Neurodegenerative diseases, vision and upper extremity Flashcards
Early stage of dementia: behavior changes
- Client becomes suspicious of people in life/caregivers about missing items or time
- Client becomes easily disoriented and socially isolated
- Clings to old habits and repetitive routines
Middle stage of dementia: behavior changes
- Pacing
- Vulgar or rude language
- Difficulty dressing self or communicating needs
- Thinking that they are back in an earlier stage of life.
- Procedural memory impairments first seen in this stage
Late stage of dementia: behavioral changes
- Communication is lost
- All occupational participation is lost
Best way to assist in fall prevention in Alzheimer’s patient
Engaging in activity-based interventions, along with providing daily structure
Main focus of group sessions for Parkinson’s patients
Improve perception of their quality of life
How to support mobility in Parkinson’s patients
Use of rhythm has been shown to support mobility in this population group
Proper lighting for client with macular degeneration
Light should be positioned opposite writing hand or nearest to best seeing eye
Scan pattern for unilateral neglect
Disorganized; random scanning
Accomidation
Ability of eye to adjust focus at a different distance
Accommodative facility
The speed of focus adjustment and ability to maintain focus over time
When is tendon repair its weakest?
10-12 weeks post-surgery
Complex regional pain syndrome
Pain, swelling, stiffness, and sudomotor and trophic changes
Cranial nerve injury and vision
When images double side by side for near-vision tasks, pupils are asymmetrical, and ptosis (droopiness) of the eyelid occur, cranial nerves may be injured
-for these symptoms, test oculomotor function
Radial tunnel syndrome
Compression of the radial nerve in the proximal forearm resulting in a dull ache and burning sensation along the lateral forearm.
Interventions for dementia patients
Interventions to control the daily structure of a person with dementia have been documented to provide balance between the times the person is in high arousal versus low arousal
-example: have patient perform a known task during a time of high arousal level to provide structure to their day
Hemispatial visual neglect
The inability to orient to relevant contralateral visual stimuli; it occurs when the left brain is damaged or when there is a lesion in the right hemisphere (i.e. Stroke)
Complex Regional Pain; work conditioning
The most recognized therapeutic intervention for CRPS is a stress loading program
Acute stage of stroke; areas of focus
Passive range of motion, positioning of the affected extremity, and bed mobility are critical components in restoring function for ADL performance
Intention tremors and ADLs
Intention tremors occur during voluntary movement, and providing proximal stabilization may be effective in decreasing the intensity of the tremor with ADLs like eating
Orthosis for zone VI tendon repair proximal to the juncturae tendinum
It is important to consider adjacent digits when applying an orthosis; if the injury falls proximal to the juncturae tendinum, this can apply force to the repaired site if the adjacent digits were to flex, thus compromising the repair.
-Orthosis should immobilize adjacent fingers and be forearm based
Cognitive compensatory strategies
- Minimize distractions and interruptions
- Use problem-solving techniques
- Use memory aids and written instructions
- Minimize multitasking
- Allow increased time to complete tasks
Visual foundation skills
Skills including visual acuity, oculomotor control, visual pursuits, saccades, and visual fields
Occlusion and OTR practice
OTRs can apply occlusion only under the direction of a physician.
Best orthotic for radial nerve palsy
A forearm-based wrist orthosis that maintains the wrist in 30° of extension usually allows the client to extend the fingers for object release using the intrinsic hand muscles. It is also less conspicuous and less costly than a dynamic orthosis.
Macular degeneration and reading difficulties
Age-related macular degeneration causes loss of central visual acuity, resulting in difficulty discriminating small visual details required for reading and writing
Malalignment of phalange; best treatment
The least invasive and most effective treatment for a slight malalignment is buddy taping
Primary role of the OTR® in addressing caregiver burden for Dementia caregivers:
Provide recommendations related to home modifications.
Order of recovery during nerve healing
One-point moving> one-point discrimination> two-point moving> and finally two-point discrimination.
