Goals and Interventions

Question 1

All candidates of post acute rehab should receive

Answer 1

organized, coordinated, interprofessional care.

Question 2

Those who qualify for or have access to inpatient rehab should receive care in

Answer 2

IRF over a SNF

Question 3

What is not recommended for stroke ?

Answer 3

high-dose, very early mobilization within 24 hours of stroke.

reduces odds of favorable outcome at 3 mo.

Question 4

Why is high dose not recommended early on?

Answer 4

could increase ischemia.

Question 5

What is used to do skin assessment?

Answer 5

Braden Scale

<18 signifies increase risk of developing ulcer.

Question 6

For hemiplegic shoulder positioning, what is emphasized?

Answer 6

approximation and shoulder ER

Question 7

What is PT role in Prevention?

Answer 7

Transfer Training
Positioning
Wheelchair cushion
Mattress.

Question 8

What should be used for spasticity/contractures?

Answer 8

Resting Hand splints
Ankle Splints
Casting
Tendon Release.

Question 9

What are principles of experience dependent plasticity

Answer 9

Use/lose it
use/improve it
Specificity
Repetition matters
Intensity Matters
Time matter
Salience
Age
Transference
Interference

Question 10

DVT prophylaxis should be initiated and maintained until patient regains___

what to use and whats not useful?

Answer 10

mobility.

intermittent compression

elastic socks.

Question 11

What is recommended for management of hemiplegic shoulder pain?

Answer 11

• edu on ROM and position
• Botox to reduce spasticity
• neuro pain meds
• devices/slings for sublux
• NMES
• NO PULLEYS

Question 12

What causes central pain in stroke

Answer 12

thalamus (thalamic pain syndrome)

Question 13

Fall prevention hacks?

Answer 13

• exercise program with balance training after d/c
• fall prevention program before discharge
• annual eval
• edu
• tai chi

Question 14

What is done for assessment of Disability/rehab needs?

Answer 14

-assess condition/impairements/function/ADL

make goals.
followup 30 days after.

Question 15

What to do to assess motor impairment/activity/mobility?

Answer 15

• use standardizes tools
• questionnaires
• technology
• compare with reassessment.

Question 16

What should be provided for hemispatial neglect?

Answer 16

prism adaptation
visual scanning training
optokinetic stimulation
virtual reality
mental imagery
stim.

Question 17

What can be done for spasticity?

Answer 17

-Botox
-oral meds
-NMES
-Intrathecal baclofen
Splint/taping. (not fingers/wrist)

Question 18

Why is botox better than oral meds

Answer 18

meds have side effects and make person sedated. botox is local.

Question 19

What is a baclofen?

Answer 19

catheter inserted to CSF to give med bypassing digestive system

Question 20

What done for Balance/Ataxia

Answer 20

balance training program
AD or orthosis
Posture training.

Question 21

What done for mobility?

Answer 21

• mobility task-training
• circuit training/TM
• robot assisted/ VR
• NMES

Question 22

What to note for chronic care management?

Answer 22

• individual POC to improve cardio and reduce risk of stoke

- participate in exercise AFTER d/c

Question 23

Nervous systems ability to adapt and modify its own organization and function

Answer 23

Neuroplasticity

Question 24

CNS remodeling in response to practice

Answer 24

Experience-dependent plasticity

Question 25

Integration of alternative motor elements from different end effectors

Answer 25

Substitution

Question 26

new motor patterns from adaptation of remaining motor elements

Answer 26

compensation

Question 27

reacquisition of elemental motor patterns present prior to CNS injury

Answer 27

Functional Recovery

Question 28

Functional recovery occurs as result of

Answer 28

spontaneous recovery
experience-dec motor training
-increased involved contralateral hemisphere
-axonal remodeling