Rehabilitation medicine Flashcards
What is rehabilitation?
A set of interventions designed to optimise functioning and reduce disability in individuals with health conditions in interaction with their environment
What does rehabilitation serve to do in the contact of the international classification of functioning disability and health?
Address pathology
Alter impairments
Improve activity and functioning
Optimise participation
What are the benefits of rehabilitation medicine?
Increase independence in functional activities
Focus on reducing impact of disability and associated distress
Long term and holistic approach to resolving problems
How are rehabilitation services organised in the UK?
Three levels:
Level 3 - non specialist rehab services
Level 2 - specialist rehab services (district/supradistrict)
Level 1 - complex specialised rehab services
How are level 1 complex rehabilitation services organised?
Have a catchment population of 1 million+
1A - Hugh physical dependency
1b - mixed disability
1c - cognitive behavioural
What happens after acute care is the national model for neurorehabilitation pathways?
In patient rehabilitation
Supported discharge to home
OR Specialist impatient rehabilitation
What happens after supported discharge at home?
Community reintegration, including supported return to work and specialist community rehabilitation if needed
Long term integrated care planning:
Long term support
Single point of contact
Health and social service planning
Multi agency care
What is the inpatient rehabilitation pathway?
Referral
Triage
Assessment
Admission
-Initial meeting (MDT case conference)
- Midpoint meeting
-Additional meetings: best interest meetings
-Discharge planning
What are the most common ABI referrals?
Stroke and trauma 75%
How is post stroke depression defined in the DSM 5?
Prominent and persistent disorder due to direct physiological effects of stroke
May be neurophysiological or may be psychological
What areas of brain injury are more associated with depressive disorder?
Basal ganglia more than thalamus
MCA more than PC strokes
What pathology is post stroke psychosis associated with?
Right hemisphere lesions
Cortical lesions
Parietal tempo-occipital junction
Small vessel disease
What other neuropsychiatric presentations are associated with stroke?
Anosognosia
Catastrophic reaction
Apathy
Disturbance of prosody
Irritability, agitation and aggression
Pathological laughing and cryibf
