Quiz #1 Flashcards
What are the three classifications of adaptive equipment and provide examples of each?
→ Assistive Technology: any item used to increase, improve or maintain function
- Examples include pencil grips, benches to support feet in sitting positions, and simple devices that enhance basic functioning.
→ Alternative Technology: a substitute toward the same end function
- Includes powered toys, recording devices, and devices that substitute functions (e.g., an alternative communication board).
→ Augmentative Technology: supplements for an inadequate function but the function remains
- Examples include computers with voice recognition or voice output and powered wheelchairs, providing supplementary support to existing functions.
What roles does adaptive equipment play in patient care?
- reinforces therapy movements
- prevents undesirable movements
- decreases caregiver demands, aiding home management
What are the benefits of sitting and standing with adaptive equipment?
→ Sitting aids
- Optimal for UE function
- Enhances overall functioning by providing an adequate and secure base of support
- Inhibits abnormal tone, providing a stable base from which the upper extremities can function
- Improves perception of the environment
- Significant social benefits
→ Standing aids
- increase LE WB
- promote circulation
- bone mineral density
- respiratory endurance
- GI function
- integumentary health
- improve/maintain LE ROM
- modulate spasticity
- increase UE function
- vertical reach
- social interaction
What principles are essential for proper seating and positioning?
- feet support
- 90-degree hip flexion
- 95-110-degree backrest angle
- armrest height (positioned to bear approximately 50% of the weight of the patient)
What are some examples of equipment for different sitting and standing needs?
→ Sitting Equipment
- Hands-free sitter: stable base for functional activities
- Hands-dependent sitter: Seating to stabilize trunk and pelvis to be able to use UE for function.
- Propped sitter: total body support
→ Standing Equipment
- Static: position in prone or supine, only one position, dependent lift into device
- Multi-positional: option for supine, prone or upright, larger in size, many options for position change with one piece of equipment
- Prone standers: Accommodate hands-free standing, Closer to horizontal: requires stabilization of shoulder girdle and WB through UE, less benefit of LE WB.
- Supine standers: Allows weight bearing through the trunk and lower extremities, Supine stander is angled toward a 90-degree upright position, No upper extremity weight bearing, Could see abnormal reflexes in a semi-reclined position.
- Sit to stand devices: Adjust between sitting and standing, transfer into from sitting, can transition to stand easier or indep.
When is a power wheelchair recommended over a manual wheelchair?
- for severe trunk/UE weakness
- respiratory compromise
- endurance issues, or transporting medical devices
How do gait trainers, posterior walkers, and standard walkers differ in mobility support?
- Gait trainers offer wheeled assistance
- Posterior walkers provide pelvic/hip stability
- Standard walkers offer minimal support.
How is adaptive equipment selected based on patient needs?
Based on patient strength, mobility goals, environment, and functional requirements, following therapist assessments.
What is spina bifida, and what are its classifications?
- Spina bifida is a neural tube defect.
- Types: Myelomeningocele, Meningocele, Spina Bifida Occulta, among others.
What factors contribute to the risk of spina bifida?
Genetics, environmental factors, low maternal folic acid, maternal hyperthermia, and certain medications increase risk.
What is hydrocephalus, and how is it treated?
An abnormal CSF accumulation treated by VP/VA shunts or surgery (Chiari malformation management).
What are key elements of physical therapy for neonates with spina bifida?
- MMT
- ROM
- side-lying/prone positioning
- focusing on lesion-level motor assessment
What is the role of sensory assessment and parent education for infants with spina bifida?
Assessing touch, pressure, temperature, and educating parents on sensitivity precautions is vital.
What are common PT goals and contracture management strategies for spina bifida?
Goals: prevent deformities, improve ROM; manage contractures with PROM exercises and daily stretching.
What orthotics are used for different paralysis levels?
- Thoracic: HKAFOs
- Lumbar: KAFOs
- Sacral: AFOs or SMOs, based on mobility level
What gait characteristics and mobility recommendations apply to lumbar and sacral paralysis?
- Lumbar: hyperlordotic spine, crutches
- Sacral: crouch gait, SMOs; focus on maintaining function.
What are tethered cord and hydromelia, and their impact on patients?
Tethered cord anchors the spinal cord, hydromelia causes nerve necrosis; both limit mobility.
What orthotics and mobility aids are needed based on specific paralysis levels?
HKAFOs, RGOs, rolling walkers, and forearm crutches are common aids for varying paralysis levels.
What health concerns are specific to young adults with spina bifida?
Obesity, urinary infections, chronic decubitus, joint pain, hypertension, neurologic and social issues are common.
What physical deformities are common in spina bifida patients?
Clubfoot, flatfoot, and pes cavus (high arch) are frequent deformities requiring attention.
What are the common causes of pediatric burns?
- thermal (fire, hot liquids)
- chemical
- electrical
- mechanical (road rash)
- cold (frostbite) are causes
What are the classifications of burns and their characteristics?
- 1st degree: epidermis
- 2nd degree: partial dermis
- 3rd degree: full dermis and subcutaneous layers
What is included in PT management for burn patients?
ROM exercises, splinting, and positioning to prevent contractures are essential components.
How do burn locations affect deformity risks and positioning needs?
- anterior burns risk flexion contractures
- posterior burns risk hyperextension
- positioning helps prevent deformities
What are characteristics and treatments for hypertrophic scars?
Red, raised, non-pliable; treatments include pressure garments, scar massage, and silicone applications.
What scar treatment and sun protection measures are important?
Pressure garments, massage, and UV protection help prevent scar worsening and encourage healing.
What surgical options are available for severe scarring?
Options include Z-plasty and laser treatments to improve mobility and appearance of scars.
What are essential education points for families on scar care?
Teach about pressure garment use, skin inspection, and gentle care to avoid complications.
Why are pressure garments essential, and how should they be maintained?
Pressure garments prevent contractures, require 24-hour wear, and should be kept clean and properly fitted.
For optimal seating posture, how should the hips be positioned?
- A) At a 45-degree flexion
- B) At a 90-degree or more flexion
- C) Extended at 180 degrees
- D) Slightly hyperextended
- A) At a 45-degree flexion – This position would not provide adequate stability or posture for sitting.
- B) At a 90-degree or more flexion – Correct! Hips should be flexed to at least 90 degrees, as this promotes a stable seated position and can help reduce extensor posturing.
- C) Extended at 180 degrees – Full extension is unsuitable for sitting posture and would not support functional sitting.
- D) Slightly hyperextended – Hyperextension does not provide a stable base and could lead to poor posture.
What type of walker is most suitable for children with minimal support needs?
- A) Gait trainer
- B) Posterior walker
- C) Standard walker
- D) Rolling walker
- A) Gait trainer – Gait trainers provide significant support and options for partial weight-bearing and are often used in early ambulatory training.
- B) Posterior walker – While these offer support, they are typically used when the child needs postural control and stability beyond minimal assistance.
- C) Standard walker – Correct! Standard walkers are most suitable for children with minimal support needs, providing basic assistance while allowing greater independence.
- D) Rolling walker – Although similar to a standard walker, rolling walkers generally offer more support for users who may need assistance with balance but not full body weight-bearing.
What condition is associated with the downward herniation of the cerebellum through the foramen magnum, commonly seen in spina bifida patients?
- A) Hydrocephalus
- B) Tethered cord syndrome
- C) Arnold Chiari Malformation
- D) Lipomeningocele
- A) Hydrocephalus – This involves the accumulation of cerebrospinal fluid within the ventricles, which can be associated with spina bifida but does not describe cerebellar herniation.
- B) Tethered cord syndrome – This is a condition where the spinal cord is abnormally attached, often at the site of a previous lesion, restricting its movement.
- C) Arnold Chiari Malformation – Correct! This malformation involves the downward herniation of the cerebellum through the foramen magnum, frequently leading to complications like hydrocephalus in patients with spina bifida.
- D) Lipomeningocele – This refers to a fatty mass in the lumbar or sacral region that may cause neurological issues but is not related to cerebellar herniation.
Which orthotic is most commonly used for children with low lumbar paralysis (L4-L5) to support ambulation?
- A) Reciprocating gait orthosis (RGO)
- B) Hip-knee-ankle-foot orthosis (HKAFO)
- C) Knee-ankle-foot orthosis (KAFO)
- D) Supramalleolar orthosis (SMO)
- A) Reciprocating gait orthosis (RGO) – RGOs are often used for children with higher levels of paralysis (thoracic and high lumbar) requiring significant support for ambulation.
- B) Hip-knee-ankle-foot orthosis (HKAFO) – HKAFOs are typically used for children with thoracic or high lumbar paralysis where additional support is necessary for hip stability.
- C) Knee-ankle-foot orthosis (KAFO) – Correct! KAFOs provide support for the knee and ankle and are suitable for children with low lumbar (L4-L5) paralysis who have stronger hip muscles but need knee and ankle support.
- D) Supramalleolar orthosis (SMO) – SMOs offer minimal support at the ankle and are more appropriate for children with less severe motor impairments.
