final op Flashcards
1
Q
SCI health history questiosn
A
- Are any other conditions present, such as hypertension, diabetes or kidney disease
- When did the injury occur?
- What is the type of injury (complete or incomplete) and at what level is the lesion?
- Was surgery performed to stabilize the spine? Are pins, wires or rods present?
- Does the client experience spasticity? If so, which limbs are affected, how severe is it and are there any specific triggers?
- What medication is the client taking? When was it last taken?
- Is the client experiencing any pain? Can the client describe the type of pain as well as where, when and how long it is experienced?
- Are there any sensory losses? What specifically was lost — pain and temperature or deep touch perception, for example?
- Does the client have autonomic dysreflexia? What are the triggers? Who should be contacted if this occurs during the massage?
- Does the client experience hypotension?
- Does the client experience difficulty in regulating body temperature? For example, is sweating or shivering functioning appropriately?
- If it is not obvious, is a leg bag used? This bag is used to hold urine and must be carefully positioned during the massage.
- What movement is affected? How are the client’s fine and gross motor skills?
- What activities can the client do? Does the client work? What are the client’s hobbies?
2
Q
CNS Strategies
Massage Techniques for Spasticity
A
- Swedish - repeatedly and slow
- Shaking - slow, rhythmical
- GTO
- Tapping antagonistic mm - for spastic bicep, tapping triceps
- PROM of affected jts
3
Q
CNS Strategies
Massage Techniques for Rigidity
A
- Swedish techniques
- Slow passive stretches
4
Q
CNS Strategies
Treatment goals
A
- Decrease SNS firing
- Maintain tissue health
- Decrease rigidity and spasticity of mm
- Maintain jt health and ROM
5
Q
Stroke/Hemiplegia Questions
A
- Are there any conditions that can affect cardiovascular health, such as diabetes, kidney disease, atherosclerosis, heart disease, hypertension or emphysema? Is there a family history of stroke or any other condition?
- When did the stroke occur? Is there a previous history of stroke or transient ischemic attack?
- What was the cause? What treatment has been received? Was surgical repair done?
- What medications have been prescribed? Does the client take them as directed?
- Is the client’s blood pressure stable? When was it last checked?
- Has the client had seizures since the stroke? If so, how often do they occur? Can the client describe what happens? Is medication being taken to control them?
- Does the client’s physician know he is seeking massage therapy?
- Does the client expenence any pain? Can the client descnbe the type of pain as well as where, when and
how long it is experienced? - What therapy was done — physiotherapy, occupational therapy, speech therapy, massage therapy? How long was it received? What was the purpose of the therapy?
- Has the physician restricted any activities, such as prolonged or vigorous walks or hot baths?
- What activities of daily living is the client able to do — walk, shop, cook, dress? How long can the person
do these activities before feeling fatigued or short of breath? Are these activities done with or without
assistance? Are supports used, such as splints, orthotics or a cane? - What is the client’s general lifestyle, including activities that can improve cardiovascular health, such as stopping smoking, reducing or eliminating caffeine and alcohol consumption, exercising and modifying diet, particularly limiting fat and sugar intake? Is the client compliant with these changes to improve his cardiovascular health?
6
Q
Parkinsons Disease Questions
A
- What is the client’s general health? Are there any cardiovascular problems, diabetes or kidney disease?
- When was the client diagnosed?
- What were the first symptoms experienced? How have they progressed? What are the current symptoms?
- What medications are currently being taken? Are any side effects being expenenced?
- Does the client expenence “on-off phenomenon? The client should be encouraged to book massage
appointments for when the medication is working to get the most benefit and allow the therapist to do the
most effective work. - What other treatment is the client receiving, such as physiotherapy or chiropractic?
- Is the client experiencing any pain? Can the client describe the type of pain as well as where, when and how long it is experienced?
- What is the functional ability of the client’s fine and gross motor skills? How able is the client to do activities of daily living? Is the client independent? Is he working? Is he retired? Does he have any hobbies or perform regular exercise?
- Are any difficulties expenenced with changing positions, such as turning over in bed or getting up from a supine position? This helps the therapist know how much assistance the client will need dunng the massage.
- Does the client use any aids, such as a cane or walker?
7
Q
MS Questions
A
- Are other conditions present, such as a cold, flu or infection? These conditions can increase the client’s
susceptibility to fatigue. - When was the diagnosis of MS made? When were the first symptoms experienced? What were the
symptoms? - How has the MS progressed for the client?
- What are the symptoms currently being experienced by the client?
Doe s the client have attacks and remissions?
- When was the last attack? How long did it last? Have any of the symptoms remained?
- Is the client taking any medication?
- Is pain present? Can the client describe the type of pain as well as where, when and how long it is
expenenced? - Is there diminished or lost sensory perception or limb proprioception
- Does the client expenence fatigue? When does it occur? How does this feels for her? How long does it take her to recover?
- Is the client seeking any other treatment, such as physiotherapy, naturopathy or chiropractic?
- How functional is the client with activities of daily living? Is she independent, working? What are the client’s gross and fine motor skills?
- Are supports used? Are they used occasionally or daily?
- What are the client’s current stress levels?
- How is the client affected by heat? By exercise, hot weather, showers or baths? Stress and heat affect fatigue levels as well as exacerbating symptoms.
- Is the client participating in any rehabilitation, exercise or other program?
- Has the client had previous massage experience?
- What is the client’s treatment focus for that day?
8
Q
Cerebral Palsy Questions
A
- Are any other conditions present, such as hypertension, diabetes or kidney disease?
- What type of cerebral palsy does the client have?
- What are the client’s general symptoms?
- What medication is the client taking?
- Is the client experiencing any pain? Can the client describe the type of pain as well as where, when and how long it is experienced?
- Are there any sensory losses? Hearing? Vision? Speech?
- Does the client have seizures? What type is experienced? What are the triggers?
- What movement is affected? How are the fine and gross motor skills? Are ambulation aids used?
- What activities can the client do? Does the client work? What are the client’s hobbies?
9
Q
Sensory testing protocol
A
- Broad strokes (eyes open)
- Light strokes different parts
- Light touch or deep touch
10
Q
Special tests for each conditions:
A
SCI: Sensory testing, postural (decubitus ulcer)
Parkinsons: Sensory, bradykinesia test (positive if more slow and difficult)
MS: ROM, Sensory, postural
huntingtons: ROM, postural
ALS: Postural, ROM
Stroke: Sensory, ROM, Postural, palpation
CP: Sensory, Postural,
11
Q
Treatment goals:
A
- Maintain tissue and joint health
- Reduce edema
- Reduce spasticity
- Relieving pain/hypertoned mm
*
12
Q
UMN Lesions indicated treatments
A
Inhibitory ROODS
Swedish massage
PROM
Joint play
13
Q
Inhibitory ROODS TEchniques
A
Inhibitory Pressure:
Light joint compression or approximation:
Maintained stretch:
Slow stroking:
Slow Vestibular Motion:
14
Q
A
