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INTRO TO PT > FUNCTIONAL TRAINING > Flashcards

FUNCTIONAL TRAINING Flashcards

1
Q

Transfer

A

safe movement of a person from one surface or location to another from one position to another

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2
Q

Processes Involved in Transfer

A

pre transfer
transfer
post transfer

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3
Q

Importance of Transfer

A

to function in various settings and make use of various equipment
to increase pt’s independence
to prevent complications of prolonged mobility

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4
Q

Preparatory Activities Prior to Functional Training

A
  1. muscle strengthening exercises
  2. development of joint and muscle flexibility
  3. endurance training
  4. sitting and standing tolerance
    *check whether the strength of the pt is enough to carry their own body weight
    *check if the joint has an adequate amount of ROM
    *adequate tolerance in the upright position (sitting/ standing)
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5
Q

General Parameters

A

PT evaluation
available written information
pt or caregiver information
goals of treatment

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6
Q

Decision Regarding the Appropriate Transfer Depends On:

A

type of transfer and amount of assistance to be given
examination of pt prior to functional training
documentation of pt’s capability
treatment goal or max help from caregivers or relatives

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7
Q

General Transfer Principles

A

evaluate the patient: mental and physical capabilities
select, position, and secure: apply safety or transfer belt
instruct pt how to perform tranfer: demonstrate
practice components of transfer as necessary before attempting: teach and practice
mentally preplan the activities and sequence associated with the transfer
position yourself to guard and protect the patient throughout the transfer
request the pt to initiate and perform the transfer: assist as necessary
at the conclusion of the transfer, position the pt for comfort, stability, and safety; document changes

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8
Q

General Precautions During Transfers

A

pt’s clothing and footwear
be alert for unusual events that may occur
ensure that the attachments are secured
do not guard the pt by using his clothers/ grasping his arm

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9
Q

Guidelines in Teaching Transfers

A

explain and demonstrate the procedure: simple, concise, understandable, brief
prepare all necessary equipment
immobilize and secure transfer surfaces
ask for assistance, when in doubt about the level of assistance required
use common commands and counts to synchronize actions of participants in the transfer
guard the pt against falls
direct contact wt the pt during transfers: best biochemical posture, proprioceptive input
allow pt to use all available and necessary function: attain highest level of function
transfer is complete when pt is moved safely in new position: appropriate positioning and draping

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10
Q

Mobility Activities for a Bed and Mat

A

a. side to side movement, patient supine
b. upward movement , patient supine (assisted)
c. upward movement, patient supine (drawsheet)d. downward movement, patient supine
e. hooklying/ pelvic bridging

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11
Q

Standing, Sitting, Lifting Transfers

A

a. assist to the front edge of the chair/ table
- side to side weight shifting
- pelvic slide
- sitting push up
b. standing transfer, dependent pivot
c. standing transfer, assisted pivot (stronger knee stabilized)
d. standing transfer, assisted pivot (weaker knee stabilized)
e. standing transfer, assisted pivot (with stool/ higher surface)
f. standing transfer, assisted pivot (hip replacement)
g. assisted/ independent sitting transfer
- lateral sliding
- anterior-posterior sliding
- push up transfer
h. sliding board transfer
i. one person dependent lift transfer
j. two person dependent lift transfer (chair <—> bed)
k. two person dependent lift transfer (chair <—> floor)
l: three person dependent lift transfer (bed <–> stretcher)

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12
Q

Wheelchair Transfers

A

a. Floor <—> w/c
- anterior- posterior
-lateral
- push up

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13
Q

Types of Transfers

A

Independent
a. independent standing transfers
b. independent sitting transfers
c. assist to front edge of chair (w/c <–> floor): side to side weight shifting, pelvic slide, sitting push up; anterior, posterior, and lateral
modified independence
Assisted
a. assisted standing pivot
b. two-person lift transfer
c. sliding board transfer
d. pushup transfer
Dependent Assistance
a. dependent
b. mechanical transfer
c. pull sheet transfer
d. three person lift transfer
e. dependent standing pivot
f. one-person lift transfer/ quad lift
Guarding
a. close guarding
b. contact guarding

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14
Q

Independent Standing Transfer

A

no memory disorders
able to sequence a task
able to follow simple directions
can learn effectively by means of demonstration
ability to move freely in bed
good sitting balance and tolerance
ability to maintain hip and knee extension (voluntary muscle contraction, orthotic device spasticity)
good to normal UE strength in atleast 1 extremity

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15
Q

Preparatory Activities for Independent Standing Transfers

A

bed activities or bed mobility exercises (pelvic bridging, rolling, supine on elbows)
sitting: balance and tolerance ex
standing: balance and tolerance ex

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16
Q

Independent Sitting Transfers

A

adequate safety awareness
bed mobility skills
- rolling supine <–> prone
- supine <–> sidelying
POE
POH
hook lying
pelvic bridging
supine <–> sitting
adequate sitting balance and tolerance
good to normal UE/ trunk muscle strength
adequate hamstring range

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17
Q

Assist to Front Edge of Chair (w/c<–> floor)

A

allows a pt to get to his COG over his BOS rapidly and easily as he stands
Techniques:
- side to side weight shifting
- pelvic slide
- sitting push up

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18
Q

Conditions in Need of Assist to Front Edge of Chair (w/c <–> floor)

A

hemiplegic: pts with half body paralysis, d/t stroke
paraplegic: pts with paralysis of LE or lower trunk, d/t spinal cord injury (assist LE when transferring)

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19
Q

Modified Independence

A

use of adaptive or assistive equipment to perform a task independently (boards, rails, overhead trapeze, grab bars, furniture)
pt has safety or timeliness issues

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20
Q

Conditions in Need of Modified Independence

A

pts who use a cane and arm rest of sofa when transferring

21
Q

Assisted Transfers

A

assistance from another person to perform the activity safely in an acceptable time/ speed
oral/ tactile/ visual cures/ directions/ instructions may be used
standby assistance or supervision
minimal assistance
- pt performs 75% or more of the activity
- assistance is required to complete the activity
moderate assistance
-50%-75% of the activity
maximum assistance
-25%-50% of the activity

22
Q

Assisted Standing Pivot Transfer

A

pt can sit, stand, pivot, and bear some weight on the LE but with weakness or paralysis that necessitates assistance
can sit and stand independently
guarding the uninvolved LE
-when unfamiliar with pt’s capabilities
guarding the involved LE

23
Q

Two Person Lift Transfer

A

when a pt has some UE strength and good trunk control (to grab on the lifters)
often used in transfers of pt from w/c <–> floor or bed

24
Q

Sliding Board Transfer

A

when a pt has enough strength to lift his body and adequate sitting balance to move but still unable to perform a push-up transfer

25
Q

Conditions In Need of Sliding Board Transfer

A

pt w/ BKA

26
Q

Push Up Transfer

A

similar to sliding board transfer but without the use of a sliding board for support
when the pt:
-is able to perform the sliding board transfer independently
- has developed enough strength to lift his buttocks clear of the supporting surface
- has developed sufficient sitting balance and endurance

27
Q

Dependent Assistance

A

pt requires total physical assistance from one or more persons to accomplish the activity safely and in an acceptable time
special equipment or devices may be used

28
Q

Conditions In Need of Dependent Assistance

A

pt in a decreased level of arousal or in a coma
paralyzed on all fours and trunk or quadriplegic
severely impaired cognitive functions (mental retardation)

29
Q

Dependent

A

pt requires total physical assistance from one or more persons to accomplish the activity safely in an acceptable time
special equipment or devices may be used

30
Q

Mechanical Transfer

A

hydraulic lift: mechanical device that provides a method for one person to transfer a dependent pt
for very large pts and for those who are extremely dependent

31
Q

Conditions In Need of Mechanical Transfer

A

pt w/t spastic quadriplegia
obese

32
Q

Pull Sheet Transfer

A

sliding transfer from cart or stretcher to a treatment table
cart is usually positioned parallel to the treatment table or bed
draw sheet is placed under the pt

33
Q

Three Person Lift Transfer

A

when treatment table and cart cannot be positioned parallel to each other
cart is positioned and secured at right angle to the treatment table

34
Q

Dependent Standing Pivot

A

for pt who are unable to stand independently but can bear some weight on their LE

35
Q

Conditions in Need of Dependent Standing Pivot

A

weakness, paresis, or paralysis on LE

36
Q

One Person Lift Transfer/ Quad Lift

A

dependent sitting transfer when pt falls out of, or tips over a w/c
when pt is unable to stand or is unable to perform any type of sliding board transfer
need a skilled and strong caregiver/ assistant to do this safely

37
Q

Guarding

A

pt requires guarding during the performance of the activity for safety
cues or directions may be used

38
Q

Close Guarding

A

caregiver positioned close to but not touching the pt
minimal likelihood of the pt requiring protection during the activity

39
Q

Contact Guarding

A

caregiver positioned close to the pt with the hands on the pt or safety belt
high likelihood of pt requiring protection during the activity

40
Q

Documentation

A

Type of transfer performed
Amount or type of assistance the patient requires to perform the transfer
Equipment or devices used
Quality of movement demonstrated
Amount of time required to complete the transfer
Level of safety demonstrated
Level of consistency of the performance
Precautions for transfer (e.g., spinal, total knee replacement, or total hip replacement)

41
Q

H.D. a 70 y/o female pt suffered a stroke 7 days ago. She cannot move the (R) side of her body and she cannot use her (L) side well due to old age weakness. She was referred for PT rx today and was prescribed to have transfer training. You want to teach the pt bed chair transfer. Upon assessment, pt has intact cognition, and a F balance in sitting if back is supported. What transfer technique will you use on this pt? Document your technique properly using the rx documentation format.

A

P> dependent standing pivot shift transfer x 3 reps to increase indep/to facilitate proper transfer technique

42
Q

G.A. a 20 y/o male pt who suffered an MVA 2 mos. ago and was diagnosed with complete quadriplegia. Pt cannot move his bilat UE/LE and trunk for mobility. He was referred for PT mobilization. Further exam showed, 0/5 strength of the UE/LE muscles, (-) trunk control and pelvic but can follow commands. What transfer technique will you use on this pt to transfer him from bed to plinth? Document your technique properly using the rx treatment format.

A

P> 3 person lift transfer x 3 reps to facilitate proper technique demonstration.

43
Q

B.G. is a 40 y/o female pt who just had an ACL reconstruction surgery on the ® knee 2 days ago because of a fall. What transfer technique will you suggest for this pt if she wants to move from the bed to the chair? Document your technique using the examination format.

A

P > Indep. standing pivot transfer c CGA X 3 rep to ^ indep.

44
Q

A 43 y.o. (B) BKA pt was referred to you today. You wanted to train her in the proper transfer from w/c ↔ high mat. What transfer technique will you teach this pt? Document your technique properly using the rx documentation format.

A

P → w/c high mat using sliding board transfer from chair to highmat (pwede c CGA or indep depending on applied method by PT) x 3 reps to ↑ independence

45
Q

A 38 y/o pt who had a L sided weakness due to stroke 2 weeks ago was referred for PT. The pt has N strength of the ® UE/LE, F trunk control and F balance in standing. The (L) LE is flaccid (no muscle tone and is limp). You wanted to train the pt how to transfer from chair to chair. What transfer technique will you use to train this pt? Document your technique properly using the rx documentation format.

A

P > w/c assisted standing pivot transfer from chair to chair x 3 reps to ↑ independence

46
Q

You have a stroke patient with ®-sided UE and LE weakness. The patient has difficulty standing from a
sitting position since his ® knee buckles when standing. The average BP of the patient is 140/90 mmHg.
This is his first PT session. Based on the patient’s presentation, perform the appropriate transfer
technique for the patient from wheelchair to bed.

A

dependent standing transfer

47
Q

You have a patient with traumatic brain injury due to a motor vehicular accident. The patient is in a coma
right now. The patient needs to be transferred from the stretcher to his bed. The average BP of the patient
is 110/70 mmHg. The beds cannot be positioned side-by-side from each other because of space
limitations. Perform the most appropriate transfer technique for the patient.

A

three person lift transfer

48
Q

You have a patient with (B) LE paralysis due to spinal cord injury but has good UE strength. The patient
is assisted by their caregiver when transferring from bed to wheelchair. They recently bought a sliding
board so the patient can do the activity so the patient can do the activity even when the caregiver is not
at home.

A

sliding board transfer

49
Q

You have a recently discharged patient with (B) LE paralysis due to spinal cord injury. He has excellent UE strength. The patient uses a wheelchair for mobility. At home, the patient sleeps on a mattress on
the floor. Currently, his caregiver helps him move between the mattress and the wheelchair, but the
patient wishes to be able to perform this task by himself. Teach the patient the most appropriate transfer
technique.

A

posterior floor<–> w/c transfer

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