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NeuroRehab > home assessment parameters > Flashcards

home assessment parameters Flashcards

1
Q

garages and driveways

A

24 feet

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2
Q

porches

A

5x5 feet

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3
Q

doorway width

A

32-34 inches

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4
Q

doorway threshold

A

no more than 1/2 in

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5
Q

doorway kick plate

A

12 feet

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6
Q

steps

A

not greater than 7 inches hight, 11 inches deep

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7
Q

lip of step

A

1/2 inch

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8
Q

handrail height

A

34-38 inches

at least one should allow for modificiations

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9
Q

handrail should extend a minimum of

A

12 inches beyond foot and top of stairs

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10
Q

ramp grade

A

1:12 (feet)

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11
Q

outdoor ramps exposed to rain and slow

A

1:20 (feet)

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12
Q

rise for ramps for power WC

A

1.5 inch first for every foot

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13
Q

if ramp more than 5% grade (power WC)

A

hand rails should be 32 inches from rap surface and extend an inch beyond top and bottom of ramp

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14
Q

minimum ramp width

A

36 inches inside rails, 48 is ideal

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15
Q

top of ramp

A

5x5feet

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16
Q

bottom of ramp

A

5 foot straight away

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17
Q

indoor doorways

A

consistent with outdoors 32-34 inches

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18
Q

indoor stairs

A

handrails extend minimum 12 inches

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19
Q

kitchen aisle

A

5x5 feet floor space
32 inch doorway
36 inch walk way

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20
Q

stoves

A

32 inches adequate height for sitting

consider raising dishwasher 6 inches

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21
Q

kitchen cabinets

A

12-15 inches

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22
Q

counter tops

A

36 in standard

30 inch for WC/LBP, child

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23
Q

bedroom windows

A

18-20 inches from floor, 30 inches from ground

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24
Q

bathroom door

A

32 in standard 36 recommended

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25
Q

toilets

A

15 inches above floor with grab bars,

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26
Q

bathroom sinks

A

30 inches

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27
Q

bathroom grab bars height

A

1.23-2 inch CSdiameter

33-36 inches next to toilet

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28
Q

bathroom grab bar length

A

42-54 inches on side wall

24-36 on back wall

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29
Q

mcconnel taping worn for up to

A

18 hours

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30
Q

acute phase kinesio tape

A

fingers with no tension, skin stretched, insertion to origin

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31
Q

kinesio tape for weak muscles

A

tension on tape, origin to insertion

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32
Q

paper off tension

A

0-15% for acute conditions

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33
Q

light tension

A

15-25%

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34
Q

moderate tension

A

25-50%

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35
Q

sever tension

A

50-75%

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36
Q

full tension

A

75-100%

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37
Q

tension on anchors

A

0% because they are meant to disperse energy

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38
Q

tape tension >50%

A

for corrective techniques only

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39
Q

mcconnel tape worn for

A

1-2 days

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40
Q

kinesio tape worn for

A

3-5 days

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41
Q

little league shoulder

A

widening of proximal humerus epiphysis
decreased ER and ABD strength
min 6 weeks no throwing, gentle post shoulder stretch, core strength
after pain free ROM begin RC strength, scap strength and control

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42
Q

little league elbow

A

medial eipcondyle apophysitis or avulsion fx
rest 6-8 weeks; rc and scap strength, dynamic shoulder stabilization
return to throw at 6 weeks if pain free ROM

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43
Q

throwing phases

A 
wind up 
cocking
acceleration
deceleration
follow through
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44
Q

phase with most stress on passive shoulder structures

A

cocking due to ER

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45
Q

phase with most stress on shoulder musculature

A

deceleration

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46
Q

phase with most elbow stress

A

acceleration phase

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47
Q

most important aspect of wind up

A

winding up lower extremity to generate force

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48
Q

phase with greatest elbow valgus stress

A

late cocking

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49
Q

phase with peak RC activation

A

late cocking

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50
Q

stride length

A

87% of height

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51
Q

most harmful phase of pitch

A

decelleration

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52
Q

increased risk for injury with limited hip ROM

A

limited flexion in lead
limited IR in lead
limited extension in train
limited ER in both

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53
Q

good predictors of UE injury and pitching performance

A

SLS control and SEBT

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54
Q

trunk rotation timing/control decreases

A

shoulder and elbow forces

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55
Q

trunk rotational strength related to

A

ball velocity

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56
Q

trunk lean affects

A

UE forces

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57
Q

CKCUEST

A

21 taps in 15 seconds predictor for injury risk

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58
Q

core strength

A 
prone plank
side plank 
Sorensen's 
DL bridges
SL bridge
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59
Q

decreased stride length and push off correlates to

A

decreased ball velocity

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60
Q

pitches need more trunk rotation to

A

the non-throwing side - more time to wind up and more time to deceleration in follow through

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61
Q

glenohumeral internal rotation deficit

A

GIRD - loss of 18 degrees or greater of IR in the throwing shoulder compared to non throwing shoulder

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62
Q

bigger difference in Max ER compared to passive ER

A

higher risk of injury

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63
Q

SA important during cokcing

A

eccentrically and isometrically to resist retraction

concentrically to cause protraction and upward rotation

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64
Q

middle and lower trap

A

fire concentrically to resist protraction

create stable surface for rotator cuff to work

65
Q

difference in protractor/retractor ratio increased risk of shoulder pain

A

> 20%

66
Q

greatest lower-upper trap ratio

A

B/L ER at 0 deg ABD

67
Q

teenage pitcher guidelines

A

75 pitches / game
1000 per competitive season
3000 per calendar year

68
Q

key guidelines for pitching

A

don’t pitch w/ elbow or should pain, or on consecutive days
don’t play year round - rest is best
age appropriate skills

69
Q

pitching emphasize

A

control, accuracy, good mechanics

70
Q

pitch type progression

A

fasteball
change up
then consider breaking pitches

71
Q

softball pitch guidelines

A

2 days rest for pitchers
<12 yo - only 2 days consecutive pitching
>13 yo - only 3 days consecutive pitching

72
Q

plyometric prerequisites

A

pull pain free AROM
80% strength vs opposite side
good quality movement
no swelling

73
Q

plyo frequency

A

2x / week
6-8 weeks
48-72 hours recovery time

74
Q

plyo volume

A

5-10 reps/set, 1-3 sets per motion with 6 different motions

60 throws low, 120 high

75
Q

plyo intensity

A

80-100 MVC
2 arms to one arm
5-10% progression each week

76
Q

injuries 2x more likely to occur in ____ thank backswing

A

down swing

due to amount of force and velocity required

77
Q

1 in 4 gold injuries occur during

A

follow through

78
Q

walking an 18 hole course

A

5-6 niles

79
Q

total joint precautions with golf

A

avoid wet conditions
use small or no spikes
use cart or caddy
limit backswing and follow through - decrease mechanical stress

80
Q

golf ROM

A

subtler joint rotates 5-8
hips 30-40 IR
40-60 ER
thoracic spine 40

81
Q

economical runners

A 
shorter stride, faster caidence (180/min)
knee joint flexion maintained
ball heel ball toe
foot lands under COM (hip extension)
decreased vertical displacement of COM
82
Q

running - forward lean

A

from foot to shoulders not at trunk so steps fall directly under COM

83
Q

rearfoot running

A

impact nearly 3X BW

most of vertical momentum is absorbed by vertical components of collision - slows down momentum

84
Q

forefoot running

A

7 times lower impact at IC

vertical momentum converted to rotational momentum

85
Q

as cushioning in shoes is lost

A

foot control improves

86
Q

plan for runners

A

flexibility
strenth
retrain of running gait

87
Q

pelvic floor muscle functions

A

supportive
sphincteric
sexual

88
Q

second leading cause of CA death in men

A

prostate cancer

89
Q

PSA

A

prostate specific antigen test
detects blood levels of a protein made only by the prostate cells
below 4 normal
4-10 slightly elevated
above 10 highly elevated and cancer likely

90
Q

Gleason score

A

rating deformity of prostate cells after biopsy has been taken
higher score - increased speed of cancer growth

91
Q

prostate CA stage T1

A

cannot be felt, confined w/in capsule, usually found by chance (PSA)

92
Q

prostate CA stage T2

A

can be felt with digital exam
still confined
no symptoms

93
Q

prostate CA stage T3

A

spread beyond capsule
varied symptoms
frequent, bloody or painful urination

94
Q

prostate CA stage T4

A

metastasis
sudden weight loss
difficult, painful urination
low back pain

95
Q

possible etiology of incontinence

A

sphincter deficiency
decreased bladder compliance
detrusor instability

96
Q

most widely recommended non invasive conservative tx for continence post RP

A

supervised pelvic floor muscle training

97
Q

first line option in curing incontinence post RP

A

pelvic floor reeducation

98
Q

effective tx for intontience from RP persisting more than 1 year

A

behavioral therapy

99
Q

PFMT offers no further benefit…

A

4-6 months after initiation of program

100
Q

neobladder- bladder emptying education

A 
no muscle to push urine out
no sense of filling/fullness
larger capacity than true bladder
normal cycle disrupted
voiding on the clock (2-4 hrs)
evacuation strategies
101
Q

possible sensitivity to certain fluids (bladder)

A

caffeine
citric acid
carbonated drinks
alcohol

102
Q

pelvic floor physical therapy focuses on

A

behavioral modification
improving pelvic floor muscle strength, endurance, coordination
neuro muscular re-ed

103
Q

common errors with pelvic floor awareness training

A

holding breath
bearing down
active abdominals
active gluteals

104
Q

pelvic floor exercise dosage

A

2-10 sec hold
15-30 reps
2-5 exercises per session
twice daily

105
Q

pelvic floor hypertonia

A

inadequate sphincter closure
voiding/defecation dysfunction
pelvic pain impaired coordination and ROM

106
Q

pelvic floor hypotone

A

inadequate sphincter closure
urinary/fecal or flatus incontinence
pelvic organ prolapse
poor pelvic floor/core muscle performance strength, endurance and coordination

107
Q

stress urinary incontinence

A

leakage upon increased load on the pelvic floor accompanied by lack of adequate urethral closure

108
Q

urge urinary incontinence

A

overactive detrusor

behavior management and coordination training

109
Q

pelvic floor strength

A

3/5 lift and squeeze against gravity

5/5 difficultly pulling finger out

110
Q

safe exercise during pregnancy

A

avoid supine > 3 mins post 1st trimester (30 degree angle)
left sidelying
avoid prone
avoid strong abdominal compression during 2nd/3rd trimester
avoid rapid bouncing or swinging
avoid overheating and stay hydrated

111
Q

benefits of exercise during pregnancy

A

lower incidence gestational diabetes
shorter 1st stage of labor
increase in APGAR scores at 1 min mark
help with fast recovery post delivery

112
Q

pregnancy exercise intensity guidelines

A

RPE moderate 13-14
talk test
150 mins/week 30 mins 5days/week

113
Q

lower extremity ROM required for dancers

A

90 PF
90 LE ER
90-100 1st MTP DF

114
Q

Your patient started CAR T-cell therapy for treatment of Multiple Myeloma. She presents with
the following symptoms: fever, nausea, headache, rash, rapid heartbeat, low blow pressure, and
trouble breathing. You are concerned about which condition?

A

Cytokines Release Syndrome

115
Q

T or F?
One benefit of Autologous stem cell transplant versus allogenic stream cell is autologous stem
cell transplant has less risk of graft versus host disease (GVHD).

A

true

116
Q

Your patient is a 43 year old male who presents with bilateral acute hypertonic lumbar
paraspinals. You choose kinesiotape as your intervention. What application would be best for
this patient’s condition?

A

From insertion to origin bilaterally

117
Q

You are treating a 19 year old male baseball pitcher with excessive anterior capsule instability.
He reports reduced pain with manual posterior glide. His anterior numeral position does not
change with activation of scapular stabilizers. Which taping method would be best for this
patient?

A

Leukotape to position the humerus more posteriorly and provide optimal alignment
within the acetabulum

118
Q

What phase of the baseball pitching motion would be most

likely to cause the most strain on the labrum of the shoulder?

A

Cocking phase

119
Q

What phase of the upper extremity athlete require is the maximum deceleration control?

A

follow through

120
Q

t or f?
When running your center or mass is at its lowest point during mid stance, and when walking
your center of mass is at its highest point during mid stance.

A

true

121
Q

Your patient is a 38 year old triathlete who is complaining of right knee pain during running. You
have diagnosed him with IT band syndrome. This patient most likely feels the moment knee
pain with running on which type of surfaces?

A

decline/downhill

122
Q

What phase of the golf swing creates the most spinal compression?

A

backswing

123
Q

Your patient is a 67 year old female recreational golfer who comes to you with complaints of
right knee pain with golfing. The pain is most significant during her back swing. The patient
reports that she is right handed. Which of the following equipment medications would you
recommend for this patient?

A

wear spineless shoes

124
Q

what dictates type of cancer treatment needed?

A

type of cancer and specific genetic mutation

125
Q

types of cancer treatment

A 
chemotherapy
radiation
immunotherapy
surgery
stem cell transplant
126
Q

immunotherapy

A

boosts body’s natural defenses to fight cancery

  • optimize immune system (increase role of agents that fight cancer cells, down regulate agents to decrease fight to cancer cells)
  • compliment immune system
  • may be dynamic with modified cells replicating in the body or reacting to cancer cells as they develop
127
Q

immunotherapy can distinguish between

A

healthy and unhealthy cells

128
Q

tumor lysis syndrome

A

electrolyte and metabolic disturbance caused by excessive calcium, potassium, phosphate, uric acid n the blood

129
Q

dx of tumor lysis syndrome

A

2 or more metabolic abnormalities that occur 3 days before or 7 days after initiation of therapy

130
Q

major risks of tumor lysis syndrome

A

renal insufficiency
seizures
cardiac dysrhythmia
death

131
Q

childhood acute lymphoblastic leukemia

A

75% of childhood leukemia
involves lympobasts (starts in bone marrow)
male, white/hispanic, exposure to radiation/chemo, hx of genetic disorder

132
Q

s/s of childhood acute lymphoblastic leukemia

A 
night sweats
discomfort in bones or joints
enlarged spleen, liver or lymph nodes
pain or feeling of fullness below ribs
unexplained weight loss or loss of appetite
133
Q

diffuse large B cell lymphoma

A

most common subtype of non Hodgkin
very aggressive
over 64, male, non asian or African American, immunocompormised, hx exposure to radiation/chemo

134
Q

first sign of diffuse large B cell lymphoma

A

lump in groin, armpit or neck

135
Q

mutiple myeloma

A

blood cancer involving plasma cells that create antibodies

over 60, men, African Americans, fam hx, hx of plasma dz

136
Q

s/s of multiple myeloma

A 
bone pain
weakness/fatigue
weight loss
infection
pathological fx
137
Q

complications of all blood disorders

A

anemia
thrombocytopenia
leukopenia

138
Q

tx for blood disorders

A

chemo
myeloablative conditioning
stem cell transplantation

139
Q

types of stem cell transplant

A

autologous
allogenic (increase risk for GVHD) matched by HLA
non-myeloablative transplant

140
Q

graft vs host disease

A

donor’s t lymphocytes do not recognize patent’s cells and attacks them
occurs in about 50% of allogenic SCT pts

141
Q

car T cell therapy

A

T cells removed, reprogrammed to find and kill cancer cells, re-entered in the body
most common use in liquid tumors

142
Q

t cells

A

specifically target cells that express peptides
long clonal life
potentially significant expansion/replication in vivo

143
Q

car T lymphodelepting phase

A

currently inpatient 3-5 days

144
Q

CAR T administration phase

A

day 0
similar to transfersion
monitor for fever and neurotoxicity

145
Q

car T recovery phase

A

2-3 weeks
blood cell recovery
bone marrow aspiration day 30

146
Q

hallmark sign of cytokine release syndrome

A

fever

147
Q

first sign of neurotoxicity

A

tremor

confusion, attention deficits, handwriting, apraxia, ataxia

148
Q

car t chart review - vitals

A 
hypotension
fever > 38 c
arrhythmias
tachycardia
SaO2 and O2
149
Q

provokes anterior labral tear

A

faber to extension, IR, ADD

150
Q

promotes posterior labral tear

A

ext abd ER into flex ADD IR

151
Q

number one cause of injury in modern dancers

A

faulty technique due to fatigue or decrease in power

152
Q

main force generator during pitching

A

legs and trunk

153
Q

hip extension deficits in trail leg leads to

A

increased shoulder external rotation

154
Q

hip IR deficits in lead leg

A

increased risk for injury

155
Q

hip flexion deficits on lead leg

A

increased risk for elbow pain

156
Q

hip ER deficits

A

increased shoulder horizontal ADD ROM

increased shoulder ER torque

157
Q

trunk most active (pitching)

A

during late cocking through acceleration

158
Q

pitching pelvic rotation

A

prior to thoracic rotation

late = increased max shoulder ER and force

159
Q

pitchingif upper torso rotates before stride foot contact

A

sig increase in elbow valgus torque

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