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Boardz > Neurological Conditions > Flashcards

Neurological Conditions Flashcards

1
Q

Human brain

A

Cerebrum
Diencephalon
Brainstem
Cerebellum

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2
Q

Brainstemo

A

Midbrain (ANS), pons, medulla oblongata

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3
Q

Hypothalamus

A

Homeostasis

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4
Q

Cerebral cortex

A

80% of brain

Front lobe-executive function, emotional control

Parietal lobe-sensation

Occipital lobe- vision

Temporal lobe-language, hearing

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5
Q

Fissures/sulci

A

Medial longitudinal fissure: separates hemispheres

Central sylvia fissure: b/n parietal/frontal and temporal

Sulcus: b/n frontal/parietal lobe

Postcentral gyrus in frontal lobe/ primary motor area

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6
Q

Frontal lobe

A

Personality, behavior, emotion, judgment, planning, problem-solving, Broca’s area (expressive speech), writing, motor strip (movement), intelligence, self awareness, concentration, STM, motor planning

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7
Q

Parietal lobe

A

Interprets language, words, sense of touch, pain (sensory strip), interprets signal from vision, hearing, motor, and sensory, memory, visuospatial perception (primary sense area)

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8
Q

Occipital lobe

A

Interprets vision, visual stimuli from optic pathways

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9
Q

Temporal lobe

A

long term memory, hearing, understanding language (wernicke’s area, receptive), sequencing/organization

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10
Q

Limbic lobe

A

Emotion and autonomic system

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11
Q

Insula lobe

A

Gustation, taste, visceral organ sensation, empathy, and self aaare essential

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12
Q

Hypothalamus

A

Autonomic system, controls hunger, sleep, thirst, secretion of hormones, and sexual response

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13
Q

Pituitary gland

A

Master gland, endocrine system

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14
Q

Pineal gland

A

Internal clock, circadian rhythms some role in sexual development

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15
Q

Thalamus

A

Relay station for all info, plays a role in pain, attention, alertness, memory

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16
Q

Basal ganglia

A

Caudate and putament glubos, pallidus

Emotional reaction and memory

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17
Q

L hemisphere

A

Communication, Broca’s/Wernicke’s area

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18
Q

R hemisphere

A

Attention, concentration, memory, problem solving
Unilateral in attention R parietal

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19
Q

Cerebral arteries

A

Anterior cerebral artery: medial air face if frontal/parietal lobee

middle Cerebral artery: lateral surface of frontal/parietal lobe, superior temporal, Deep internal capsule and basal nuclei

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20
Q

Posterior Cerebral Artery

A

Inferior temporal lobe and occipital lobe

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21
Q

Cranial nerves in brainstem

A

Most originate in brainstem

Midbrain: Oculomotor CN3, Trochlear CN4, trigeminal CN5

Pons: abducen CN6, facial CN7

Medulla oblongata: vagus cn10, hypoglossal CN 12

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22
Q

Cranial nerves

A

1)olfactory: smell
2) optic: vision
3)oculomotor: eye movement/pupil
4) trochlear: eye movement
5) trigeminal: somatosensory of face, muscles for chewing
6) abducens: eye movement
7) facial: taste of anterior 2/3 of tongue, somatosensory from ear muscles for facial expressions
8)vestibulocochlear: hearing/balance
9) glossopharyngeal: taste of posterior 2/3 of tongue, tonsil, tongue, pharynx, controls some muscle in swallowing
10)vagus: glands, digestion, HR, autonomic
11) spinal accessory nerve: muscles in head movement
12) hypoglossal: muscle of tongues

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23
Q

Cerebellum

A

Inferior to cerebrum, posterior to brainstem, superior/inferior cerebral peduncles carry fibers from major spinal tracts cerebrum to spinal cord

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24
Q

Pons

A

Relay center between spinal cord, cerebrum, cerebellum

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25
Q

Midbrain

A

Autonomic nervous system, reflexive vision, hearing, motor control, level of alertness, body temp control, sleep/wake cycles

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26
Q

Medulla

A

Sends motor messages from cerebrum to spinal cord, heart rate, BO, rate of breathing, vomiting, coughing, swallowing, sneezinf

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27
Q

Spinal cord anatomt

A

Begins at foramen magnum, conus medullaris

Ascending tracts (sensory), dorsal horn
Descending tracts (motor), ventral horn

31 pairs of spinal nerve: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, coccygeal
Cervical= hand
Thoracic= hand, abdominal, chest muscles
Lumbar=ankle, hip, knee
Sacral= bowel, bladder, reproductive organs

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28
Q

Age-related neurological changes

A

Decrease processing soeed
Difficulty attending to more than 1 stimuli, alternating/divided attention
Decreased working memory depended on cog load
Procedural memory increase, difficulty using new method with familiar task
Increase difficulty with age conscious awareness of environment
Less efficient problem solving
Decreased fluid increased crystalized

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29
Q

Long term memory

A

Declarative and procedural memory

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30
Q

Declarative memory

A

Verbal based memory
Episodic: memory of every day events (better in young age)
Semantic: long term of words, #s, concepts (better in older age)

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31
Q

Procedural memory

A

Nonverbal memory, how to do a task, stores information regarding motor skills and behaviors

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32
Q

Prospective memory

A

Decreased external cues increase complex cognitive process = difficulty with age

Remembering future appointments and planned actions

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33
Q

Working memory

A

Rehearsal occurs and info is manipulated for saving in LTM

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34
Q

Fluid intelligence vs crystallized

A

Fluid = Abstract concepts
Crystallized = general knowledfe

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35
Q

Working memory strategies

A

Organizing/repeating stimuli in STM to transfer to LTM, increased age =increased difficulty with tasks with increased cognitive load

Make checklist/note talking, be aware of pt’s capacity

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36
Q

Procedural memory strategies

A

More difficult to access with increased cognitive load, such as finding way to MDs office

Decrease cognitive load such as using a navigation system

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37
Q

Prospective memory strategies

A

Reminders such as calendars, recordings, or 2nd person to remind

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38
Q

Executive functioning strategies

A

Increase time

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39
Q

CVA

A

Interruption of blood flow to the brain, impacting brain function

Ischemic: obstructed blood vessel secondary to embolism, thrombus, dissection

Hemorrhagic: bleed into the brain from ruptured blood vessel, ICH in brain/SAH around brain

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40
Q

TIA

A

Resembles stroke with symptoms no longer than 24 hours

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41
Q

Embolic stroke

A

Type of ischemic stroke, abrupt onset from embolism forming in a cardiac region or other arterial sources outside the brain

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42
Q

L brain lesion impairmenrs

A

R side paralysis
Speech and language
Slow/cautious behavioral style
Memory loss

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43
Q

R brain lesion impairment

A

L side paralysis
Vision impacted
Memory loss
Quick inquisitive behavioral
Style

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44
Q

Anosognosia

A

Denial/unaware of neurological deficits

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45
Q

Agraphia/dysgraphia

A

Inability/impaired ability to write

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46
Q

Acalculia/dyscalculia

A

Inability/impaired ability to perform simple math before stroke dx

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47
Q

Apraxia

A

Inability/impaired ability to perform skilled movements as desired

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48
Q

Dysarthria

A

Speech disorder from weakness, paralysis, or incoordination of muscles involved in sound production of speech

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49
Q

Aphasia

A

Language disorder that results from damage to language center of brain
Expressive
Receptive
Global

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50
Q

Broca injury

A

Labored speech/problems initiating speech, nonfluent/expressive aphasia

Increased time to speak and periods of silence
MCA
Often pairs with R paralysis

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51
Q

Wernicke’s aphasia

A

Receptive aphasia, fluent aphasia, do not typically present with R paralysis

May show visual deficits, difficulty comprehending spoken language

use gestures and familiar words, face individual, speak at a slower cadence, context

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52
Q

Contralateral homonymous hemianopsia

A

Ocular condition where vision is lost in the same field halves if both eyes to the ocular nerve lathway

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53
Q

Neglect spatial inattention

A

Result of damage to R side of brain

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54
Q

Eye movement disorder

A

Occurs due to nerves/muscles that become damaged resulting in nystagmus, strabismus, diplopia, oculomotor dysfunction

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55
Q

Assessing chronic stroke

A

COPM
Fugl-Meyer Assessment of Motor Recovery FMA
Modified Ashworth Scale MMAs

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56
Q

Fugl-Meyer Assessment of Motor Recovery FMA

A

Based on brunnstrom recovery levels, UE/LE section, completion of both more than 1 hour point scale

Severity of limb impairment

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57
Q

Modified Ashworth Scale

A

Removes 1+ grade and modified grade 2 from original scale, marked increased tone by catch in middle range and resistance in remainder of ROM, but easily moved

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58
Q

Managing spasticity

A

Strong evidence for dry needling to reducing spasticity and increasing ROM

Low level evidence for static/dynamic splinting in UE

No evidence for manual stretching in UE, moderate evidence for splinting/stretching in the hand

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59
Q

Motor retraining:NMES

A

No effect of motor ability, positive effect for improved ADLs

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60
Q

CIMT

A

Time consuming, 90 minute protocol, increased use of limb during ADLs

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61
Q

Mirror Therapy

A

Effective in acute/chronic strategies
Moderate evidence for increased motor/sensation, 1-8 weeks home MT improved arm/hand function, 6 week, 2days OT/30 min home MT
X5 days, unilateral training more official

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62
Q

Occupational therapy task-oriented approach OT-TOA

A

Function based for persons with a stroke based on motor behavior/motor learning/control/concepts, top down approach, focuses of roles/occupational performance

Practice in natural environment beyond sessions leads to increased paretic UE use, performance, and satisfaction

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63
Q

Task specific training

A

Use affected UE to complete various tasks for brain to relearn skill

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64
Q

Visual intervention

A

Visual scanning activities
Balance technique
Spatial awareness
Prisms: change perception by changing direction of light, relaxation, breathing techniques

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65
Q

Pt/ caregiver education as neuro intervention

A

Moderate to strong evidence for effectiveness

Caregiver experiences negative emotion, employment, finance and physical health=strong evident for CBT and problem solving

Moderate for multimodal ADL training, counseling, community resources, education, and relaxation techniques

Moderate evidence for in hime training and remote training

Inpatient visit strong evidence

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66
Q

Neuro intervention: community reintegration

A

Return to participation in desired meaningful IADLs, life roles, and community interests, community based care programs

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67
Q

Leisure in neurological conditions

A

Complicated by types of activities available, individual, stage of life, social/cultural environments, leisure role, satisfaction and use of time

Attend and treat use of time to avoid social isolation

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68
Q

Leisure evaluation

A

Checklist questinnaires
MOHost
Modified interest checklist
Activity card sort-ID new and existing leisure tasks
Nottingham leisure Questionnaire stroke poo

69
Q

Leisure intervention

A

Time management training to incorporate leisure, increased leisure awareness, identify barriers, adapt/modify task

70
Q

CVA Discharge considerations

A

Goals setting/flexibility to respond to evolving needs

Includes reintegration, recovery, treatment, adaptation, and end of life care

Transition management goal to facilitate and support seamless movement across continuum

Supported living environment

Discharge disposition: impacts function and mortality, admission to IRF within 90 days of CVA increases mobility and decreases risk of readmission vs d/c home

71
Q

ABI Acquired Brain Injury

A

Damage to brain may be traumatic or nontraumatic

Non traumatic ABI: tumor, anoxia, nutritional deficiency, falls, stroke, environmental causes

72
Q

TBI traumatic brain injury

A

Caused by falls in higher income countries and traffic incidences in lower income countries

Cognitive reserve is important in managing intervention and discharge recommendations

Younger age increase TBI IQ for better cognition, increase mortality with age

73
Q

Classification of ABI

A

4 factors: GCS, time of LOC, presences of post traumatic amnesia and result of neuro imaging

74
Q

Mild TBI

A

GCS 13-15
Less than 30 min to 1 hour LOC
Less than 5 min if amnesia
Normal imaging

75
Q

Moderate TBI

A

GCS 9-12
Greater than 30 to 24 hour and 6 hours LOC
1-24 hour amnesia
Normal/abnormal imaging

76
Q

Severe TBI

A

GCS 3-8
Greater than 24 hours to 76 hours of LOC
Greater than 1 day to leas than 7 days of amnesia
Focal abnormalities on imaging

77
Q

Glascow Coma Scale

A

Eye opening: 4 spontaneous, 3 to sound, 2 to pressure, 1 none

verbal response: 5 oriented, 4 confused, 3 words, 2 sounds, 1 none

Motor response: 6 obeys command, 5 moves to localised pain, 4 flex to withdraw from pain, 3 abnormal
Flexion, 2 abnormal extension 1 no response

78
Q

Ranchos LOS Amigos

A

Level 1: no response total a
Level 2: generalized response, total a
Level 3: localized response, total a
Level 4: confused agitated, max a
Level 5: confused, inappropriate, nona agitated, max a
Level 6: confused appropriate moderate assistance
Level 7:automatic appropriate, min a

79
Q

TBI Assessment

A

Motor: ROM, MMT, muscle torn
Vision: saccades, visual field, oculomotor, near and distant acuity
ADLs: A-One, AMPs 9, Barthel Index, ACS, Performance Assessment of Self-Care

80
Q

TBI intervention

A

Internal cuing/strategy training for self-initiation
External cues
Memory Aids
Blocked practice
Random practice
Sensory stimulation
Group based physical activity
Virtual reality
Group based multi-component cognitive progra

Errorless learning
Occupation based tx
Vision therapy
Education/skills training
Goal focused intervention
Caregiver education

81
Q

TBI intervention: internal cuing and strategy training for self initiation

A

4 step process-Writer Organize Picture Rehearse several sessions

82
Q

TBI intervention: external cues

A

Checklist, timers, memory books
Memory aids: those managed by others vs impaired individual, passive memory aids require pt to develop a habit

83
Q

TBI intervention: blocked practice

A

Repeatedly practicing the same task in the same environment for more severely impaired

84
Q

TBI intervention: random practice

A

Practicing task in between other tasks, more beneficial learning of skill

85
Q

TBI intervention: sensory stimulation

A

Strong evidence for family delivered multi-modal sensory stimulation to increase arousal and awareness in clients with decreased level of consciousness, moderate for practitioner delivered stim

86
Q

TBI intervention: physical activity

A

Moderate evidence for group based physical activity
-aerobic, balance, and strengthening lead to increased mobility

87
Q

TBI intervention: virtual reality

A

Moderate evidence for motor
Abilities for mild to moderate aTBI

88
Q

TBI intervention: Group based multicomponent cognitive program

A

Strong evidence for problem solving in mild to severe TBI

89
Q

TBI intervention: occupation based tx

A

Strong evidence involving clients in IDC tx, CO-OP (goal, plan, do, check)

Mild to severe tbi to solve problems experiencing in daily life

90
Q

TBI intervention: errorless learning

A

Moderate evidence to increase ADLs in those who have not emerged from posttraumatic amnesia

91
Q

TBI intervention: vision therapy

A

Moderate evidence for outpatient, vision therapy consisting of techniques to increase vergence, saccadic eye movement, visual attntion, visually evoked potentials

92
Q

TBI intervention: education/skills training

A

Strong for 1:1outpatient education to improve compensatory strategies with mild to severe TBI

93
Q

TBI intervention: goal focused intervention

A

Moderate support for goal focused individual/group treatment to increase emotional control and social interactions

94
Q

TBI intervention: caregiver education

A

Individual strong evidence exists for promoting caregiver health and well-being via inpatient and community based caregiver group, may be via phone

Family based strong evidence exists for promotion caregiver health/well being through online/home therapy, group to build skills such as problem solving, communication, and strategy development

95
Q

Meniere’s Disease

A

Unknown inner ear dysfunction that causes dizziness, vertigo, ringing in the ear, and hearing loss

No cure, but tx
Increase endolymph in the ear secondary to poor fluid drainage, autoimmune disorder, viral infection, genetics

96
Q

BPPV

A

Vertigo, dizziness, nausea, vomiting more prevalent in older adults

97
Q

Vestibular symptoms

A

Vertigo
Oscillopsia
Disequilibrium
Spatial orientation deficits
Visual motion sensitivity
Decreased dynamic visual acuity
Decreased ability to concentrate
Limited ability to complete dual tasks

98
Q

Triggers for vestibular symptoms

A

Rolling over in bed, getting out of bed, shifting weight during transfer in/out of shower, bending to put shoes on, retrieving from low levels, driving, reading

99
Q

Vestibular Assessments

A

Occupational profile
COPM
Task Analysis
Vestibular disorder ADL scale (specific ADLs that are affected)
ABC
Dizziness Handicap Inventory
Ordinal Scales of vertigo intensity
Vestibular activities and participation measure
CTSIB
TUG
Berg Balance
5x STS

100
Q

Vestibular intervention

A

Entry-level/generalist: functional mobility training, ADL training, education on symptom management, medication management, environmental modification/adaptation (use of reacher), establish daily routine, incorporate balance of work, sleep, and leisure, stress management/mindfulness technique, relocating objects, reduce triggers

101
Q

TBI visual deficits

A

Saccades, pursuits, and convergence insufficiency

Primary visual deficits: acuity, visual field, eye movement, pursuits, saccades

Complex: visual perception, motion vision, visual spatial function

102
Q

Vestibular system

A

Inner ear = 3 semicircular canals, 2 otoliths—-peripheral disorder

Central vestibular disorder-brain not integrating, processing information from vestibular system

103
Q

Components of visual-vestibular convergence

A

Thalamus, cortex, cerebellum

104
Q

Sensory Organization Test by NeuroCom

A

Posturography with complex hardware/software to assess client’s ability to maintain an upright posture in 6 conditions

Similar to CTSIB, CTSIB more affordable and practical

105
Q

Low sensitivity assessments advised against vestibular disorder use

A

Head shaking, un-instrumented head impulse test, video lead impulse test

106
Q

Vestibular ocular motor screening tool

A

Sports related concussion, integrate effects of cognitive load, evaluate gaze stabilization

107
Q

Model of multisensory integration

A

Separates process of motor planning and motor control with praxis at the center

Necessary for sensorimotor adaptation

Vestibular system is critical for body’s position in space, midline, spatial awareness, navigational skills, body schema/internal representation, and environmental awareness

Perceptual awareness can be altered by cognitive input

108
Q

Sensory organizational dysfunction

A

Apraxia
Motor apraxia, ideomotor apraxia, ideational apraxia

109
Q

Vestibulo-ocular Hierarchy model

A

Visual integrity (peripheral field, activity, ocular motor skills) —>visual efficiency (accommodation, pursuits, saccades, fixation, convergence, gaze stabilization) —>visual perceptual processing (visual attention, scanning, visual memory, spatial orientation, pattern recognition, discrimination)-> cognitive-perceptual—> occupational performance

Imbedded in multisensory models
Occupatuonal performance from
Environmental and sensory feedback

Diffierentiates ocular motor function and oculomotor skills

110
Q

Brock string

A

Assess binocularity and suppression

111
Q

Reflexive saccades

A

Stimulated by movement in peripheral field, parietal eye field

112
Q

Intentional saccades

A

Follow command to focus on target frontal field

Central nervous problem demo’s normal reflexive saccade and difficulty with intentional saccades

113
Q

Incremental VOR training

A

Improve vestibular function

114
Q

Advance level therapist vestibular intervention

A

Habituation, balance training, and gaze stabilization

115
Q

Persistent postural-perceptual dizziness

A

Describes long term problems experienced by clients with vestibular problems, chronic functional vestibular disorder

Exacerbated by visually complex or dynamic visual simti

Sx: visual hypersensitivity, unsteadiness, imbalance, avoidance of environment with dynamic visual stimuli

116
Q

Visual vertigo

A

Visually induced dizziness experienced by people who use vision to compensate for vestibular problems

Triggers: riding as a passenger in the car, walking across lines in crosswalk, coping with children’s spinning brightly colored toys, walking past people

117
Q

Treatment for visual vertigo

A

Visual/vestibular activities
Promote desensitization
AVOR app to educate clients on vestibular system

118
Q

Brain tumor

A

Top 10 Ca related deaths
90% primary tumor s/p 20 y.o, onset average 57 y.o., highest incidence 85+

Black people more likely to develop primary brain Ca and non malignant tumors

White people more likely to develop malignant brain tumor

119
Q

Primary tumor

A

Originates in the area tumor is indentified

120
Q

Secondary tumor

A

METs from primary tumor
Grade=reflects appearance
Stage= size and progression from original site

121
Q

Meningioma

A

Tumor of meninges, 20-30% of brain tumors, benign

122
Q

Schwannoma

A

Cranial nerve VIII, acoustic neuroma, hearing loss, tinnitus, imbalance, incoordination, facial weakness

123
Q

Common Brain Tumor symptoms

A

Deficits in sensation, motor, vision, visual perception, cognition, and emotional coping interfering with occupational performance and QOL

124
Q

Assessment if Brain Tumor: ADLs

A

Section GG, Barthel Index, Katz ADL scale, AMPAC (acute care)

125
Q

Assessment of brain tumors: cognition

A

EFPT, Kettle Test, multiple errands test, functional cognition

126
Q

Assesment of fatigue with brain tumors

A

Brief fatigue inventory

127
Q

Assessment of brain tumors: QOL

A

Functional assessment of Cancer Therapy (FACT)

128
Q

Interventions for brain tumors

A

CBT
Compensatory skills training
Meaningful functional activities
Lifestyle redesign
Remediation/restoration of skill

129
Q

Psychosocial Intervention for Brain Tumors

A

CBT for
Body image
Loss of role
Depression
Relaxation
Mindfulness
Stress management

130
Q

Multiple Sclerosis

A

Chronic reoccurring demyelinating disease if CNS impacting communication between brain and spinal cord

Body’s immune system attacks myelin sheath

131
Q

3 types of MS

A

Relapsing/remitting MS
Secondary progressive MS
Primary Progressive MS

132
Q

Relapsing and Remitting MS

A

Most common dx, exacerbations followed by periods of remission, partial or complete recovery of symptoms

133
Q

Secondary progressive MS

A

Starts out as relapsing/remitting and transitions into a more progressive course as the remission period does not allow for recovery of symptoms resulting in disability over time

134
Q

Primary progressive MS

A

Steady declining neurological function from onset without apparent relapse, symptoms gradually worsen overtime

135
Q

MS Assessment

A

Multiple Sclerosis intimacy and sexuality questionnaire

COPM

Functional Assessment of Multiple Sclerosis

Fatigue modified Impact Scale
9 hole peg test

136
Q

Multiple Sclerosis Intimacy and sexuality Questionnaires

A

MSISQ-19, rate degree of which MS symptoms interfere with sexuality

137
Q

Functional Assessment of Multiple Sclerosis

A

FAMS, 58 likert scale response items, self-administered or interview style

Areas: mobility, thinking and fatigue, emotional well being, family/social well being, and MS symptoms

138
Q

Fatigue Modified Impact Scale

A

Understand impact of fatigue on daily function of persons with MS, effects if fatigue of cognitive, physical, psychosocial functioning over last 4 weeks

139
Q

MS Intervention for fatigue

A

ECT/work simplification (positive response)

Results: improvement in fatigue, feeling less pessimistic, experiencing few positive consequences of MS, improvement in perceiving disparity in social support

140
Q

MS intervention for Sleep

A

Moderate evidence for online mindfulness/meditation group for sleep problems

Moderate evidence for individual or group CBT, 90 minute x8 weeks=increase sleep in women with MS

141
Q

MS intervention of ADLs

A

Address environment and adaptationspl to increase (I) with ADLs

Home visit focusing on task specific exercise

PEO Model:mismatch of pt’s ability
And environment

142
Q

intervention for MS: exercise

A

16-30 minute of HeP bc longer intervals are burdensome, videotape, complete in front of mirror, pictures/words

143
Q

Interventions for MS: bladder

A

Moderate to high evidence supporting pelvic floor muscle training to decrease leakage and neurogenic bladder symptoms

144
Q

MS Intervention: IADLs

A

PEO Model: address environment in home visits with task specific exercises, mismatch of environment and abilities

145
Q

MS intervention: falls and functional
Mobility

A

Moderate evidence for fall/mobility interventions, balance training, exercise program, 6 week protocol for virtual reality balance training

12 week HEP decrease falls targeting balance and LE strength, not strength but balance improvement related to reduced falls

String evidence for Group/ in home fall prevention: 10-12 week 4-10 sessions

146
Q

MS interventions: sexual function

A

Strong evidence for OT to address sexual function, 4 weeks, 16-20 minute, community based model, PLISSIT or EXPLISSIT model

Moderate evidence for in person group, 5 full days of meetings to increase quality of relationship

147
Q

MS Intervention: activity tolerance

A

Strong evidence for providing educational materials in 4-15 online, newsletters, or DVD material with 7-15 1:1 videos or phone coaching

Leads to increased physical activity and self-reported participation

148
Q

MS Intervention: Caregiver

A

In person group caregiver intervention and support during 6-12 week collaborative care or psycho education program

149
Q

MS intervention: medication management

A

3-5 week duration using CBT/mindfulness to increase medication adherence

150
Q

MS intervention: work

A

Moderate evidence for 4 weeks, educational module to increase confidence in career goals and problem solving work place difficulties in MS

151
Q

SCI

A

Can occur as a result of a traumatic or non traumatic event damaging the spinal cord or nerves

Paraplegia: LE/lower part of body, typically resulting from injury to thoracic/lumbar region of spinal cord

Tetra/quadriplegia: involves paralysis of both UE/LE typically resulting from an injury to cervical region of spinal cord

152
Q

SCI Assessments

A

SCI QOL FM Functioning
COPM
Assessing client factors: level of injury/completeness, neurological impairment, motor function, cognitive function, sensation, shoulder pain, depression

153
Q

SCI QOL FM Functioning

A

SCI functional index, 9 item pt report outcome measure, functional abilities with SCI

Domains: basic mobility, self-care, fine motor, ambulation, wheelchair mobility

154
Q

Common shoulder injuries with SCI

A

Impingement
RTC injury
Bursitis
Joint swelling
Glenohumeral joint instability

155
Q

Assessing Shoulder pain in SCI

A

Assess with wheelchair user shoulder pain index: 15 item self-report tool

156
Q

SCI shoulder pain intervention

A

Exercise, massage, e-stim, neuromuscular retraining, corticosteroid injections, strengthening and stretching

157
Q

Aging with SCI concerns

A

Health literacy
Perceived quality and satisfaction with healthcare services
Lack if collaboration between provider and pt
Functional changes due to aging process (energy level, memory, sleep, bowel/bladder, comorbidities)
Increased falls
Change in level of participation in activities
Reassess environment

158
Q

Treatment of Aging concerns in SCI

A

Active engagement with health literacy
Practice and discussing problem solving
Educate on strategies to continue meaningful life role
Balance activities to reduce falls later in life
Modifying existing leisure activity to allow for participation
Increase professionals participation after DC
Tx co-occurring medical conditions

159
Q

Co-occurring Medical Conditions of SCI

A

Secondary health conditions in first 6 months greater chance of LT disability

Want to treat co-occurring conditions with 2.5 years post injury

Leg spasms, constipation, back pain below level of injury and shoulder pain

Higher level of impairment leads to constipation, UTI, and headaches and back pain= greater disability at 18 months

Difficulty coughing = more significant disability at 30 months

160
Q

SCI intervention

A

Bowel/bladder management
AD
Adaptive techniques
Safety training
ADL training
Transfer training/functional mobility
Fall prevention
Pressure ulcer (80% will have a sore, 30% more than one)-pressure relief tech
VR, AT, splinting,
strengthening
caregiver education
Modalities
Spasticities management
Medication management
Health promotion/prevention
Adaptive sports
ROM exercise/contracture prevention
Educate sexuality concerns

161
Q

Pressure Ulcers risk factors in SCI

A

Prolonged sitting
Shearing forces
abrasions
Bumps
Falls
Loss of muscle mass
Extreme temps
Wet skin
Under/overweight
Decrease circulation
Swelling DN
Increased BP
Alcohol/drug use
Depression
Aging

162
Q

Pressure relief techniques

A

Weight shifting in wheelchair 15-30 minute for 30-90 seconds
Inspect skin 2x/day
Padding/positioning
Turning in bed
Avoid elevating HOB while sleep secondary to increase pressure on buttocks/low back areas

163
Q

SCI pressure relief program

A

Program consisting of didactic lectures, group discussions, and practice sessions to increase benefits on 5 skin care belief scales

Domains: susceptibility to pressure ulcer, barriers to skin, skin check belief, benefit to wheelchair pressure relief, barriers to turning/positioning belief, and self-efficacy

Reaching forward during computer use to redistribute pressure compared to upright sitting

164
Q

Amyotrophic Lateral Sclerosis

A

Nerve cells breakdown break down which reduces functionality in muscles

Sx: muscle twitching, weakness in arm/leg, trouble swallowing, slurred speech

165
Q

ALS Assessment

A

COPM
Amyotrophic lateral sclerosis functional rating scale

Client factors: shoulder pain (visual analog scale to monitor pain), dysphagia, pain, strength/ROM

166
Q

ALS shoulder pain intervention

A

Scapular mobilization, ROM, caregiver education research shows increase ROM and reduce VAS score for pain

167
Q

ALs intervention

A

HEP of stretching/resistive exercise- moderate evidence

Use of wheelchair, limited evidence, PWC did not increase community participation

Home modification with participants reporting satisfaction with use of elevated toilet seat, toilet rails, shower seats, grab bars, slip on shoes, transfer board (not satisfied with button hooks/long handled tools)

OT related to improved perceived fatigue, manual dexterity, fall prevention, and improved cognitive aspects (memory, communication, depression, QOL)

Functional t/f and mobility: power wheelchair features frequently tilt in space, reclining, power elevating leg rests, joystick control, air/gel cushion, height adjustable armrests, soft headrests, and seatbelts

Bowel/bladder management

Fall prevention/safety training

AD/adaptive techniques

ADL training

Caregiver training: increase communication between client and caregiver, family members did not understand mental, social, and emotional state of each other

Home Health care

168
Q

Catherine Bergego Scale

A

observational, functional, performance based assessment. There are 10 items, Each item is scored from 0-3. The minimum total score is 0 (indicating no neglect), and the maximum total score is 30 (indicating severe neglect)

Assesses spatial neglect

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