Final Important Points Flashcards
_____ is a known predictor of falls in older adults
cognitive impairment
research shows what 2 factors contribute to increased fall risk?
increased dementia severity
reduced dependance on visual input
CVA pts have longer onset _____ that were smaller in amplitude in the _____ paretic limb mm
latencies
distal
concussion/mTBI
GCS:
PTA:
LOC:
imaging:
concussion/mTBI
GCS: 13-15
PTA: <24 hr
LOC: 0-30 min
imaging: NDA
moderate TBI
GCS:
PTA:
LOC:
imaging:
moderate TBI
GCS: 9-12
PTA: 24h-7d
LOC: 30min- 24h
imaging: some findings
severe TBI
GCS:
PTA:
LOC:
imaging:
severe TBI
GCS: 3-8
PTA: >7days
LOC: >24 hr
imaging: significant findings
what is the most common TBI?
concussion
what are the 12 Rs of SRC?
Recognize
Reduce
Remove
Re-evaluate
Rest
Refer
Rehabilitation
Recovery
Return-to-learn/sport
Reconsider
Retire
Refine
what are the 5 steps for SCAT?
observable signs
GCS
cervical spine assessment
coordination and ocular/motor screen
memory assessment
what are the red flags of concussion (SCAT)?
neck pain or tenderness
double vision
weakness or tingling/burning in >1 arm or leg
severe or increasing HAs
seizure or convulsion
LOC
deteriorating consciousness
vomiting
increased restless, agitation, aggressiveness
GCS <15
visible skull deformity
what are the pre-existing risk factors for developing PPCS?
female
adolescent
hx of personal or family anxiety/depression
PMHx or family Hx of migraine
DD or learning disorders
pre-existing visual dysfunctin
what are the post-injury risk factors for developing PPCS?
- CONTINUING TO PLAY POST CONCUSSION
- severity of initial sx in 1st few days post
- having vestibular and convergence abnormalities
- high inflammation levels
- resting too long
what 5 systems interact to cause persistent sx following concussion?
cervical spine
vestibular system
visual system
ANS
psychological factors (mood, anxiety, etc.)
what are the 4 major ocular motor systems affected by concussion?
convergence (50-60%)
smooth pursuit (60%)
saccadic (30%)
vestibulo-ocular
what are the 3 systems for sensory input for balance and postural control?
vestibular
visual
proprioceptive
what 3 structures are integrate sensory input for balance and postural control?
cerebellum
cerebral cortex
brain stem
the rule for ramps is AT LEAST ____ foot of length for each ____ of height
1 foot length for every 1 inch height
person must be in a WC at least ___ hours per day to qualify for funding
4
what question MUST be answered yes to qualify for WC funding?
require WC to perform “mobility related ADL” WITHIN HOME
seat width measurements for WC
less than 1 & 1/4” wider than person’s hips/thighs
seat depth measurements for WC
1-2” less than posterior buttocks to popliteal fossa
seat height measurements for WC
standard: 19-19.5
hemi height: 17-17.5
what needs to be considered for seat height measurements?
lower leg length
transfer type
propulsion method
type of thickness of WC cushion
where to measure for arm rest height
with cushion in place
from bottom of seat (not cushion)
what is a secondary condition?
occurs after individual acquires or is born with a disability.
characteristics not associated with trauma
examples of secondary conditions
CV issues/heart disease
pressure ulcers
obesity
diabetes
the aims of health promotion program for people with disabilities are to:
- reduce secondary conditions
- maintain functional independence
- provide opportunity for leisure enjoyment
- enhance overall quality of life by reducing environmental barriers to good health
T/F: sedentariness is not a major mortality risk if the person is physically active
F!!!!
“sedentariness is describe as a major mortality risk INDEPENDENT of physical activity
a person initially enters the transtheoretical model of change at the ___ stage
pre-contemplation
each time a person goes through the cycle, they learn from each ____ and each relapse is shorter (____ spiral)
relapse
upward spiral
tests of activity limitations
bed mobility
transfers
gait
stair climbing
ADLs
what are the 4 main interventions for cerebellar dysfunction?
muscle tone
voluntary movement coordination
static and dynamic balance
oculomotor performance
common gait and balance interventions for cerebellar dysfunction
gaze and eye movements
static stance
dynamic stance
gait
complex gait
hallmark of cerebellar damage
ataxia
prognosis of cerebellar damage depends on what 3 things?
tumor type
nuclei involved
(dentate, emboliform, globose, fastigial)
age
cerebellar zones and their function
medial - posture
intermediate - coordinating limbs
lateral - planning complex movements
flocculonodular - balance & eye movements via vestibular
Movement deficits following cerebellar damage include
dysmetria
dyssynergia
dysdiadochokinesia
cerebellar tremor
hypotonia
gait ataxia
imbalance
PT should emphasize the cerebellum’s role in _____ and ______
procedural motor learning and adaptation
SCA stroke symptoms
ipsi limb dysmetria
gait instability
AICA stroke symptoms
facial sensory loss
vestibular issues
dysmetria
PICA stroke symptoms
vertigo
nystagmus*
gait ataxia
medicare part B only pays ___% for WC
80%
(20% copay)
a study showed that on a split belt treadmill cerebellar pts have what issues?
slower adaptation
lower symmetry restoration
minimal aftereffects
what is the leading cause of morbidity and mortality in the US?
chronic, noncommunicable disease
__ is the leading cause of chronic disability
stroke
____% of people with chronic stroke have IGT or T2DM
81%
IGT or DM predict _____ x increased risk for recurrent stroke
2-3x
nearly ____ of pts with stroke experience recurrent stroke w/i ____ years
1/3
5
which mm fiber types decreases most with chronic stroke?
slow twitch
which mm fiber type are less sensitive to insulin?
fast twitch
what is the highest predictor of insulin resistance in chronic stroke?
fat content of paretic limb (not central obesity)
primary prevention
most effective strategy
prevent illness from occurs
secondary prevention
detecting and treating illness/disease early
tertiary prevention
managing existing disease to prevent further complications/disability
primordial prevention
risk factor reduction
through laws and national policy
layers of the social ecological model
individual
interpersonal
organizational/institutional
community
societal
social determinates of health
economic stability
education access and quality
health care access and quality
neighborhood and build environment
social and community context
what is termination?
permanent change in behavior
