Practical

Question 1

Assisted cough techniques

Answer 1

Assisted Cough Techniques
Assisted cough techniques are crucial in preventing complications like pneumonia

Technique: 2 coughs per 1 breath out

Question 2

self cough technique

Answer 2

1. Breathe in as deeply as possible
   If possible, combine with trunk and neck extension as well as shoulder flexion or scapular adduction
   Can use glossopharyngeal breathing to augment inhalation is needed
2. Hold breath briefly
3. Cough
   If possible, combine forced exhalation with trunk and neck flexion as well as shoulder extension or scapular abduction
   If patient can control it, can even have them fall into a folded position
   If adequate UE strength and balance, can self-apply Heimlich-like maneuver to stomach

Question 3

glossophayngeal breathing

Answer 3

Glossopharyngeal Breathing (tetra)
Use of tongue and pharyngeal muscles; force air in lungs through series of “gulps”
Can also help with chest wall mobility

Question 4

abdominal binders breathing

Answer 4

Can also be used with higher paraplegic injuries
Used to contain abdominal contents in sitting and better position diaphragm
↑ VC, TV, MEP, and blood oxygenation

Question 5

eccentric control of breathing

Answer 5

Patient inhales maximally and then counts or says, “ah” or “oh” for as long as possible before taking another breath
Goal: 10-12 seconds
Can further promote by + manual vibration or resistance

Question 6

chest wall mobility breathing interventiosn

Answer 6

Deep breathing exercises, passive stretching, joint mobilizations, intermittent positive-pressure breathing

Question 7

posture considerations
Respiration

Answer 7

Ideal posture for enhanced respiration: anterior pelvic tilt, erect trunk, adducted scapulae, neutral head & beck alignment

Question 8

C spine SCI edu

Answer 8

autonomic dysreflexia
pressure relief

Question 9

T spine SCI edu

Answer 9

pressure releif
autonomic dysreflexia if above T7

Question 10

autonomic dysreflexia

Answer 10

above T7
Pounding HA (due to ↑ ↑ BP), goose bumps, sweating above level of injury, bradycardia, skin blotching

Question 11

Egris

Answer 11

risk of respiratory failure

Question 12

EGOS

Answer 12

prog estimate of ability to walk
higher = worse for walking

Question 13

GBS mm

Answer 13

AAROM for mm 3/5 and functional training for mm >3/5

Question 14

education on GBS

Answer 14

prog - 2 yr full recovery and 80 percent walking in 6 mo

Question 15

PD compensation

Answer 15

internal external cueing
4 S’s

Question 16

CMT edu

Answer 16

foot orthosis
fall reduction strategies

Question 17

PD edu

Answer 17

4S
stretching schedule
meds
meds side effects
power stance when opening activities

Question 18

4s

Answer 18

stop stand up weight shift big step

Question 19

SINEMET AE and Effects

Answer 19

SINEMET
Does not improve axial rigidity
Typically worsens postural responses to external perturbations
improve hypokinetic gait in the early stages of PD but less effective at improving gait as the disease progresses.
Generally improves freezing of gait in the “OFF” state but not during the “ON” state.

Question 20

MS edu

Answer 20

heat intolerace
fatigue
therapy timing
eventual use of AD

Question 21

therapy scheduling MS

Answer 21

schedule therapy sessions during optimal times for function*, minimize fatigue, establish schedule of rest and moderate exercise, avoid stressors and overheating
*Exception: Patients with mild disability may benefit from examination when fatigued

Question 22

HD interventions

Answer 22

HD
- strengthening
- gait
- balance - static, dynamic
- EOM
- fall strategies
- coordination

Question 23

SCI interventions

Answer 23

SCI
- upright tolerance/standing — pt edu on OH, autonomic dysreflexia
- balance dynamic and static — skin integ
- WC mobility/endurance
- UE strength stretch — core available below T7
- LE strength stretch
- gait - lokomat
- bed mobility/transfers
- breathing - C7 should be I with cough and breathing

Question 24

GBS interventions

Answer 24

GBS watch out for fatigue
- LE strengthening
- gait
- balance
- breathing
- transfers/bed mob/WC training
- desensitization
- EOM intervention
- endurance

Question 25

PD interventions

Answer 25

PD
- gait
- Turns
- balance
- midline disorientation
- aerobic
- UE strengthening
- LE strengthening
- Bed mob, transfers
- stretching
- Gait/ dual task

Question 26

CMT interventions

Answer 26

CMT
- LE strength — DF and everters
- UE hand
- stretching
- balance
- gait
- aerobic — aqua
- desensitization
think of foam change of surfaces

Question 27

MS interventions

Answer 27

MS
- motor dysfunction = incoordination, spasticity, weakness
- EOM - optic neuritis, big H/visual tracking
- brainstem - vertigo, dysphasia, dysarthria
- chronic nuero pain — desensitization
- aerobic - 20-30 min 5x wk
- cognitive as dual task
- UE/LE strengthening
- CORE
- Balance static and dynamic

think with FOAM change of surfaces

Question 28

CMT strength and aerobic recommendations

Answer 28

60-80 moderate
aquatic therapy be weary of fatigue

Question 29

GBS strength and aerobic recommendations

Answer 29

40-60 early on
60-80 later on 3x/wk

Question 30

aerobic vigorous, strength, cardiometabolic health SCI

Answer 30

Cardiorespiratory fitness and muscle strength
20 minutes moderate to vigorous intensity aerobic exercise 2x/week
3 sets of strength exercises 2x/week for each major functioning muscle group
Moderate to vigorous intensity

Cardiometabolic health
30 minutes 3x/week of moderate to vigorous intensity aerobic exercise

Question 31

0-3.5 EDDS

Answer 31

normal to mild

Question 32

4-5.5 EDDS

Answer 32

mild to moderate

Question 33

6-7.5 EDDS

Answer 33

moderate to severe

Question 34

8-9.5

Answer 34

severe disability w/ restriction to bed or WC