MDT treatment of Neuropsychiatric Disorders

Question 1

What are the main aims of physiotherapy?

Answer 1

▪️ Restore normal movement and function
▪️ Reduce risk of future injury or illness
▪️ Considering body as a whole

Question 2

What are the main principles of retraining in PT?

Answer 2

▪️ Induce neuroplastic changes
▪️ Best through repetition of movements

Question 3

What are the main steps of the PT process?

Answer 3

1. Information gathering
2. Assessment
3. Formulation and goal-setting
4. Treatment planning
5. Intervention
6. Re-assessment and evalutation

Question 4

What can you check in a PT assessment?

Answer 4

▪️ Physical exam (e.g., posture, balance, movements etc)
▪️ Functional activities
▪️ Gait
▪️ Exercise tolerance

Question 5

What factors should be assessed indirectly during PT assessmnet?

Answer 5

▪️ Neuropsychiatric symptoms such as anxiety, low mood
▪️ Cognition
▪️ Insight
▪️ Unhelpful illness beliefs

Question 6

What are the three key components of PT-related issues associated with a disease/disorder?

Answer 6

▪️ Impairments
▪️ Limitations
▪️ Restrictions

Question 7

What is goal setting?

Answer 7

▪️ Method of organising and evaluating client-oriented clinical activity
▪️ Agree end point to work towards

Question 8

What are the benefits of goal-setting?

Answer 8

▪️ Identifies what is important to the patient
▪️ Improves motivation, self-efficacy and mood
▪️ Explicit feedback on progress
▪️ Involve patient so more likely to maintain gains following treatment

Question 9

What are the three main principles of goal setting?

Answer 9

▪️ Relevant
▪️ Achievable
▪️ Measurable

Question 10

What are the main techniques used in physiotherapy?

Answer 10

▪️ Education and advice
▪️ Movement retraining, tailored exercise and physical activity advice
▪️ Manual therapy/hands on facilitation
▪️ Treatment adjuncts (e.g., hydrotherapy, acupuncture)
▪️ Adaptive equipment and aids

Question 11

What strategies outside of regular PT can be employed to help with the PT process?

Answer 11

▪️ CBT principles
▪️ Behavioural management strategies
▪️ Communication aids
▪️ Memory aids etc

Question 12

What is the aim of occupational therapy?

Answer 12

Increase independence and satisfaction in all aspects of live, particularly in the activities that are meaningful to them

Question 13

What are the three main domains of OT?

Answer 13

▪️ Self care
▪️ Work/productivity
▪️ Leisure

Question 14

What are the five main considerations for OT?

Answer 14

▪️ WHAT they do (activities/occupation)
▪️ WHY they do it (motivation)
▪️ HOW they ORGANISE it (patterns, routines etc)
▪️ HOW they DO it (performance skills)
▪️ WHERE they do it (environment)

Question 15

What are the main barriers that may affect someone ability to carry out meaningful activities following injury?

Answer 15

▪️ Motivation (reduced or changes?)
▪️ Change in roles and routines
▪️ Performance skills
▪️ Environment

Question 16

What are the main steps of the occupational therapy process?

Answer 16

▪️ Information
▪️ Assessment
▪️ Treatment, planning, goal setting
▪️ Intervention
▪️ Evaluation (repeat if necessary)

Question 17

What are the two components of an OT assessment?

Answer 17

▪️ Interview (explore strengths, challenges, barriers, goals etc)
▪️ Observations (personal care, food prep, community access)

Question 18

What are the main OT approaches?

Answer 18

▪️ Activity as a therapeutic tool
▪️ Purposeful activity - goal setting and motivation
▪️ Activity/task analysis
▪️ Grading activity to gradually increase demands and reduce support
▪️ Adapting an activity or environment to enable greater independence

Question 19

What are the main roles of SLTs?

Answer 19

▪️ Communication difficulties
▪️ Swallowing difficulties
▪️ Support differential diagnoses
▪️ Educate and advice staff/family
▪️ Mental Capacity Act

Question 20

What is the ratio of swallowing to communication issues addressed by SLT?

Answer 20

60:40 (more swallowing)

Question 21

What is the difference between dysarthria and dyspraxia?

Answer 21

▪️ Dysarthria = weakness/loss of range/loss of coordination of muscle movements
▪️ Dyspraxia = difficulties programming muscle movements

Question 22

What is dysphonia?

Answer 22

Abnormality of voice (typically hoarse, gravelly)

Question 23

How common are swallowing difficulties in neuropsychiatry?

Answer 23

▪️ 50-100 times more likely to choke
▪️ Up to 80% of advanced dementia

Question 24

What might poor dysphagia management lead to?

Answer 24

Aspiration pneumonia (food, fluids, secretions onto lungs causing infection)

Question 25

What might cause dysphagia in neuropsychiatric conditions?

Answer 25

▪️ Structural issues
▪️ Neuromuscular changes
▪️ Cognitive and behavioural factors
▪️ Sensory impairment
▪️ Poor dentition and oral hygiene
▪️ Medication

Question 26

What is the IDDSI framework?

Answer 26

The International Dysphagia Diet Standardisation Initiative

▪️ Provides common terminology for describing food and drink textures
▪️ E.g., pureed, liquidised etc

Question 27

What are the main types of communication assessment?

Answer 27

▪️ Formal, standardised (rare - SLaM or forensics)
▪️ Informal assessment with formal tasks
▪️ Informal assessment with real world activities
▪️ Informal assessment with communication tools
▪️ Observation
▪️ Look at strengths

Question 28

What are the main types of communication therapy?

Answer 28

▪️ Direct impairment based
▪️ Direct task focused
▪️ Strategies for the patient
▪️ Strategies for those communicating with the patient