable loss of motor and sensory function, preservation of proprioception
what is conus medullaris syndrome?
damage to sacral cord and lumbar nerve roots, impaired bladder, bowel and lower limb function
what is cauda equina syndrome?
lower motor neuron injury to lumbar nerve roots, impaired bladder, bowel and lower limb function
what are some secondary health conditions of spinal cord injury?
- autonomic dysreflexia
- postural hypotension
- pressure sores
- spasticity and spasm
- pain
what is autonomic dysreflexia as a secondary health condition of spinal cord injury?
dangerously high bp in response to noxious stimulus
what is postural hypotension as a secondary health condition of spinal cord injury?
dangerously low bp as a result of lying down to upright too quickly
what are pressure sores as a secondary health condition of spinal cord injury?
caused by constant pressure due to immobility
what is spasticity and spasm as a secondary health condition of spinal cord injury?
hyperactive stretch reflex
what are some barriers to social and community participation following spinal cord injury?
- professionals help or hinder
- social attitudes
- enviro inaccessible
- depression
what are some facilitators to social and community participation following spinal cord injury?
- adequate financial resources
- social support
- transport
what are the main parts of a wheelchair?
- frame
- brakes
- foot rests
- arm rests
- wheels
what is newton’s 3rd law?
every action has an opposite and equal reaction
what is normal force?
when force is perpendicular to material
what is shear force?
parallel or tangential to face of material
what does normal force in sitting compression?
means blood vessels, muscles, skin tissues are compressed, means oxygention of cells is reduced
what does shear force result in?
causes rubbing of skin over bone, leads to sores which combined with compression leads to pressure injuries
what are the common symptoms areas of ASD?
- social
- cognition
- emotional
- language
what does the diagnosis of ASD rely on?
observation of behaviour and checklists/testing with diagnostic criteria
what are the four criteria of the DSM V that must be met for ASD?
- deficit in social communication
- repetitive/restricted behaviour and interests
- symptoms present in early childhood
- limit daily functioning
what are some other associated features that are present with ASD but not parr of diagnostic criteria DSM V?
- gross/fine motor
- sleep
- sensory processing
- diet
- organisation skills
what are some co-morbidities of ASD?
- intellectual disability
- depression
- speech and language disorders
- attention disorders
what sensory processing occurs in frontal lobe?
emotions, judgement and voluntary movement
what sensory processing occurs in temporal lobe?
hearing and memory
what sensory processing occurs in the occipital lobe?
vision and reading
what sensory processing occurs in parietal lobe?
sensory integration centres
what is responsivity in ASD?
range within which sensory input is tolerated and used
what are some tools for assessing sensory processing?
- sensory profile 2
- sensory processing measure (SPM) (preschool)
- sensory integration and praxis test
what is sensory profile 2?
family of assessments that provide tools to evaluate sensory processing patterns in context of home, school and community based activities
what does the sensory profile 2 help determine?
- identify how SP interferes
- contribute info to assessment strengths and challenges in context
- develop interventions
who is the child sensory profile 2 for?
care-giver questionnaire for children 3-14
what does the child sensory profile 2 measure?
sensory processing, modulation and emotional responses
what are the four clusters of factors of the sensory profile 2?
- poor registration
- sensitivity to stimuli
- sensation seeking
- sensation avoiding
what are the 4 areas of the adult sensory profile?
- sensory seeking/avoiding
- sensory sensitivity
- low registration
what are some disruptive features of low registration of sensory processing?
- uninterested
- dull affect
- withdrawn
- self absorbed
what are some useful features of low registration of sensory processing?
high ability to focus and unaffected by varying enviros
what are some disruptive features of sensory sensitivity of sensory processing?
- distractible
- hyperactive
- vigilant
what are some useful features of sensory sensitivity of sensory processing?
particular about task and high ability to notice enviro
what are some disruptive features of sensory seeking of sensory processing?
- active
- fidgety
- excitable
- continuously engaging
what are some useful features of sensory seeking of sensory processing?
generates ideas and notices/enjoys activity in enviro
what are some disruptive features of sensory avoiding of sensory processing?
rule bound and rigid routines
what are some useful features of sensory avoiding of sensory processing?
designs and implements structure and enjoys routine
what are some parent observations common with children with sensory processing difficulties?
- no sense of humour
- avoids getting dirty
- touches things
- slow to respond to name
- dislikes haircuts
what are some things to consider when assessing children?
- areas of development interrelated
- parents experts on child’s ability
- needs to be fun
- performance influenced by experiences
who typically completes COPM for children?
primary caregiver
what are some functional goal-setting assessments for children?
- Miller Function and Participation scales (M-FUN-PS)
- school function assessments (kinder-year 6)
- school AMPS (3-15yrs)
what are some developmental goal-setting assessments for children?
- developmental indicators of the assessment of. learning (DIAL4)
- developmental profile 3 (DP-3)
what does the DIAL4 measure for goal setting for children?
physical, adaptive behaviours: social-emotional, cognitive and communication
what are some motor skills (fine and gross motor) for goal-setting assessments for children?
- Bruininks-Osertesky test of motor proficency, 2nd Ed (BOT-2)
- movement assessment battery for children (Movement ABC-2)
- peabody developmental motor scales (PDMA-2)
what age. is the sensory processing measure for?
preschoolers 2-5yrs
what is an assessment tool for handwriting for children?
shore handwriting screener (early hand writing 3-7yrs)
what is an assessment tool for visual ability for children?
- developmental test of visual perception (DTVP-3)
- beery buktenica developmental test of visual motor integration (Beery VMI)
what is an assessment tool for play skills for children?
- symbolic and imaginative play developmental checklist (SIP-DC)
- child-initiated pretend play assessment
what age is the SIP-DC for play skills of children for?
1-5yrs
what age is the child-initiated pretend play assessment for play skills of children for?
4-7yrs
what is an assessment tool for ADLs for children?
- the roll of evaluation of activities of life (REAL)
- paediatric evaluation of disability inventory (PEDI
- PEDI-CAT
what age is the PEDI assessment for ADLs for?
6months- 7yrs
what age is the PEDI-CAT assessment for ADLs for?
birth- 20yrs
what does the M-FUN assess?
- visual
- fine
- gross motor skills
how long does the M-FUN take to complete?
45-65 mins
what are some strengths of M-FUN?
- enjoyable
- sections scored independently
- easy to follow
- holistic understanding
what are some weaknesses of M-FUN?
- limited age range
- assessing and scoring at same time can be hard
what are some subacute mental health services for adults?
- prevention and recovery care service (PARC)
- community care unit (CCU)
when was the national mental health strategy first launched?
1992
what are the aims of the national mental health strategy?
- reform service delivery
- promote mental health
- reduce impacts
- assure rights of people
what are some key principles embedded in practice standards in mental health?
- promote QoL
- value lived experience
- recognise rights
- involve people in decisions
- tailor treatments to specific needs
what does the CHIME stand for?
- connectedness
- hope and optimism
- identity
- meaning and purpose
- empowerment
what is connectedness as part of CHIME?
- peer support
- being part of community
- relationships
what are hope and optimism as a part of CHIME?
- belief in recovery
- motivation
- positive thinking
what is identity as part of CHIME?
- individually defined
- rebuilding identity
- positive self identity
what are meaning and purpose as part of CHIME?
- rebuilding life
- quality of life
- spirituality
what is empowerment as part of CHIME?
- personal responsibility
- control
- focus on strengths
