Lab

Question 1

Where should we place a patient w/ left neglect

Answer 1

On the far right side of the room so everything they need to attend to is on the L

Question 2

During scooting Foward be sure not to block the _____________

Answer 2

Anterior advancement of the knee

Question 3

When a patient lifts off for scooting, if their knees dorsiflex it means that their center of gravity is ______

If they plantarflex it means the center of gravity is _________

Answer 3

Posterior

Anterior

Question 4

How should a patient scoot Foward if their feet are unable to contact the floor?

Answer 4

Unilateral scooting

Question 5

Where should you place your Hand to facilitate unilateral scooting

Answer 5

Top of the pelvis

Note: if you place your hand under the glute the patient will be cued to sit on your hand

Question 6

Squat pivot transfer vs stand pivot transfer: what is safer

Answer 6

There is less of a chance of falling with the squat pivot transfer

Question 7

How many scoots should a patient use to get to their wheelchair

Answer 7

The more the better!

Question 8

Does the squat/scoot pivot represent a lower level of function than the stand pivot transfer

Answer 8

F , need to determine what each of the limbs and trunk is doing to participate in the transfer

Question 9

Where should a therapist position their leg for a proper leg block

Answer 9

Anterior-lateral to anterio-lateral

Question 10

Where should you facilitate a patient on the bottom of their foot for bringing their foot up to bridge

Answer 10

Lateral aspect of the foot

Or

Under the lateral aspect of the 5th metacarpal

Question 11

How far apart do you want a patients hands on the table for support?

Where should their wrist creases be?

Answer 11

As far apart as possible so you don’t activate the synergies

If they are a high functioning patient they can be shoulder width apart

Wrist creases close to edge of table

Question 12

How should a patients hands be positioned on a table for support (flat?)

Answer 12

Pt should have the natural transverse curvature of their hand allowed

Question 13

What is the motion of the table during a sit to stand

Answer 13

Away from patient

Up

Back toward patient

Question 14

What should we first cue the patient to do when sitting back on the mat during sit to stands

Answer 14

Bend at the knees

Question 15

What should come first, stance or swing activities?

Answer 15

We should first work on stance activities

Question 16

From a force used standpoint, which LE should be used as the pivot point and which should be used as the stepping around leg

Answer 16

Pivot point = more involved LE

Question 17

What is the first thing that should be cued when teaching a patient to step backward

Answer 17

Knee flexion

Question 18

Where should a patients hips be positioned when sitting on a plinth

Answer 18

Close to edge of surface, slightly higher than knees

Question 19

______ should be under knees for sitting activities

_______ should be under knees for standing activities

Answer 19

Heels

Toes

Question 20

If a patient has a plantar flexion contracture how do we need to position their feet?

Where on their foot should they bear weight?

Answer 20

Feet further out than otherwise would be to allow their heel to touch the ground

We want the patient bearing weight through the heel, if weight bearing is through ball of the foot it stimulates plantar flexion

Question 21

Presence of what 2 things is required for a patient to achieve anterior pelvic tilt and sit up tall

Answer 21

Hip flexion of over 90 degrees

Lumbar extension

Question 22

Proper hand position for facilitating patient to sit up tall

Answer 22

Fingers are flat and open, not touching pelvis

Hands positioned as vertically as possible, so that your little finger applies pressure with palmar surface.

Question 23

How does the therapist move their hands to facilitate anterior pelvic tilt

Answer 23

Supination and wrist flexion applying most pressure at finger 3 and 4

Question 24

When shifting weight laterally to the R while sitting. what happens on the R and the L side of the trunk

Answer 24

Shortening on L , Elongation on R

You cannot have shortening or elongation on one side without the opposite occurring on the other side

Question 25

What is the first step to seated weight shifting?

Answer 25

Dynamic trunk

Question 26

Which side should we shift a patient to first when working on seated weight shifting

Answer 26

Shift to patients more involved side first

Unless they’re a pusher

Question 27

Why should we not touch the medial surface of the foot?

Why not touch ball of the foot?

Navicular and MTP 1?

Calcaneus?

Answer 27

Medial surface- stimulates inversion

Ball of foot - stimulates PF

plantar aspect of MTP 1, navicular, calcaneus - stimulate inversion

Question 28

Therapist hand placement for helping foot w/ bridging

Answer 28

Lateral border of 5th metatarsal with finger pads to facilitate eversion of ankle

Or index finger and middle finger on plantar surface of lateral 4 toes to hold those toes in extension

Question 29

What is raimiste’s phenomena

Answer 29

Resisted abd on strong side will reinforce abduction on weak side

Question 30

Which side is it more convinent for a patient to roll towards

Answer 30

Toward the weak side (better so the stronger arm isn’t trapped below the body)

Question 31

What is the first step we ask a patient to do when sitting up from laying down?

Answer 31

Tuck their chin

Question 32

Where does a patient need to hold their affected arm when doing bed mobility

Answer 32

At the shoulder

Question 33

Can you put a patient with a peg tube in prone?

Answer 33

Only if it’s a bolus feed tube with a clamp

If it’s a continuous feed tube you cannot put them prone

Question 34

If we are a patient is in quadruped and the wrist extension is hurting them, how can we modify this

Answer 34

Move their hands forward or have them grip something

Question 35

When using alternating isometrics in sitting, what should we do in between each reversal?

Answer 35

Apply an approximation pressure to reinforce trunk stability and communicate to the patient the timing of the reversals

Question 36

How many repetitions of reversal of isometrics do we do?

Answer 36

3-5 reps without resting in between

Question 37

How can we stop a patient with pusher syndrome from pushing on the Swiss ball

Answer 37

Shoulder in external rotation, elbow flexed or extended, keep their hand off the ball

Question 38

How far back to to the center do we allow patients with pusher syndrome to go in between stretches on the Swiss ball

Answer 38

Do not let them cross midline

Question 39

When a patient is doing sit to stands, how should their elbows be positioned as compared to their hands on the table

Answer 39

Keep hands slightly lower than elbows at all times

Question 40

Length of treatment effect:

Neurotomy

Motor point block

Botox

Answer 40

Neurotomy: permanent

Motor point block: 6 months

Botox: 12 weeks

Question 41

What kind of device is best for gait training patients

Answer 41

Lower functioning patients -> bilateral symmetrical devices

Higher level -> possibly the smallest possible unilateral assistive device that will work, if any needed. (No quad canes, no hemi walkers)

Question 42

Practicing turning to which side is more functional

Answer 42

Toward the weak side

(Weight bearing on weak side as the strong side steps around)