Lectures 2-4 Flashcards
What are three parts of evidence based practice?
- research and evidence
- PT experience
- pts goals/circumstances
What is difference between activities and participation?
activities- stepping on a step (limitations)
participation- not being able to work (restrictions)
When does your discharge planning start?
with the chart review
What is the center of your PT evaluation?
the goals of your patient’s
What is important to think about co-morbidities?
how will past co morbidities will affect current condition
What questions are most important in social history?
functional questions and discharge plan questions
What are A and O components?
- name
- where they are
- date
- why are they there
What is point of systems screen?
are they safe to treat, any change from chart or nursing notes
leads to any tests you want to perform
yellow flags can either go to green or red
What is important to think about for neuromuscular screen?
if there are any deviations in gait why are they happening
What are types of functional mobility?
bed, transfer, ambulation, balance
What is an example of sitting dynamic balance?
hip flexion at edge of bed
For endurance testing what are subjective findings?
angina, SOB, RPE
What are objective measures for endurance?
vital response (exaggerated), time to complete an activity, number of rests, 2mwt etc.
remember you can time anything
What is the timed up and go test?
test of general ability and correlates well with balance, gait speed and functional capacity
What are norms for TUG?
60-69- 8.1 seconds
70-79- 9.2 seconds
80-89- 11.3 sec
over 13.5 seen as failure
How long does pt walk during TUG?
3 meters
What is purpose of 5 times sit to stand?
measures lower extremity functional strength and power
What are norms for 5x STS?
under 70 y/o- under 10 seconds
70-100 under 15 seconds
What is purpose of 30 second STS?
strength functional capacity balance fall risk
What are norms for Berg Balance test?
48-56 low risk
40-47 medium risk
39 or less high risk
under 36- 100% chance of fall in next 6 months
What are numbers for prognosis?
poor 0-50
fair 50-75
good 75-90
excellent 90+
What are SMART goals?
specific, measurable, attainable, realistic, timely
What else must goals be?
functional, measurable, accurate
How long are goals in acute care?
short term 1-2 days
long term- 1 week
How long are goals in long term care (rehab)?
short term- 1-2 weeks
long term- 2 weeks +
What are two factors that affect discharge planning?
Length of stay, level of care
What is difference between observation and inpatient LOC?
ob- never admitted but in hospital
inpatient- 24/7 care
What does Medicare A cover?
hospital and rehab stays
What are IADL?
instrumental activities of daily living
ex- driving, meds, accessing community services
What are general ADL’s ?
toileting, bed mobility, transfers, ambulating, eating, grooming
What is number one goal of acute care discharge plan?
home with family support
What is home with elder cares services?
non skilled services, includes home makers, health aides, meals of wheels
What are requirements for home with elder care services?
pt must be homebound for insurance to pay
If you are homebound can you get outpatient services?
No, this includes OT, PT, dialysis
What are requirements to meet sub acute or SNF LOC?
needs nursing help and help with atlas 1 ADL, pt has PT less than 3 hours a day but will have it 5 days a week
What are Medicare requirements for SNF?
must have had hospital stay of atleast 3 nights
What are requirements for inpatient rehab?
pt must do 3 hours of therapy a day and follow 2-3 steps
primary problem must involve recent functional loss, where as prior to injury or illness they were indpt with that function
must make rapid progress
What is needed average LOS for LTAC?
21 days
Does medicare pay for a nursing home or assisted living?
no, private pay
Why should you air on side of rehab for new neurological pts?
due to neuroplasticity can enhance rehab with further time to practice
What are average different LOS for certain pathologies?
THA- 3 days
colectomy- 3 days
CABG- 5 days
transplant- 14 days
What must treatment session be based around?
function function function
What are examples of functional training?
mobility, bed mob, transfers, stairs
What is most common functional tx in acute care?
functional mobility
What is important to remember about ambulation training?
you have to state as to why you are walking- indpt mobility, increase aerobic capacity, prevent deconditioning etc.
What is max heart rate formula?
220- age (0.7)
