Mobility Flashcards
Functional mobility
Moving from one position or place to another (bed mobility, transfers, etc), performing functional ambulation, and transporting objects.
Developmental theory of mobility
Progression of physical and psychological capacities are interconnected and early experiences influence subsequent behavior (560). motor skills, vision, auditory capacities, and proprioception–> explore the environment and interacting with others –>interactions cognitive, social, sensory, motor abilities, and a child’s sense of self grows.
Primitive Reflexes
Appear at birth, Integrated by 6 months
Spasticity
increased resistance to passive movement, just in antagonist (Damage to upper motor neurons)
Rigidity
increased tone in agonist and antagonist (Any direction) (Damage to upper motor neurons, basal ganglia and brainstem)
Flaccidity
Lack of muscle tone and limited to no response. Can lead to subluxation and hypermobility. (damage lower motor neurons)
Obligatory response
The movement is dominated by reflex that should be integrated
Self-initiated mobility
Actions done by individual’s choice
Gross Motor Function Classification System, Level I
Walks without limitations
Gross Motor Function Classification System, Level II
Walks with limitations
Gross Motor Function Classification System, Level III
Walks using a hand-held mobility device
Gross Motor Function Classification System, Level IV
Self-mobility with limitations; may use powered mobility
Gross Motor Function Classification System, Level V
Transported in a manual wheelchair
Acute care OT responsibilities
Appraisal, interventions for immediate needs, and assistance in transition planning or discharge
Acute Care assessments
FIM and Wee-FIM II (6 months - 7 years)
PEDI-CAT (7-21 years)
Term for dependent children discharging home
“inter-reliance”
primary goal in acute care
Preventing secondary disability and restoring performance
primary prevention
Efforts that decrease the likelihood of accidents, violence, or disease for everyone
secondary and tertiary prevention
Specific interventions, arrangement of care systems, and environmental modifications to prevent the onset of problems in at-risk populations
prevention measures in acute care
Positioning, prevention of aspiration, provision of orientation, reduce stresses, prevent self-injury, complications from immobilization, abnormal muscle tone
Neuromuscular and musculoskeletal complications tx
Maintain or regain normal ROM Handling techniques slow stretch and joint mobilization Positioning and splinting techniques Improve movement and strength through play
Musculoskeletal and lower motor neuron unit disorders tx
progressive exercise and activity routines
Wound healing and protection of insensate skin
Apply care, monitor skin, prevent pressure ulcers, help develop tolerance to new position or orthotics
Prevention emphasis
Programs ensure safety w/ physical activities and handling objects
TBI -> perceptual, cog, and beh impairment tx
environmental modifications
compensation for disorientation and memory loss, least restrictive environment, create a stimulating and more comforting environment
when child is more alert, may use an educational approach alongside behavioral interventions, inform of rules and post them - maintain boundaries, daily orientation programs and memory books ease burden of confusion, teach family about perceptual and cognitive impairments, create programs to help ensure orientation, safety, and comfort
Resuming and Restoring Occupational Performance (2nd level of priority)
Prevent dependent behavior, early emphasis on choices, AD or modifications, learning of new performance methods, instructional aids, restoration of lost skills and function (biomechanical and sensorimotor techniques) therapeutic activities, exercise
splinting, positioning, facilitation of movement
use of biomedical devices (estim) modalities,
Perceptual-cognitive and rehabilitative approaches, Adapting ADLs, joint protection, work simplification
ICU OT
Eval and treat at bedside, immobility can lead to contractures, generalized weakness w/ decreased endurance, cardiopulmonary compromise, maintain strength and enhance functional capacities, positioning and orthotics preserve ROM and prevent deformity, communicate plan of wear, sensory concerns
Oncology and Bone Marrow Transplantation Units recommendations
Chronic nature of illness, may see child inpatient and outpatient or coordinate care across services, working when energy is highest, OT must be aware of stages during transplantation process and strictly adhere to precautions
Neutropenia
abnormally low count of neutrophils, a type of white blood cell that helps fight off infections, particularly those caused by bacteria and fungi.
Oncology OT interventions
May include strengthening, ROM, endurance, resuming ADLs, feeding, or play
OT tx for graft-versus-host-disease (GVHD)
Stretching, extremity weight bearing, & general endurance improve function w/ GVHD
CP
Umbrella term for a form of brain damage that occurs in children before, during, or shortly after birth
Acute rehab needs met (3)
- organize and implement planned approach for management of recovery and rehab of children post-trauma or with rapid-onset disorders
- redirect care after onset of complications in children with chronic disorders
- provide environment for specialized medical or surgical procedures that involves specific care regimens and protocols
Leading cause of death and disability in children over 1year
Injuries
Purpose of inpatient rehab
optimize recovery
prevent complications
organize and implement an approach to initial and long-term management that optimizes function in family and community life
Focus of outpatient rehab (3)
- health status and development
- emphasizing functional progress
- participation in home, school, and community activities
OT is typically for what purposes (3) outpatient
- part of diagnostic assessment
- provide needed intervention and AT after hospital discharge
- provide intervention for individuals w/ disabilities or other medical conditions not requiring hospitalization
OT functions in Acute Care
primary focus: ADLs IADLs, education, and community participation
Development of goals w/ child, family, and care team
Prevention of problems associated with illness/trauma/disability
Altered mental status interventions:
help establish routine
provide purposeful activities to facilitate cognitive, psychosocial, and motor functions
positive social interaction and use of entertainment & play activities may be especially helpful for reducing stress & promoting engagement of young children
