Pt Care

Question 1

Rolling sidelying to supine

Answer 1

• Control descent against gravity • Prevent LEs from “flopping” • Reposition to normal alignment • Can push with elbow against mat • Can push with LEs

Question 2

Rolling prone (Rare)

Answer 2

• Patient must have head control • Patient should have control of one arm • Start in sidelying • Will need to assist at upper chest. • Work on moving arms to a position of comfort

Question 3

Supine to sit (Austin technique if needed)

Answer 3

• Roll supine to sidelying (as above) • Flex hips and knees • Bring feet of the edge of mat and lower legs • Patient lifts trunk up using UEs as able. • Key points of control: lateral upper trunk/scapula, pelvis/LEs • Stay in contact after sitting

Question 4

Supine to sit at the edge of bed (after total hip replacement)

Answer 4

• In supine, bring patient up onto elbows, then hands. • Patient will be in a partial long sit, pivot moving legs towards EOB • Assist as needed with LEs and trunk support. - 2 person: one at LEs and one at trunk

Question 5

Scooting left and right

Answer 5

• Limit friction and shearing forces • Move segmentally (if not using a sheet) • Position yourself with a staggered stance • Create shift using your legs. • Move segmentally • Hook-lying to bridge If dependent: • Use a draw sheet • Use a 2nd person

Question 6

Scooting up and down in bed

Answer 6

• Limit friction and shearing forces • Don’t move patient outside your BOS • Use multiple small shifts Training: • Hook-lying position Dependent: • Use a draw sheet • Use a 2nd person • Position head of bed

Question 7

Supine to sit at edge of bed Log roll technique

Answer 7

• In side-lying, flex up hips and knees • Limit time with Les dangling off in side lying • Key points of control: Lateral upper trunk Pelvis/LEs • Stay in contact after sitting Training: • On elbow as mid-point • Can do part task training Dependent: • Support head as needed

Question 8

Edge of bed to supine

Answer 8

• Key points of control: Lateral upper trunk LEs • Control descent Dependent:• May do trunk first then LEs • If using 2nd person, one does trunk and other does LEs

Question 9

Crutch fitting sequence

Answer 9

 1. Introduction of therapist  2. Application of gait belt  3. Adjust crutches to estimated length, ATNR method  4. Instruct pt in proper tech of sit←→stand with axillary crutches*!!!!!!!!  5. Hands on pt during sit←→stand  6. Ensure pt is stable  7. Fine tune fit of length and grip  8. Pt sit while adjusting fit*!!!!!!!!!

Question 10

Stair training

Answer 10

 1. Instruction of proper tech-remember demonstration is a valuable form of teaching  2. Assist pt in sit←→stand  3. Hands on pt during gait to stairs  4. Therapist placement*  Below pt  5.Hands on pt-may have one hand on rail prn  6. Staggered foot placement through out task  Work as a team*  7. Therapist moves only when pt is NOT moving-this includes pts AD  8. Slow pt down prn to ensure safe tech  9. Hands on pt at top of stairs* turn around and do it again.

Question 11

UE D2 Flexion

Answer 11

Question 12

UE D2 Extension

Answer 12

Question 13

UE D1 Extension

Answer 13

Question 14

UE D1 Flexion

Answer 14

Question 15

LE D1 Extension

Answer 15

Question 16

LE D1 Flexion

Answer 16

Question 17

LE D2 Extension

Answer 17

Question 19

LE D2 Flexion

Answer 19

Question 20

Hold-relax (antagonist contraction

Answer 20

requires patient to perform an isometric contraction of the muscle that is to be elongated just before it is passively lengthened. Start with muscle in comfortably lengthened position, then perform isometric submaximal contraction for 5-10 sec, release and move muscle into new ROM. (autogenic inhibition)

Question 21

Agonist contraction (contract-relax)

Answer 21

requires patient to perform concentric contraction of muscle/s on opposite side of joint with shortened or tight muscle. Start in comfortable position and then contract agonist (the muscle opposite tight muscle) against tactile guidance. (reciprocal inhibition)

Question 22

Hold-relax with agonist contraction (hold-relax with opposing muscle contraction)

Answer 22

Combination of (a) and (b). Perform as in hold-relax, except that once the isometric contraction is completed, the patient concentrically contracts muscle opposite to tight muscle (agonist) into the new ROM (Clinician may support segment, but is not moving the segment/joint into the newly achieved ROM.)