Midterm Flashcards
Ankle Strategy
Ankle movement to restore COG to a stable position. (small perturbations)
Hip Strategy
Hip movement to restore COG to a stable position. (Large/rapid perturbations)
Stepping Strategy
Restoration of COG when large forces displace COG beyond limits of stability.
Test for measuring fall risk
Activities-Specific Balance Confidence (ABC) Scale.
-A list of 16 questions a patient answers w/ a percentage of their confidence. An avg. <67% means increased fall risk
Static balance grade PTA descriptors: Patient able to maintain balance without support
Normal
Dynamic balance grade PTA descriptors: Accepts maximal challenge and can shift weight in all directions
Normal
Static balance grade PTA descriptors: Patient able to maintain balance without support, limited postural sway noted
Good
Dynamic balance grade PTA descriptors: Accepts moderate challenge, can shift weight (although limitations are evident), and can reach to floor within BOS
Good
Static balance grade PTA descriptors: Patient able to maintain balance with hand held support
Fair
Dynamic balance grade PTA descriptors: Can tolerate only minimal challenge, cannot maintain balance while weight shifting, and able to rotate head L/R
Fair
Static balance grade PTA descriptors: Patient requires support to maintain balance
Poor
Static balance grade PTA descriptors: Patient requires Max A to maintain balance
Zero
Testing a pt. balance while they are sitting or standing still
Static testing
What is the Romberg Stand?
Standing with feet together EO/EC and arms crossed (Static)
What is the Sharpened Romberg Stand?
Standing with feet heel to toe EO/EC and arms crossed (Static)
What is the Single Leg Stand?
Standing on one leg EO/EC and arms crossed (Static)
How to perform a Dynamic Balance test
Perform in sitting EO/EC, then in standing EO/EC
- Head rotation, weight shift, reach in all directions
- Nudge
Coordination PTA grading: Smooth/Accurate/ Controlled Motion
Within Normal Limits
Coordination PTA grading: Slow or jerky
Impaired
Coordination PTA grading: unable to perform
Absent
Pressure Ulcer Stage: The area looks red and feels warm to the touch
Stage 1
Pressure Ulcer Stage: The area looks more damaged and may have an open sore, scrape, or blister
Stage 2
Pressure Ulcer Stage: The area has a crater-like appearance due to damage below the skin’s surface
Stage 3
Pressure Ulcer Stage: The area is severely damaged and a large wound is present. Bone may be showing.
Stage 4
Bony landmarks at risk of breakdown in supine
- back of head
- spine of scapula
- spinous processes of vertebrae
- elbows
- sacrum
- heals
Bony landmarks at risk of breakdown in side-lying
- ear
- shoulder
- side of elbow
- greater trochanter
- side of knee
- side of ankle
- heal
Bony landmarks at risk of breakdown in prone
- forehead
- front of shoulders
- elbows
- rib cage
- ASIS
- knees
- dorsum of feet
- toes
Bony landmarks at risk of breakdown in sitting
- spine of scapula
- spinous processes of vertebrae
- sacrum
- coccyx
- ischial tuberosities
- greater trochanters
- under thighs
- heals
Key elements of a safe transfer
- Use a gait belt
- Plan ahead
- Clear path
- check for tubes and lines
- Know the ability of you and your pt.
- Visualize the transfer
- Check for wb status and contraindications
- Lock brakes and check stability of equipment
- Use good body mechanics
Contraindications for THA
- No adduction
- No internal rotation
- No flex. beyond 90 deg.
- No ext. beyond neutral
The pt. can perform transfer w/o any type of verbal or manual assistance
Independent
The pt. may require vc or uses assistive equipment or adaptive equipment (bed rail, grab bar, transfer board, furniture)
Modified Independent
The pt. requires assistance from another person to perform the activity safely in an acceptable time frame; physical assistance, verbal or tactile cues, directions, or instructions may be used
Assisted
The pt. requires verbal or tactile cues, directions, or instructions from another person positioned close to, but not touching the pt. to perform the activity safely and in an acceptable time frame; the assistant may provide protection in case the patient’s safety is threatened
Standby Assist
The caregiver is posistioned close to the pt. with his/her hands on the pt. or a gait belt; it is very likely the pt. will require protection during the performance to complete the activity
Contact Guarding
The pt. performs >or= 75% of the activity; assistance is required to complete the activity
Min A
The pt. performs 50-74% of the activity; assistance is required to complete the activity
Mod A
The pt. performs 25-49% of the activity; assistance is required to complete the activity
Max A
The pt. requires total physical assistance from one or more persons to accomplish the activity safely; special equipment or devices may be used
Dependent
How should you measure for the back height of a wc
4 in below axilla
How should you measure for the seat depth of a wc
2 in proximal to popliteal fossa
How should you measure for the armrest height of a wc
Have pt. hold flex elbow to 90 deg. Position armrest 1 in above ant. forearm
How should you measure for the leg rest length of a wc
Measure from popliteal fossa to sole of foot. Extend feet for 2 in floor clearance
Fitting for parallel bars
- 20-25 deg elbow flex
- hand 6in ant. to hips
- bars 2in lat. to hips
Fitting for walker
- 20-25 deg elbow flex
- hand piece at wrist crease
Fitting for axillary crutches
- 77% of total height
- crutch tips 2” lat. & 4-6” ant. to feet
- 20-25 deg elbow flex
- hand piece at wrist crease
- 2” between axilla and axillary pad
Fitting for forearm crutches
- 20-25 deg elbow flex
- hand piece at wrist crease
- cuff 1-1.5” below elbow
Fitting for cane
- 20-25 deg elbow flex
- hand piece at elbow crease
- cane used on good side
Guarding Basics for pt. with assistive device
- Hand supinated on gait belt
- Behind and beside on affected side
- BOS
- Bend knees w/ transfers
Contraindications for massage
Specific Area -break in skin -rash -local inflammation -bruise No Massage -fever -scabies -impetigo
Indications for massage
- Increases relaxation
- Increases circulation
- Decreases stiffness
- Before/after treatment/exercise
Purpose for Compression massage technique
Useful to warm up tissue before deeper techniques
Purpose for effleurage massage technique
To move the fluid contents of the superficial veins and lymph vessels. Useful in stimulating the circulation and mobilizing tissue fluids
Purpose for petrissage massage technique
Mobilize muscle fibers and other deep tissues; lengthen shortened tissue
Purpose for picking up/lifting/wringing massage technique
To mobilize muscle and facilitate joint mobility typically used on a limb where petrissage is not easily performed
Purpose for skin rolling massage technique
To mobilize the skin and subcutaneous tissue
Purpose for the push/pull massage technique
To mobilize muscle and facilitat joint mobility
Purpose for the percussion (tapotement) massage technique
Used to stimulate tissue, used primarily to mobilize lung secretions
Purpose for the friction massage technique
Heat local tissues, break up adhesions, reorganize collagen fibers
Purpose for the vibration/shaking/jostling massage technique
Vibration: mobilize lung secretions
Shaking/jostling: encourages “letting go” of tension in muscles
Physiological effects of the compression massage technique
Creates a deep hyperemia and softening effect in the tissues
