Neuro Occupational Therapy Flashcards
is the use of assessment and treatment to develop, recover, or maintain the daily living and work skills of people with a physical, mental or cognitive disorder; client centered practice that places emphasis on progress towards pt goals
OT
what does OT focus on treating
adapting the environment, modifying tasks, teaching skill, and educating client/family to increase participation in and performance of daily activities
who makes up the neuro rehab team
PT, OT, SLP, MD, RN, rec therapy, CM/social workers, neuropsych, nutritionist, pts, families
non-skid plastic to prevent sliding
Dycem
how to dress with hemiplegia
- putting on: dress affected side first
- taking off: take off affected side last
what devices make up the hip kit
- reacher
- sponge
- long shoe horn
- dressing stick
- device to put socks on
is adaptive driving equipment covered by insurance
no
what are the 4 types of attention
- sustained attention
- selective attention
- divided attention
- alternating attention
working memory, hours to months post stimulus presentation
short time memory
composed of declarative and procedural memory
long term memory
factual; episodic; personal events and semantics; facts about the world
declarative memory
knowing how to do things (tying shoes)
procedural memory
occurs when the situation is different from desired situation and the person does not immediately know what action to take
- problem solving
what are the 3 higher levels of thinking
problem solving
reasoning
concept formation
drawing conclusions from known or assumed facts; sequencing, categorization, deduction
reasoning
what are the 5 steps to problem solving
- identify the problem
- define the problem
- generate possible solutions and select one
- implement preferred solution
- evaluate the outcome
ability to analyze relationships between objects; concrete to abstract thinking
concept formation
two subtypes of metaproccessing
executive functioning
self awareness
volition/initiation, planning/organization, purposive action, and effective performance
executive functioning
ability to process information about the self and compare to a longstanding self evaluation
self awareness
how treat/interact with an individual with cognitive deficits
- speak slowly
- provide 1 step commands and allow pt time to process
- repetition for carryover
- put into a meaningful context
- use different types of learning - verbal, demonstration, provide written example
things to take note of when documenting about cognition
document EVERYTHING you see outside of exercise and treatment
- arousal levels
- attention
- requirement of cues (verbal, tactile, physical, and how much)
- ability to follow commands (simple 1 step vs complex multi-step)
- perseverative, impulsive, labile, confabulating
unawareness of visual denial or deficits
anosognosia
can be motor or perceptual; do not acknowledge side of body
unilateral neglect
awareness of body parts and positions of body parts in relation to themselves and environment (dressing apraxia, unsafe transfers)
body scheme
ability to understand concepts of R and L (dressing apraxia)
R/L discrimination
what are the 3 types of apraxia that can occur
limb
constructional
dressing
inability to carry out purposeful movement in the presence of intact sensation, movement, and coordination
limb apraxia
complex but disorganzied, spatial relation and poor orientation in space; constructional apraxia
RBD
simplified with few details; constructional apraxia
LBD
inability to dress oneself; attempts but clothes on backwards, inside out, or in the wrong order, may only dress one half of body
dressing apraxia
how to tx limb ataxia
use manual contact, complete GMC activity, minimize VC, use chaining, ask pt to visualize action
how to tx constructional apraxia
practice, use a model, use cues and progress from simple to complex; not function based, not as useful for practice application
how to tx dressing apraxia
teach a pattern of dressing, cognitive cues, practice
s/s of visual field deficit
- abbreviate scanning pattern
- scanning pattern is organzied
- re-scan is observed (redirect to impacted side)
- length of time for task is appropriate
s/s of visual neglect
- disorganized, random scanning pattern
- asymmetrical search pattern in hemispace
- scanning pattern is carried out with reduced effort and little or no rescanning
- task is completed swiftly or if the pt is aware of deficit longer time is taken by individual in order to compensate
inability to orient to or respond to stimuli from one side of the environment
hemi-inattention U/L neglect syndrome
inability to orient to relevant contralateral visual stimuli
hemispatial visual neglect
motor neglect, impaired initiation or execution of movement into contralateral hemispace by either limb - no standardized test, based on observation
hemiakinesia U/L neglect syndrome
how to tx U/L neglect
- attention training
- visual scanning - anchoring (light house strategy)
- patching (single and half field)
- prisms (must have orders from optometry)
- compensation (moving non-emergent items to affected side)
ability to distinguish the foreground from background
figure-ground
judging distances, distinguish forms, and separate objects from surrounding background, important to orient environment, recognizing objects, scenes, and language
spatial relations
difficulty understanding and remembering relationships of places to another, difficulty finding ones way in space
topegraphical disorientation
pt’s lack to recognize familiar objects
agnosia
prosopangnosia
inability to recognize familiar faces
detail discrimination, identification, attention, concentration, oriented to the present - concious
focal vision
spatial orientation, posture, balance, movement, anticipates change - pre-concious
ambient vision
