Lab Flashcards
Where should we place a patient w/ left neglect
On the far right side of the room so everything they need to attend to is on the L
During scooting Foward be sure not to block the _____________
Anterior advancement of the knee
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 _________
Posterior
Anterior
How should a patient scoot Foward if their feet are unable to contact the floor?
Unilateral scooting
Where should you place your Hand to facilitate unilateral scooting
Top of the pelvis
Note: if you place your hand under the glute the patient will be cued to sit on your hand
Squat pivot transfer vs stand pivot transfer: what is safer
There is less of a chance of falling with the squat pivot transfer
How many scoots should a patient use to get to their wheelchair
The more the better!
Does the squat/scoot pivot represent a lower level of function than the stand pivot transfer
F , need to determine what each of the limbs and trunk is doing to participate in the transfer
Where should a therapist position their leg for a proper leg block
Anterior-lateral to anterio-lateral
Where should you facilitate a patient on the bottom of their foot for bringing their foot up to bridge
Lateral aspect of the foot
Or
Under the lateral aspect of the 5th metacarpal
How far apart do you want a patients hands on the table for support?
Where should their wrist creases be?
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
How should a patients hands be positioned on a table for support (flat?)
Pt should have the natural transverse curvature of their hand allowed
What is the motion of the table during a sit to stand
Away from patient
Up
Back toward patient
What should we first cue the patient to do when sitting back on the mat during sit to stands
Bend at the knees
What should come first, stance or swing activities?
We should first work on stance activities
From a force used standpoint, which LE should be used as the pivot point and which should be used as the stepping around leg
Pivot point = more involved LE
What is the first thing that should be cued when teaching a patient to step backward
Knee flexion
Where should a patients hips be positioned when sitting on a plinth
Close to edge of surface, slightly higher than knees
______ should be under knees for sitting activities
_______ should be under knees for standing activities
Heels
Toes
If a patient has a plantar flexion contracture how do we need to position their feet?
Where on their foot should they bear weight?
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
Presence of what 2 things is required for a patient to achieve anterior pelvic tilt and sit up tall
Hip flexion of over 90 degrees
Lumbar extension
Proper hand position for facilitating patient to sit up tall
Fingers are flat and open, not touching pelvis
Hands positioned as vertically as possible, so that your little finger applies pressure with palmar surface.
How does the therapist move their hands to facilitate anterior pelvic tilt
Supination and wrist flexion applying most pressure at finger 3 and 4
When shifting weight laterally to the R while sitting. what happens on the R and the L side of the trunk
Shortening on L , Elongation on R
You cannot have shortening or elongation on one side without the opposite occurring on the other side
What is the first step to seated weight shifting?
Dynamic trunk
Which side should we shift a patient to first when working on seated weight shifting
Shift to patients more involved side first
Unless they’re a pusher
Why should we not touch the medial surface of the foot?
Why not touch ball of the foot?
Navicular and MTP 1?
Calcaneus?
Medial surface- stimulates inversion
Ball of foot - stimulates PF
plantar aspect of MTP 1, navicular, calcaneus - stimulate inversion
Therapist hand placement for helping foot w/ bridging
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
What is raimiste’s phenomena
Resisted abd on strong side will reinforce abduction on weak side
Which side is it more convinent for a patient to roll towards
Toward the weak side (better so the stronger arm isn’t trapped below the body)
What is the first step we ask a patient to do when sitting up from laying down?
Tuck their chin
Where does a patient need to hold their affected arm when doing bed mobility
At the shoulder
Can you put a patient with a peg tube in prone?
Only if it’s a bolus feed tube with a clamp
If it’s a continuous feed tube you cannot put them prone
If we are a patient is in quadruped and the wrist extension is hurting them, how can we modify this
Move their hands forward or have them grip something
When using alternating isometrics in sitting, what should we do in between each reversal?
Apply an approximation pressure to reinforce trunk stability and communicate to the patient the timing of the reversals
How many repetitions of reversal of isometrics do we do?
3-5 reps without resting in between
How can we stop a patient with pusher syndrome from pushing on the Swiss ball
Shoulder in external rotation, elbow flexed or extended, keep their hand off the ball
How far back to to the center do we allow patients with pusher syndrome to go in between stretches on the Swiss ball
Do not let them cross midline
When a patient is doing sit to stands, how should their elbows be positioned as compared to their hands on the table
Keep hands slightly lower than elbows at all times
Length of treatment effect:
Neurotomy
Motor point block
Botox
Neurotomy: permanent
Motor point block: 6 months
Botox: 12 weeks
What kind of device is best for gait training patients
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)
Practicing turning to which side is more functional
Toward the weak side
(Weight bearing on weak side as the strong side steps around)
