Neurological impairments Flashcards
C5 SCI and splinting/assistive devices
- C5 SCI’s benefit from mobile arm support to support weight of arm during activities (grasping/holding objects w/ require wrist stabilization)
- Dorsal splints useful to provide sensory feedback
C6-C7 SCI and splinting
Wrist-hand orthosis- or tenodesis splint- useful for maximizing pinch strength
Decorticate rigidity
Abnormal flexion:
- Upper extremities are in spastic flexion w/ internal rotation and adduction; lower extremities are in spastic extension, internal rotation and adduction
- Level 3 Glascow Scale
Decerebrate rigidity
Extensor response:
- Upper and lower extremities are in spastic extension, adduction and internal rotation
- indicates severe brain damage; Glascow level 2
Autonomic dysreflexia precautions
- Loosen restrictive clothing or devices; check catheter for obstructions
- Pts should carry medical card describing condition and treatment
Hemiparesis symptoms
Affected side weakness, edema, and joint contractures
How often should pressure relief techniques be performed to reduce skin breakdown
Every 30 minutes
Rancho Los Amigos Level I
No response; completely unresponsive to any stimuli
Rancho Los Amigos Level II
Generalized response; exhibits inconsistent and nonpurposeful reactions to stimuli
Rancho Los Amigos Level III
Localized response; reacts specifically and inconsistently to to stimuli
Rancho Los Amigos Level IV
Confused/agitated; has heightened state of activity with severely decreased ability to process information
Rancho Los Amigos Level V
Confused, inappropriate non-agitated; appears alert with fairly consistent reactions, although increased complexity of commands causes random responses
Rancho Los Amigos Level VI
Confused, appropriate; exhibits goal-directed behavior but is dependent on external input for directions
Rancho Los Amigos Level VII
Automatic/appropriate: behaves appropriately and is oriented to place and routine but frequently displays shallow recall
Rancho Los Amigos Levels VII-X
Purposeful and appropriate; is alert and oriented and able to recall and integrate past and recent events
Strategy for TBI patient with sequencing deficits
Minimizing environmental distractions and decreasing the complexity of the task will allow the client to experience success in completing one step of the task at a time
Strategy for TBI patient with agitation during session
Providing passive orientation information and preparing the client for what to expect in the session will provide the client with a sense of familiarity, decreasing confusion and agitation
Ataxia vs tremors
- Ataxia: Movements that appear oscillating and exaggerated (seen often in pts with TBI)
- Tremors: involuntary rhythmic oscillations which are not as exaggerated as those seen in clients with ataxia.
Hemiparesis and recovery for ADL function
-First focus on postural stability, utilizing edge-of-bed activities to increase
Postural stability is essential to performing many ADLs, and hemiparesis influences the client’s ability to maintain postural stability at the edge of the bed.
