Rehab Flashcards
What is one way to characterise bladder dysfunction?
Upper motor neurone: Hyperactive
Lower motor neurone: underactive
Mixed
What jobs can speech pathologists do?
- Assess and management speech/swallowing/cognition
How do you circumvent a receptive aphasia?
- Provide multiple means of conveying information to a patient
eg written material
Who can assess a patient’s cognition?
Physician
Neuropsych
Speech therapist
OTs
Which anti-depressant is used for stroke patient?
Fluoxetine
Which allied health can help with depression?
Psychology
Social work
What are the 3 steps of swallowing?
Cephalic
Glottis opening
Peristalsis
How do speech assess swallowing
Hx including cognition
Dry swallow
Fluids - thick and thin
Videofluoroscopy
How do you assess bowel and bladder?
Bowel - stool chart
Bladder - post voiding residual volume
What must you do prior to trial of void?
Check for regular bowel actions
What is the role of physio?
Assess balance
- Static and dynamic, sitting and standing
Assess ambulation
- transferring and mobility
- falls risk
- Need for walking aids
What is the role of OT?
- Functional assessment of cognitive
- Functional capacity for pADLs, dADLs, cADLs
- Assess the home and work environment
- Falls
- Access
- Showering
- Driving
What is the role of social work?
- Link with accommodation
- Assess funding/finances/pension
- Driving
What do you need to assess for driving? Who does it?
- Physical
- Hearing
- Limbs
- Cognition
- Medical, OT, and Neuropsych
What is the OT driving test consist of?
Off the road written test
On the road driving
What are the possible outcomes of OT driving assessment?
- Cannot drive
- Drive with conditions only eg no night driving
- Free to drive
How do you assess return to work?
What type of work - tasks at work
OT assessment at work
What is post stroke shoulder hemiplegic pain? How is it managed?
Loss of peripheral tone puts stress on shoulder and causes pain
- Support the limb
- Avoid weight bearing on the limb
- Meds: amitriptyline > pregabalin > gabapentin > carbamazepine > duloxetine
What are the smart goals for hip replacement?
Specific Measurable Achievable Relevant Time-limited Pain not limiting function/disturbing sleep
What are the medical goals of mx for rehab?
- Optimise health status
- Treat disability
- Prevent complications
- Compensate for disability
- Educate
- Re-integrate in society
- Follow-up
What are the criteria for suitability for rehab?
“SHMEG”
S: Stable - medically, psychiatrically, reasonable cognitive and can tolerate 3 hours per day
H: Home/family to go home to
M: Motivated
E: Expectation of rapid increase in function
G: Goals
What are the basic goals of stroke rehab?
“PICHE” tribe
P: Prevent Complications
I: Independent in personal care and mobility
C: Assess communication, cognitive function, and behavioural difficulties
H: Home assessment and services
E: Educate, supportive counselling
What are the general goals of all rehab?
“GRIPDOT”
G: Goals R: Review arranged I: Interdisciplinary input P: Prevent complications D: D/C planning at admission O: Objective outcomes T: Trial cause of admission
