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NM 2 > lecture 8: PT management of individuals with mild brain injury > Flashcards

lecture 8: PT management of individuals with mild brain injury Flashcards

1
Q

what is ranchos levels VII-VIII

A

VII – Automatic-appropriate
VIII – Purposeful-appropriate

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2
Q

*Appropriate and oriented
*Robot-like
*Minimal confusion
*Shallow recall of activities
*Poor insight into condition
*Carryover for new learning but decreased rate
*Initiates social activities with structure
*Poor judgment, problem-solving, and planning skills

what ranchos level does this describe

A

VII: automatic appropriate

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3
Q

*Alert and oriented
*Recalls and integrates past and recent events
*Aware of and responsive to environment
*Carryover for new learning
*Decreased level of abstract reasoning, tolerance for stress, and judgment

what ranchos level does this describe

A

purposeful appropriate

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4
Q

what is the clinical presentation for a mild brain injury for the integumentary system

A

ulcers , incisions

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5
Q

after a mild brain injury deficits may increase with what 4 things

A

faitgue
stress
illness
heat

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6
Q

what are the activity limitation after a mild brain injury

A

*Activity limitations
◦ Bed mobility
◦ Transfers
◦ Wheelchair mobility and management
◦ Gait/stairs

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7
Q

what is apart of the participation outcome measures for a mild brain injury

A
  • Craig Handicap Assessment and Reporting
    Technique (CHART)
  • Community Integration Questionnaire (CIQ)
  • DRS (BS&F, activity, and participation)
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8
Q

what is apart of the body functions and structures outcome measures for a mild brain injury

A
  • Rancho Levels of Cognitive Function
  • Modified Ashworth Scale
  • MMSE
  • Montreal Cognitive Assessment
  • Patient Health Questionnaire
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9
Q

what is apart of the activity outcome measures for a mild brain injury

A
  • FIM/FAM
  • High Level Mobility Assessment Tool (HiMAT)
  • 6MWT, 10mWT
  • Berg Balance Scale (BBS)
  • Functional Gait Assessment (FGA)
  • 5 Time Sit to Stand (5TSTS
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10
Q

what is apart of the environment outcome measures for a mild brain injury

A
  • Craig Hospital Inventory of Environmental
    Factors (CHIEF
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11
Q

what is the description for the High Level Mobility Assessment Tool (HiMAT)

A

Description
◦ Assess high level mobility in individuals with TBI
◦ No use of assistive devices but orthotics permitted
◦ Must walk without assistance x 20 meters

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12
Q

how can u prioritize PT goals

A

Participation restrictions → Activity limitations → Impairments

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13
Q

what 3 things go into motor control

A

-task
individual
-environment

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14
Q

what are some of the communication deficits one will present w after a mild brain injury

A

◦ Dysarthria
◦ Aphasia
◦ Impaired reading/writing
◦ Auditory deficits

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15
Q

why is awareness important

A

-leads to improved attention , memory , and problem soling
- ability to analyzer own performance

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16
Q

what are the 4 different attention types

A

-sustained
-selective
-alternating
-divided

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17
Q

what is sustained attention

A

Ability to maintain focus on a continuous, repetitive activity

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18
Q

what is selective attention

A

Focus on a particular task or activity in the presence of distractors

19
Q

what is alternating attention

A

Switching between tasks

20
Q

what is divided attention

A

Performance of multiple tasks simultaneously

21
Q

how can u integrate attention into ur PT sessions

A
  • modification of treatment environment
    -Begin in environment which allows optimal function
    Ultimate goal is function in high distraction with low structure
22
Q

what is the stroop test

A

have the pt say word not the color of the word

23
Q

what is the The ability to organize sensory input into meaningful patterns that emerge from increasingly integrated levels of processing that form a perceptual whole

A

perception

24
Q

Body image and unilateral spatial inattention/neglect
Unilateral spatial inattention/neglect with homonymous hemianopsia
Visual agnosia
Visual-spatial disorders

these are all examples of what kind of deficits

A

visual

25
Q

what is unilateral spatial in attention/hemisphere in attention/neglect

A
  • failure to orient toward, respond to, or report stimuli on the side contralateral to the cerebral lesion
    ◦ Inability to integrate and use perceptions from one side of body
26
Q

what is visual agnosia

A

failure to recognize visual stimuli

unable to name objects due to having no concept of what the object is

basically they can see the object but can tell u what it is but they could feel it and know it is a spon

27
Q

what attention does the right adn left hemisphere pay attention to

A

R hemi: explores left and right attention
L hemi: pays attention just to the righ

so if u have a deficit on the R hemisphere that would lead to L side neglect bc there would be no attention to the L side bc the R explores teh L and R

28
Q

what is Topographic disorientation:

A

Difficulty way finding in a familiar environment

if a patient after a TBI can not remeber how to get home form store evne tho they liveed in same home for 60 yrs

29
Q

what is Figure ground perception

A

inability to distinguish foreground from background (poor depth percpetion) so not being able to see the difference between the wheelchair break and the ground

30
Q

◦ Midline orientation deficits
◦ Pusher’s syndrome

these are what kind of visual spatial disorders

A

position in space

31
Q

what are tips to integrate during PT session for addressing executive functions

A
  • ask pt to predict performance before they begin a task to max their attention to the task
  • ask pt for feedback about their performance
  • allow error to occur bc it helps pt self monitor to look for errors and prevent them from next time
32
Q

if a pt has a L hemispheric lesion waht are their communicant deficits

A

◦ Aphasia (can’t understand or express speech)
◦ Apraxia ( can’t person purposeful actions)
◦ Alexia (cant read)
◦ Agraphia (cant write letters )
◦ Anomia (cant recall names of an object)

33
Q

if a pt has a R hemispheric lesion what will their communication deficits be

A

◦ Deficits in abstract verbal
tasks like ….
-Storytelling and
interpretation
- Integration of emotional
elements
-Sense of humor

34
Q

what are the dominant hemisphere language deficits

A

Wernicke’s (receptive) aphasia
Broca’s (expressive) aphasia
Global aphasia

35
Q

for brocas (expressive) aphasia …

Word comprehension ___-
Syntax and fluid speech ____
____ fluency
Prosody is lacking
____ of grammatical structure
Aware of deficits

A

Word comprehension retained
Syntax and fluid speech lost
Decreased fluency
Prosody is lacking
Lack of grammatical structure
Aware of deficits

36
Q

WERNICKE’S (RECEPTIVE) APHASIA
____ comprehension
Speech is fluent, but paraphasic errors, jargon,
empty, meaningless speech
Basic intonation and syntax maintained, word
meaning _____
Patients ____ of their deficits
(anosognosia)

A

WERNICKE’S (RECEPTIVE) APHASIA
Impaired comprehension
Speech is fluent, but paraphasic errors, jargon,
empty, meaningless speech
Basic intonation and syntax maintained, word
meaning inaccessible
Patients unaware of their deficits
(anosognosia)

37
Q

what is apraxia

A

inability to perform certain skilled purposeful movements in the absence of any loss of motor power, sensation or coordination

38
Q

what is Alexia and agraphia

A

inability to read/write

39
Q

what is Lack of recognition of familiar objects

A

agonsia

40
Q

what kind of gait is present for gait apraxia

A

magnetic gait

41
Q

what is verbal apraxia called

A

aphemia (basically mute) but they can write

42
Q

what are positive factors to return to work for pt’s

A

◦ Previous employment
◦ Shorter length of time since injury
◦ < 40 years old
◦ Greater cognitive abilities
◦ Lack of behavioral problems

43
Q

how can u incorporate principles of motor control/learning/neuroplasticity

A
  • Treadmill training, high intensity gait training (Hornby et al, 2020)
  • Virtual reality
  • Dual-task training
  • Aerobic exercise
  • Vestibular rehab

NM 2 (13 decks)

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