Neurodegenerative diseases, vision and upper extremity

Question 1

Early stage of dementia: behavior changes

Answer 1

• 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

Question 2

Middle stage of dementia: behavior changes

Answer 2

• 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

Question 3

Late stage of dementia: behavioral changes

Answer 3

• Communication is lost

- All occupational participation is lost

Question 4

Best way to assist in fall prevention in Alzheimer’s patient

Answer 4

Engaging in activity-based interventions, along with providing daily structure

Question 5

Main focus of group sessions for Parkinson’s patients

Answer 5

Improve perception of their quality of life

Question 6

How to support mobility in Parkinson’s patients

Answer 6

Use of rhythm has been shown to support mobility in this population group

Question 7

Proper lighting for client with macular degeneration

Answer 7

Light should be positioned opposite writing hand or nearest to best seeing eye

Question 8

Scan pattern for unilateral neglect

Answer 8

Disorganized; random scanning

Question 9

Accomidation

Answer 9

Ability of eye to adjust focus at a different distance

Question 10

Accommodative facility

Answer 10

The speed of focus adjustment and ability to maintain focus over time

Question 11

When is tendon repair its weakest?

Answer 11

10-12 weeks post-surgery

Question 12

Complex regional pain syndrome

Answer 12

Pain, swelling, stiffness, and sudomotor and trophic changes

Question 13

Cranial nerve injury and vision

Answer 13

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

Question 14

Radial tunnel syndrome

Answer 14

Compression of the radial nerve in the proximal forearm resulting in a dull ache and burning sensation along the lateral forearm.

Question 15

Interventions for dementia patients

Answer 15

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

Question 16

Hemispatial visual neglect

Answer 16

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)

Question 17

Complex Regional Pain; work conditioning

Answer 17

The most recognized therapeutic intervention for CRPS is a stress loading program

Question 18

Acute stage of stroke; areas of focus

Answer 18

Passive range of motion, positioning of the affected extremity, and bed mobility are critical components in restoring function for ADL performance

Question 19

Intention tremors and ADLs

Answer 19

Intention tremors occur during voluntary movement, and providing proximal stabilization may be effective in decreasing the intensity of the tremor with ADLs like eating

Question 20

Orthosis for zone VI tendon repair proximal to the juncturae tendinum

Answer 20

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

Question 21

Cognitive compensatory strategies

Answer 21

• Minimize distractions and interruptions
• Use problem-solving techniques
• Use memory aids and written instructions
• Minimize multitasking
• Allow increased time to complete tasks

Question 22

Visual foundation skills

Answer 22

Skills including visual acuity, oculomotor control, visual pursuits, saccades, and visual fields

Question 23

Occlusion and OTR practice

Answer 23

OTRs can apply occlusion only under the direction of a physician.

Question 24

Best orthotic for radial nerve palsy

Answer 24

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.

Question 25

Macular degeneration and reading difficulties

Answer 25

Age-related macular degeneration causes loss of central visual acuity, resulting in difficulty discriminating small visual details required for reading and writing

Question 26

Malalignment of phalange; best treatment

Answer 26

The least invasive and most effective treatment for a slight malalignment is buddy taping

Question 27

Primary role of the OTR® in addressing caregiver burden for Dementia caregivers:

Answer 27

Provide recommendations related to home modifications.

Question 28

Order of recovery during nerve healing

Answer 28

One-point moving> one-point discrimination> two-point moving> and finally two-point discrimination.