Rehab

Question 1

What is one way to characterise bladder dysfunction?

Answer 1

Upper motor neurone: Hyperactive
Lower motor neurone: underactive
Mixed

Question 2

What jobs can speech pathologists do?

Answer 2

• Assess and management speech/swallowing/cognition

Question 3

How do you circumvent a receptive aphasia?

Answer 3

• Provide multiple means of conveying information to a patient
  eg written material

Question 4

Who can assess a patient’s cognition?

Answer 4

Physician
Neuropsych
Speech therapist
OTs

Question 5

Which anti-depressant is used for stroke patient?

Answer 5

Fluoxetine

Question 6

Which allied health can help with depression?

Answer 6

Psychology

Social work

Question 7

What are the 3 steps of swallowing?

Answer 7

Cephalic
Glottis opening
Peristalsis

Question 8

How do speech assess swallowing

Answer 8

Hx including cognition
Dry swallow
Fluids - thick and thin
Videofluoroscopy

Question 9

How do you assess bowel and bladder?

Answer 9

Bowel - stool chart

Bladder - post voiding residual volume

Question 10

What must you do prior to trial of void?

Answer 10

Check for regular bowel actions

Question 11

What is the role of physio?

Answer 11

Assess balance
- Static and dynamic, sitting and standing

Assess ambulation

• transferring and mobility
• falls risk
• Need for walking aids

Question 12

What is the role of OT?

Answer 12

• Functional assessment of cognitive
• Functional capacity for pADLs, dADLs, cADLs
• Assess the home and work environment
  
  • Falls
  • Access
  • Showering
• Driving

Question 13

What is the role of social work?

Answer 13

• Link with accommodation
• Assess funding/finances/pension
• Driving

Question 14

What do you need to assess for driving? Who does it?

Answer 14

• Physical
  
  • Hearing
  • Limbs
• Cognition
• Medical, OT, and Neuropsych

Question 15

What is the OT driving test consist of?

Answer 15

Off the road written test

On the road driving

Question 16

What are the possible outcomes of OT driving assessment?

Answer 16

• Cannot drive
• Drive with conditions only eg no night driving
• Free to drive

Question 17

How do you assess return to work?

Answer 17

What type of work - tasks at work

OT assessment at work

Question 18

What is post stroke shoulder hemiplegic pain? How is it managed?

Answer 18

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

Question 19

What are the smart goals for hip replacement?

Answer 19

Specific
Measurable
Achievable
Relevant
Time-limited
Pain not limiting function/disturbing sleep

Question 20

What are the medical goals of mx for rehab?

Answer 20

• Optimise health status
  
  • Treat disability
  • Prevent complications
  • Compensate for disability
  • Educate
  • Re-integrate in society
    
    • Follow-up

Question 21

What are the criteria for suitability for rehab?

Answer 21

“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

Question 22

What are the basic goals of stroke rehab?

Answer 22

“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

Question 23

What are the general goals of all rehab?

Answer 23

“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