Rehab FOR Flashcards by michell wishek

What are the assumptions of rehab FOR

pt. can regain independence using compensation when underlying deficits can’t be restored
motivation for independence can’t be separated from volitional and habitual systems
motivation for independence can’t be separated form environmental context
a minimal level of cognition and emotional skills is required to make independence possible
Clinical reasoning should take a top-down approach

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What are areas of function for the rehab FOR

ADL’s/self-care
Work
Leisure

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What is the eval for this FOR similar to

OTPF

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What other assessments can you utilize in the Rehab FOR

Home assessment
w/c assessment
leisure assessment
work assessment

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What Do you always do in the rehab FOR for interventions

identify the underlying performance skills that the pt. is unable to complete

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What are the 7 intervention areas

Adaptive devices
UE orthotics 
Environmental modifications
W/C modifications
Ambulatory devices
adapted procedures
safety education

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What is the rationale behind using adaptive devices

Compensation for lose of ROM/strength

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What do you do to determine pt.’s need and device

observe pt.’s performance

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What are advantages of using adaptive devices

increase independence
therapy/task success
decrease safety concerns
easy to use/understand

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What are disadvantages of using adaptive devices

can be used too soon
still need to have cognitive & perceptual skills to use
need to have device at all times to be successful
stigma
many don’t use after discharge

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What are examples of adapted devices

reacher
long handle sponge
sock aide
cane
built up handles
shoe horn

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What is the rationale for using UE orthotics

compensation for weak muscles

*may see partnered w/ adapted devices

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What are UE orthotics

items to support or correct something

may use to mobilize, immobilize, prevent, or correct deformity, postural problems

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What is the OT role in the team

may create

may train pt.

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What are the two different kinds of orthotics

distal

proximal

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What is an example of a distal orthotic

universal cuff

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What is an example of a proximal orthotic

brace
splint
mobile arm support

What are advantage of using UE orthotics

can eliminate gravity

allow for functional movt.

What are disadvantages of UE orthotics

limited motion/movt.
skin breakdown
adds bulk
more expensive 
need help putting it on and off
stigma
not attractive
most not meant to use heavy objects

What is the rationale for using environmental modifications

promote independence by providing access, safety, and energy conservation, work simplification, and joint protection

What are advantages to environmental modifications

be in home longer 
stay at job
typically not items involved
increases accessibility and safety
may allow you to do something you couldn't do

what are the disadvantages of using environmental modifications

can be really expensive
can be dangerous for others
must consider other individuals
aren't always generalizable to all settings
may require a lot of space
have to get other people on board

What are the 3 factors that must be present when considering w/c modifications

must facilitate transfers, allow for proper positioning, and address architectural barriers that are present
be cautious of their cognitive skills (can hey propel, can they use power)
Transportation of objects while in w/c (what do they need w/ them, can they manage them)

What are advantages of using w/c modifications

increase mobility, independence in mobility
may increase comfort, proper position, strength
possibly decrease stigma

Disadvantages of using w/c modifications

``` stigma self-conscious hard to transport, bulky not all accessible places skin breakdown socially-lower when talking to people can be expensive ```

What is the rationale behind using ambulatory devices

to reduce weight bearing in LE provide wider BOS support unstable LE jts substituting for loss of a limb

what are examples of ambulatory devices

cane | walker

What are advantages of using ambulatory devices

increase safety more portable increase mobility still using muscles and proprioception as opposed to w/c

What are disadvantages of using ambulatory devices

``` takes motivation, willingness to use may not have enough cog. ability fatigue requires use of UE Slower mode of transportation ```

what is the rationale behind adapted procedures

substitute for lost motion provide stability use reflex inhibiting patterns to inhibit spasticity conserve energy and simplify work

Examples for substitutes for lost motion

``` hemi-dressing shoulder flexion to open prosthetic device hook arm on w/c for stability to learn tenodesis ```

How does adapted techniques provide stability

elbow hook for SCI | sliding body to maintain contact to provide stability

What are adapted procedures

accomplishing a task by changing, modifying, altering things

What are examples of conserving energy and simplifying work

``` rest breaks work simplification not working through pain prioritizing activities avoid/alternate stressful positions ```

What are advantages of using adapted procedures

not as noticeable can become auto w/ practice inexpensive/free promote independence

What are disadvantages of using adaptive procedures

frustration tasks may take longer may be unwilling/difficult to learn need to have cog. ability

What is an important part of discharge planning

safety education

Examples of why safety precautions my be diagnosis specific

body mechanics safe transfers precaution sensory loss

Advantages of safety education

prevent accident/injury | may be discharged to LRE

What are disadvantages of safety education

may not be followed need some cog ability requires change of habit requires them to be apart of it

What does the rehab for do

provide compensation when restoration is not appropriate

Rehabilitation refers to

return to ability