General items to memorize Flashcards
PICO purpose
EBP strategy used to create clinical questions and direct research
PICO acronym
- P= Person/ problem interest/ population (what are characteristics of patient?)
- I= Intervention (What do you want to do with the patient?)
- C= Comparison/ control conditions (other interventions or treatments, no treatments, etc.)
- O= outcomes (what are you trying to accomplish?)
PICO example
- P=child with attention and sensory seeking behaviors has difficulty completing assignment in classroom
- I= increase child’s attention by used of therapy ball
- C= therapy ball vs, student chair at desk
- O= does child’s learning improve on therapy ball vs. desk chair?
Levels of evidence: level 1
Systematic reviews, meta-analysis, RCT and intervention groups
-highest level of evidence
Levels of evidence: Level 2
Non-randomized studies with 2 groups; 1 is a control group
Levels of evidence: Level 3
Non-randomized study with 1 group; before and after, longitudinal, etc.
Levels of evidence: Level 4
Descriptive studies, analysis of outcomes, single-subject design, case series, survey studies
Levels of evidence: Level 5
Expert opinion, lit review, research not performed on human subjects
Alpha level (p-value)
Pre-selected level of statistical significance; percentage of error due to chance researchers are willing to accept
-usually .05 (only a 5% chance of this error)
MET levels
Amount of energy burned or oxygen needed during exercise and various physical activities (generally rated 1-10)
Common MET level requirements
- Dressing requires 2 MET levels
- All self-care is under 3 METs EXCEPT for hot showers (around 4-5 METs)
- Most IADLs under 6 METs
- During healing process after heart attack, most MET levels kept around 2-4.
ASIA scale A
Impairment in complete: there is no motor or sensory function below the level of injury
ASIA scale B
Impairment is incomplete: sensory, but no motor function below level of injury
ASIA scale C
Impairment is incomplete: motor function preserved below injury, but more than half of key muscles are at muscle grade less than 3
ASIA scale D
Impairment incomplete: motor function preserved below injury, around half of key muscles have muscle grade of 3 or more
ASIA scale E
All motor and sensory functions are unhindered
Alzheimer’s stage 1
Mild memory decline; present with anxiety and confusion
- IADLs and ADLs still possible
- Can learn new tasks, but will need them graded for success
- Post-its, calendars and physical reminders helpful in this stage
Alzheimer’s stage 2
Mild-to-moderate decline; patient will remove themselves socially and experience paranoia and hostility
- ADLs mildly impacted, IADLs moderately impacted
- No new tasks can be learned, stick to simple instructions
- focus on maintaining structure, routines and environmental support
- Using photos can be helpful for reality orientation
Alzheimer’s stage 3
Moderate to mod-severe cognitive decline; not oriented to time or place, agitated and prone to angry outbursts
- ADLs and IADLs not possible
- Overlearned activities with simple 2-3 steps
- safety very important; remove sharp objects, increase lighting, give identification bracelet, declutter environment
- caregiver training imperative
Alzheimer’s stage 4
Sever cognitive decline; unable to communicate, walk or control bodily functions
-goal in treatment to maintain proper positioning and teach caregiver on things like skin integrity (all about comfort)
C1-C3 SCI
Usually dependent on ventilator for breathing; talking sometimes difficult
- C3 may have limited movement of head and neck
- primary OT goals should be wheelchair mobility
- Power tilt chair allows for pressure relief; can be operated through head control, mouth stick or chin control
C4 SCI
Full head and neck control, some limited shoulder movement, complete paralysis of body and legs; able to breath without ventilator, need assistance clearing secretions and coughing
-Power wheelchair controlled by either chin or sip-and-puff
C5 SCI
Full head and neck control, good shoulder movement, some elbow flexion/supination, complete body and leg paralysis
- Electric wheelchair can be used with hand controls; can use manual wheelchair on flat, even surfaces
- Can use typing stick or voice recognition for communication
- driving may be possible
C6 SCI
Radial wrist extension gained at this level; passive key-grip (tenodesis) possible at this level by flexing wrist backwards to grip
- A sliding board can be used for assisted transfers
- Can used Wanchik splint or tenodesis splint to help with writing
- some clients can manage bowel and bladder
- can assist in pressure relief
C7-C8 SCI
Full elbow extension and flexion, full wrist flexion and extension; C7 allows some movements of thumb
-independent in upper-body grooming and showering dressing
T1-T4 SCI
Full use of arms, wrists and fingers; lower body paralyzed, upper-body strength depends on level of injury
-Manual wheelchair may be used for everyday living; may need assistance loading and unloading wheelchair in car
Lower SCI milestones
- T10-L1: trunk stability achieved
- L2-S5: partial to full control of LE
Right hemisphere CVA
- Left hemiparesis
- Visual field deficits
- Neglect
- Poor insight and judgement or impulsive behavior
Left hemisphere CVA
- Right hemiparesis
- Aphasia (issues understanding or expressing language)
- Apraxia (motor planning deficits)
- Abstract reasoning/math deficits
- Analytical and sequential thinking deficits
Psychodynamic FOR
FOR suggests unresolved childhood events are the reason for dysfunction; therapy is usually discussion based
Cognitive behavioral FOR
Suggests distorted thinking leads to behavioral and emotional problems related to mental illness; focus of therapy is to increase awareness and change distorted thinking to alter behavior and emotions
-Psychoeducation is a component of this theory
General treatment of complex regional pain syndrome (CRPS)
Elevate affected limb, do NOT use heat, focus on managing edema before ROM
