Rehabilitation

Question 1

5 specific rehab interventions for upper extremity motor and sensory stroke

Answer 1

1. Range of motion exercises
2. Mental imagery
3. Functional electrical stimulation
4. Constraint induced movement therapy
5. Mirror therapy

Question 2

Define prehabilitation

Answer 2

Optimizing functional capacity before surgery to improve tolerance to physiologic stress
Includes pre op exercise, nutritional support and psych support

Question 3

What types of activities are associated with prehabilitation?

Answer 3

1. Exercise - strength, balance, proprioception
2. Nutrition
3. Inspiratory muscle training
4. Assess cognition and mental health
5. CGA
6. Pre op education
7. Acupuncture
8. Neuromuscular electrical stimulation

Question 4

4 positive post surgical outcomes from prehab

Answer 4

1. Post operative pain
2. Dec LOS
3. Overall physical function
4. Incidence of delirium

Question 5

Inclusion and exclusion criteria for rehab unit admission

Answer 5

Inclusion
1. Medically stable
2. Demonstrate ability to participate (stamina, follow 1 step command, attention and STM)
3. Consented and willing to participate
4. Goals established and are SMART

Exclusion
1. Medically unstable
2. Severe cognitive impairment
3. Inappropriate behaviours
4. Not willing to participate

Assessment shouldn’t be single point in time, should reflect fluctuations/overall impression

Question 6

Prehab orthopaedic surgery JAMA 2023

Answer 6

Improved:
Prior to surgery
1. Function
2. Health related QOL
3. Muscle strength
4. Back pain
Post surgery
1. Function

Question 7

Cochrane 2020 rehab for dementia patients post hip fracture surgery

Answer 7

Enhanced rehab may reduce rates of post op delirium
Geriatrician led management may shorten hospital stay