Principles Of Practice And Clinical Reasoning

Question 1

Apply the ICF framework and person-centres practice to rehab of stroke patients

Answer 1

Activity limitations (tasks) provide good short term goals
Participation restrictions (societal level) provide good long term goals
Body function and structure impairments (primary +ive -ive, secondary adaptive)

Environmental and personal factors

Question 2

Describe the principles guiding physiotherapy practice for adults with damage to the nervous system

Answer 2

• Applies knowledge and scientific evidence from a number of different areas
• Evidence based
• Delivered within the ICF framework
• Delivered across the continuum of care
• Is person centred
• Ongoing use of clinical reasoning with measured outcomes
• Task orientated
• Fosters active participation and self Mx
• Variety of models of delivery to maximize intensity of practice
• Conducted in an optimal training environment

Question 3

Describe the features of an enriched rehabilitation environment

Answer 3

INCREASE PHYSICAL, COGNITIVE AND SOCIAL ACTIVITIES
Therapist behavior -safety, visual cues
Encourage active participation - patient centred goals
Provide KP and KR
Encourage families to be involved
Use group/individual/workstation

Question 4

Discuss the critical factors that enable stroke survivors to be active participants in rehab and increase their intensity of practice

Answer 4

400 reps for 10 days = increased cortical representation
Set up to complete practice
Exercises are suited to their skill level

Question 5

Describe a clinical reasoning model

Answer 5

Initial Ax
Create a problem list
Set goals with patient
Rx planning and implementation
Measure outcomes

Create goals->

Question 6

Describe the components of a subjective and objective Ax of stroke survivors

Answer 6

Subjective - CHx, PMHx, SHx, accommodation, previous mobility, goals, main problems, hobbies, hand dominance

Objective - tactile sensation, proprioception, strength, spasticity, eye mvmt, visual fields

Question 7

When should you increase/decrease difficulty of exercise?

Answer 7

> 300 reps in one hour too easy