Lecture 9 - The acute patient: Guidelines for neuro intervention

Question 1

What are some aims of assessment of a acute neurological patient

Answer 1

describe activity limitations
establish presence of impairments
establish a baseline
degree to which patient can participate in therapy

Question 2

What are the clinical implications of the AVERT study

Answer 2

lower dose out of bed activity regimen is preferable to a very early, frequent, high dose intervention

Short frequent treatment sessions are preferred in early days following acute stroke

Question 3

Prevention of contracture

Answer 3

if strength is less than grade 3 MMT, position in neutral positions throughout the day

active training with muscles in lengthened position, monitor ORM

for moderate to severe spasticity - casting/splinting

Question 4

What muscles are at risk of shortening in the LL?

Answer 4

hip flexors, 
Hip external rotators 
hip abductors (adductors with TBI)

Question 5

What muscles are at risk of shortening in the UL

Answer 5

internal rotators
elbow flexors
forearm pronators
shoulder extensors

Question 6

What factors are important to consider when Mobilizing

Answer 6

timing -
ICP- stable, monitor signs of ICP
BP - <220/110 and >90/60
WB restrictions