Rehabilitation in neurology Flashcards
Who needs rehabilitation
Those with
-Impairment
-Disability (activity limitation)
or
-Handicap (Participation restriction)
What is the definition of handicap
Problems individual may have in involvement in life situations
what is the definition of impairment
Problems in body function or structure such as a significant deviation or loss
What is the definition of disability
Difficulties an individual may have in executing activities
Define rehabilitation
The restoration of patients to their fullest physical, mental and social capability
What is the conceptual definition of rehabilitation
A process of active change by which a person who has become disabled acquires the knowledge and skills needed for optimal physical, psychological and social function
What is the service definition of rehabilitation
The use of all means to minimise the impact of disabling conditions and to assist people with activity limitation to achieve their desired level of autonomy and participation in society
What is the definition of rehabilitation medicine
The specialty of Medicine involved with the prevention and reduction of activity limitation and participation arising from impairments, and the management of disability from a physical, psychosocial and vocational point of view.
What is the definition of long term neurological condition
Disease of, injury or damage to the nervous system which will affect the individual and their family in one way or another for the rest of their life
What are sudden onset if long tern neurological conditions
Acquired brain injury
spinal cord injury
stroke
What are intermittent/ unpredictable long term neurological conditions
Epilepsy
Early multiple sclerosis
What are progressive long term neurological conditions
Motor Neurone Disease
Parkinson’s disease
Later stages of Multiple Sclerosis
What are stable long term neurological conditions
Post-polio syndrome
Cerebral palsy in adults
Spina bifida in adolescence/adults
{Changing needs due to development or ageing}
What are other long term neurological conditions
Guillain Barre Syndrome
Muscle diseases (e.g. myotonic dystrophy)
Hereditary spastic paraparesis
Huntington’s disease
What are physical problems experience from long term neurological conditions
Weakness (hemiparesis/paraparesis)
Loss of / abnormal sensation
Increased or decreased tone / spasticity
Visual disturbance, e.g. homonymous hemianopia
Loss of hearing
Loss of smell and taste
Swallowing and communication difficulties
Bladder and bowel difficulties
Pain Syndrome
Seizures / Epilepsy
What are cognitive problems after brain injury
Post-traumatic amnesia
Confusion / disorientation
Severe memory problems (especially with recent events / working memory)
Poor concentration/ attention
Slowed thinking
Poor “executive functioning”
What is psychiatric / behavioural problems after brain injury
Depression
Anxiety
Personality change
Irritability
“Childishness, selfishness, laziness”
Behavioural problems, including aggression disinhibition, apathy
What is assessed in rehabilitation
History and Examination
Mobility
Activities of Daily living
Mood and Cognition
Bladder and bowels
Communication and swallow
Skin, Vision and hearing
What is the process of rehabilitation
Problem lists
Set Goals (SMART)
Identify barrier issues
Formulate management
plan
Draw upon all relevant disciplines
Involve patient (family/carers)
When is rehabilitation most effect
When delivered by a coordinated multidisciplinary team
What is spasticity
Motor disorder characterised by a velocity dependent increase in tonic stretch reflexes with exaggerated tendon jerks
What is the pathology of spasticity
Disordered sensorimotor control due to an upper motor neurone syndrome (UMN) lesion, presenting as intermittent or sustained involuntary activation of muscles
eg stroke, spinal cord injury, traumatic brain injury
What is the complications of spasticity
Poor seating and lying positions
Sleep difficulties and fatigue
Dressing and hygiene issues
Pain, spasms and associated reactions
Communication and feeding problems
Pressure sores and contracture
Poor self-image and relationship issues
Define Contracture
a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints
