MIDTERM Flashcards
1
Q
Bio-mechanical Frame of Reference
Treatment Continuum
A
Progression of performance and intervention from dependent to independent ( see chart)
2
Q
Rehab Frame of Reference
A
- promotes use of assistive technology, compensatory strategies, and environmental modifications to maximize clients ability to engage in meaningful occupation.
- focuses on clients strengths rather than limitations.
- aligns with “modify” approach
- used with clients who have chronic, permanent, or progressive conditions (CHF, COPD, ALS)
- can be used after remediation approach (stroke etc)
3
Q
Bio-mechanical Frame of Reference
A
- mostly focuses on motor skills and client factors of body structure and function.
- applied to individuals who demonstrate difficulty with moving freely, with strength, or with motion over a sustained amount of time.
4
Q
Rehab FOR - 3 Components of Capacity for Motion
A
- potential for ROM at a joint
- muscle strength
- endurance
- clinician must look at force, leverage, and torque required by body to perform task.
5
Q
Primary Weakness (1st °)
A
- result of condition/disease such as ALS, MD, or nerve injury
6
Q
Secondary Weakness (2nd °)
A
- symptom of primary condition or disease
7
Q
Rehab Frame of Reference Approach
A
TOP DOWN
1. identify environmental demands/resources
2. evaluate motivation, habits and roles
3. determine functional abilities
4. identify impairments affecting function
8
Q
Efficiency
A
- time x distance
9
Q
Workplace Assessment
A
- help prevent injury, promote comfort, safety, and productivity
- help us understand the sequencing and patterns of job tasks, motions that are involved, typical posture used, and risk for musculoskeletal disorders
10
Q
Who can request workplace assessments?
A
- workers physician
- insurance company
- companies safety dept.
- human resources (for ADA purposes)
11
Q
How to prepare for workplace assessment
A
- contact company/identify reason
- request job description
- set visit date
- identify tasks, sequences, physical and cognitive demands, and physical positions required to accomplish job
12
Q
Components of workplace assessment
A
- observe worker or rep perform job tasks to see if the workstation supports the job tasks.
- assess CLEARANCE - should be designed for largest user.
- consists of headroom, legroom, and elbowroom in work area. - assess REACH- should be designed for smallest user.
- consists of location of controls and materials used to perform job tasks.
13
Q
General positioning for computer station
A
- desk height should be about the same as elbow height when flexed to 90°
- seat angle should be about 100-110°, and should support lumbar
-feet flat on floor or on footrests
- keyboard should be flat or at a neg. tilt and should be shld. width to avoid IR
- monitor should be arm lengths away, perpendicular to window to avoid glare, screen top at eye level or lower
- mouse should be close to keyboard, should fit transverse arch of hand
14
Q
Lifting Equations
A
- identify impact on lifting and level of risk (NIOSH, Liberty Mutual Tables)
15
Q
Importance Principle
A
- place most important items in easily accessible locations
16
Q
Frequency of Use Principle
A
- place most frequently used items in convenient and close to reach locations
17
Q
Function Principle
A
- organize similar items together
18
Q
Sequence of Use Principle
A
- lay out items in sequence used
19
Q
Workstation should promote what?
A
- neutral posture
- head upright, neck slightly flexed
- shoulders at sides, flexed less than 20-25°
- elbows at 90°
- wrists in neutral or 0° of flex
20
Q
Reach Envelope
A
- PRIMARY WORK ZONE for table top work is within about 10 to 14 inches of the elbow.
- this zone should include frequently used work equipment such as the keyboard and primary equipment.
- SECONDARY WORK ZONE should be within about 20 inches of the elbow
- includes items such as phones, calculators, and less frequently used tools.
21
Q
Tools for ergonomic assessment
A
- measuring tape
- paper & pen
- computer/phone for photos
- goniometer
- scale for force (needed to move and object)
- decibel device
- lumens device
- stopwatch
22
Q
HEART RATE - PULSE
Document as BPM
A
- NORM: 60-100 BPM
- Tachycardia = high
- Bradycardia = low
- Radial: hold at volar wrist medial to styloid process of the radius
- Assess: strength and regularity
- Ask:
- have you had anything hot or cold to eat or drink
- have you done any physical activity in the past 10 min
23
Q
PULSE OXIMETRY- O2
Document as %
A
- NORM: above 95 percent
- Consult with team when under 90 percent
- Check baseline, during and post activity
24
Q
RESPIRATION
Document as RPM
A
- NORM: 12-18 RPM
- CHECK FOR:
- Rhythm (regularity or pattern) is it consistent or inconsistent
- Rate (# of breaths per min)
- Depth (amount of air exchanged with each resp)
- Character (deviations from norm resting or quiet respiration) is there wheezing, gurgling etc.
- DOCUMENT:
- normal breath sounds or abnormal breath sounds
- if they on room air or nasal canula etc. (NC = nasal canula L = liters of o2)
- is rhythm normal or abnormal
- document how often on O2
ASK: does it change at night or with activity etc.
- You can’t just crank o2 up because it will increase carbon dioxide
25
Q
Blood Pressure
Document as Systolic / Diastolic mmHG
A
- NORM: - currently >130/80
HTN - risk factors of smoking, drinking, obesity - report systolic over diastolic mmHG
- document L/R arm and position during measurement
26
Q
Metabolic equivalent (MET) and CARDIAC REHAB
A
- oxygen cost of completing an activity, this is different person to person, used as a standard recommendation
- ACUTE REHAB
- 1-3 METS
- precautions, education, intolerance rec., energy conservation
- 1 = rest only
- 1.5 = transfers, seated self care
- 2-3 = seated shower (heat of water increases cost) - OUTPATIENT (OT ~3x per week)
- 3.5 - 5 METS
- standing shower
- independent BM
- sexual activity
- priorities of work hardening and avoidance of isometric exercise
- 3-4 = standing warm shower, most household chores, and light recreation
- 4-5 = standing hot shower and moderate recreation - MAINTENANCE
- 6-10 METS
- continue outpatient therapy or community program
- 5-6 = sexual activity and all household chores
- 6-10 = progression from jog (5 mph) to run
27
Q
Sternal precautions
A
- do not lift/push/pull anything heavier than 10 lbs
- do not bear any weight on arms (ex: push up from sitting)
- do not raise elbows above 90°
- do not reach behind your body or twist trunk
- train caregivers not to assist by pulling on arms
- train on pillow use for coughing, sitting up etc.
- Use ADs like dressing stick, reacher and bathroom buddy
