Outcomes And Measurments

Question 1

Why do we assess a patients progress when they are in rehab?

Answer 1

1) completion of the program
2) check in status- monitor QOL/adjust goals
3) helps to reinvigorate the rehab program
4) help adjust treatment plan

Question 2

At what point during rehab should reassessment take place?

Answer 2

1) at a set point- at end of a specific phase of healing
2) throughout the program at set intervals- every 2-3 weeks
3) if the goals change- new diagnosis that changes the rehab plan, owner changes goals
4) if there is no improvement or something else changes (disease progresses to a point where rehab wont help or senior patients with a decreased QOL

Question 3

The following are (subjective/objective) tools to assess how a patient is doing in rehab:
1) behavior of patient
2) Pain assessment (validated or owners assessment)
3) QOL survey or owners perception
4) body condition score
5) gait analysis and stance analysis

Answer 3

Subjective- gait analysis and stance analysis can be either subjective or objective

Question 4

Following are (Subjective/objective) tools to assess how a patient is doing in rehab:
1) goals- have we met them?
2) Overall function and ability of the patient
3) joint function- joniometry measurement
4) strength- muscle girth measurements
5) stance analysis
6) gait analysis

Answer 4

Objective

Question 5

Which of the following is the best chronic pain scale to give to the owner because it is easy to use/fill out?
1) Helinski chronic pain index
2) Canine Brieft pain index
3) Liverpool osteoarthritis in dogs scale (LOAD)

Answer 5

Canine brief pain index (all of those scores are validated)

Question 6

When should QOL surveys be given to a client?

Answer 6

At the first appointment- be upfront with clients about QOL if they fill it out sooner they can use that initial form as a baseline to compare the animals QOL throughout rehab.

Question 7

T/F It can be useful to have clients monitor their dogs QOL by just having them rate each day as a good day or bad day

Answer 7

True

Question 8

What are some things regarding QOL that you should NOT say (in rehab setting)

Answer 8

1) your dog is in pain
2) your dogs QOL is not good
3) your dog needs to be euthanized
4) your dog is fat and needs to lose weight- weight can be a OOL issue

Question 9

T/F the following things should be done when discussing QOL when managing a rehab case:
1) talk through your exam and ask questions about pain
2) give QOL surveys to the client to have them do thorughout rehab
3) give pain scale surveys to the clients to have them do throughout rehab
4) give the client handouts with info on various disease
5) educate the client and clearly communicate with them

Answer 9

True

Question 10

How can goal setting be helpful regarding objective measurements in rehab

Answer 10

This can be an easy yes/no assessment when looking at the success of the rehab/ if it’s working. ITs an easily identifiable outcome to the client- if you set a goad has the dog met it

Question 11

T/F joint health is not related to joint angle measurements

Answer 11

F- joint health is DIRECTLy related to angle measurements, if there is something impacting the joint the measurement will be off

Question 12

T/F the following are considered healthy goniometry measurements for their respective joints
Carpus (flexion/extension): 20-35/190-200
Elbow (flexion/extension): 20-40/160-170
Shoulder (flexion/extension): 30-60/160-170
Hock (flexion/extension): 40/170
Stifle (flexion/extension): 45/160-170
Hip (flexion/extension): 55/160-165

Answer 12

True

Question 13

Why can the hip be tricky to measure when using a goniometer?

Answer 13

Because there are a lot of soft tissue structures that can make ID the joint hard

Question 14

When measuring a joint with a goniometer, where should you place your hands

Answer 14

hands should be stabilized on the 2 long bones on either side of the joint you’re measuring

Question 15

T/F Atrophy of the muscle around a joint can result in a reduction of that joint’s flexion

Answer 15

T- no soft tissue approximation, resulting in reduced flexion

Question 16

When measuring muscle girth, what two things should remain constant each time you measure?

Answer 16

The location you measure and the tension on the measuring device (use a band with tension beads to ensure tension is the same)

Question 17

When measuring muscle girth, what are the “normal” parameters based off of?

Answer 17

Symmetry (on the same dog, every dog is different so look for symmetry between the legs, if the dog is a tripod assess the muscle of the amputated limb over time)

Question 18

When measuring the muscle girth of thoracic limbs, where should you place the tape measure?

Answer 18

Just proximal to the medial and lateral epicondyles of the humerus (less of an exact joint when compared to the location for measuring girth in the pelvic limb so try to get in the same area each time)

Question 19

When measuring the muscle girth of the pelvic limbs where should you place the tape measurer?

Answer 19

Measure the length of the femur, either place the tape 70% of the length of the femur distal from the greater trochanter or 30% proximal to the distal femur.

Question 20

T/F stance analysis is a static measurement of weight distribution in time. You only need to use this one time when assessing the effectiveness of a rehab plan

Answer 20

False- you need to look at the pattern over time. Also you take multiple measurements and average them at the same appointment.

Question 21

What is the minimum weight in kg for a dog to sue the stance analysis or gait analysis equipment

Answer 21

10 kg

Question 22

T/F when lameness scoring, just write down the number that you assess

Answer 22

F- Try to describe and quantify (ex: a 3/5 right hind lameness with a hip hike, slight head bob etc)

Question 23

Match the following lameness score with the appropriate grade 0-5
Slightly noticeable intermittent lameness

Answer 23

1

Question 24

Match the following lameness score with the appropriate grade 0-5
Normal

Answer 24

0

Question 25

Match the following lameness score with the appropriate grade 0-5
Obvious weight bearing lameness

Answer 25

2

Question 26

Match the following lameness score with the appropriate grade 0-5
Severe weight bearing lameness

Answer 26

3

Question 27

Match the following lameness score with the appropriate grade 0-5
Intermittent non-weight bearing lameness

Answer 27

4

Question 28

Match the following lameness score with the appropriate grade 0-5
Non-weight bearing lameness

Answer 28

5

Question 29

T/F every rehab center has a gait analysis mat, it is very common and easy to use

Answer 29

F- it is expensive and only some specialty rehab facilities have them. Get a lot of data out of these, can be cumbersome to use- dog needs to be walking at a specific speed; good for research

Question 30

What are some pros to using thermal imaging?

Answer 30

Pros:
1) cool visual resource of O to see potential inflammation sites of pain
2) Can be useful as objective data over time
3) helpful in honing in on a certain part of the dog (consistent hot spots in the shoulder that keeps popping up, can prompt further diagnostics)

Question 31

What are some cons of Thermal Imaging

Answer 31

Cons
1) O can hyperfocus on one problem area
2) NOT a diagnostic tool (can only help clue you in to pursing further diagnostic testing)
3) Patinet needs to be sitting still/alone for around 10 minutes as being pet/handled can falsely appear as an area of inflammation/heat
4) variability in results if not used correctly