MDT treatment of Neuropsychiatric Disorders Flashcards
What are the main aims of physiotherapy?
▪️ Restore normal movement and function
▪️ Reduce risk of future injury or illness
▪️ Considering body as a whole
What are the main principles of retraining in PT?
▪️ Induce neuroplastic changes
▪️ Best through repetition of movements
What are the main steps of the PT process?
- Information gathering
- Assessment
- Formulation and goal-setting
- Treatment planning
- Intervention
- Re-assessment and evalutation
What can you check in a PT assessment?
▪️ Physical exam (e.g., posture, balance, movements etc)
▪️ Functional activities
▪️ Gait
▪️ Exercise tolerance
What factors should be assessed indirectly during PT assessmnet?
▪️ Neuropsychiatric symptoms such as anxiety, low mood
▪️ Cognition
▪️ Insight
▪️ Unhelpful illness beliefs
What are the three key components of PT-related issues associated with a disease/disorder?
▪️ Impairments
▪️ Limitations
▪️ Restrictions
What is goal setting?
▪️ Method of organising and evaluating client-oriented clinical activity
▪️ Agree end point to work towards
What are the benefits of goal-setting?
▪️ 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
What are the three main principles of goal setting?
▪️ Relevant
▪️ Achievable
▪️ Measurable
What are the main techniques used in physiotherapy?
▪️ 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
What strategies outside of regular PT can be employed to help with the PT process?
▪️ CBT principles
▪️ Behavioural management strategies
▪️ Communication aids
▪️ Memory aids etc
What is the aim of occupational therapy?
Increase independence and satisfaction in all aspects of live, particularly in the activities that are meaningful to them
What are the three main domains of OT?
▪️ Self care
▪️ Work/productivity
▪️ Leisure
What are the five main considerations for OT?
▪️ 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)
What are the main barriers that may affect someone ability to carry out meaningful activities following injury?
▪️ Motivation (reduced or changes?)
▪️ Change in roles and routines
▪️ Performance skills
▪️ Environment
What are the main steps of the occupational therapy process?
▪️ Information
▪️ Assessment
▪️ Treatment, planning, goal setting
▪️ Intervention
▪️ Evaluation (repeat if necessary)
What are the two components of an OT assessment?
▪️ Interview (explore strengths, challenges, barriers, goals etc)
▪️ Observations (personal care, food prep, community access)
What are the main OT approaches?
▪️ 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
What are the main roles of SLTs?
▪️ Communication difficulties
▪️ Swallowing difficulties
▪️ Support differential diagnoses
▪️ Educate and advice staff/family
▪️ Mental Capacity Act
What is the ratio of swallowing to communication issues addressed by SLT?
60:40 (more swallowing)
What is the difference between dysarthria and dyspraxia?
▪️ Dysarthria = weakness/loss of range/loss of coordination of muscle movements
▪️ Dyspraxia = difficulties programming muscle movements
What is dysphonia?
Abnormality of voice (typically hoarse, gravelly)
How common are swallowing difficulties in neuropsychiatry?
▪️ 50-100 times more likely to choke
▪️ Up to 80% of advanced dementia
What might poor dysphagia management lead to?
Aspiration pneumonia (food, fluids, secretions onto lungs causing infection)
What might cause dysphagia in neuropsychiatric conditions?
▪️ Structural issues
▪️ Neuromuscular changes
▪️ Cognitive and behavioural factors
▪️ Sensory impairment
▪️ Poor dentition and oral hygiene
▪️ Medication
What is the IDDSI framework?
The International Dysphagia Diet Standardisation Initiative
▪️ Provides common terminology for describing food and drink textures
▪️ E.g., pureed, liquidised etc
What are the main types of communication assessment?
▪️ 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
What are the main types of communication therapy?
▪️ Direct impairment based
▪️ Direct task focused
▪️ Strategies for the patient
▪️ Strategies for those communicating with the patient
