SCI treatment pt 4

Question 1

two main uses of FES

Answer 1

independent application
FES dependent application

Question 2

independent application of FES

Answer 2

use of it for a finite time period to minimize impairments & to encourage motor relearning - will be weaned off

Question 3

example of independent application of FES

Answer 3

bioness
FES over anterior tib to improve foot drop

Question 4

FES dependent application

Answer 4

allows pt to perform activities that otherwise would not be able to do

“neuroprosthesis”

Question 5

example of FES dependent application

Answer 5

FES on LE muscles of pt with paraplegia while peddling on leg ergometer

Question 6

indications for FES

Answer 6

UMN injury
absent/diminished motor fxn
demonstration of active contraction when e-stim is provided
pt able to tolerate stim

Question 7

FES contraindications

Answer 7

LMN injury
pacemaker
prego
unhealed fx
skin breakdown
internal stimulator near area
DVT
malignancy
uncontrolled autonomic dysreflexia

Question 8

precautions FES

Answer 8

absent sensory
severe spasticity
heterotopic ossificans
severe osteoporosis
chronic pain syndrome

Question 9

bioness L300 indications

Answer 9

foot drop
poor foot clearance

Question 10

bioness L300+ indications

Answer 10

knee instability
poor foot clearance

Question 11

RT300 FES bike indications

Answer 11

relax muscle spasms
prevention or reduction of disuse atrophy
increasing local blood circulation
maintaining or increasing ROM
improve muscle endurance with intact innervation

Question 12

considerations for RT300 FES bike

Answer 12

risk of raising unrealistic expectations
difficult to predict outcome
insufficient evidence for duration and dosage

Question 13

robotic assisted treadmill benefits for a complete injury

Answer 13

upright benefits
physiological and social benefits

Question 14

robotic assisted treadmill benefits for a incomplete injury

Answer 14

individually adjustable gait pattern and guidance
real-time biofeedback
neuroplasticity, CPGs

Question 15

robotic assisted treadmill considerations

Answer 15

realistic expectations/goals
hemodynamic stability
skin integrity
autonomic dysreflexia

Question 16

contraindications for lokomat training

Answer 16

fixed LE contractures
reduced bone density
bone instability
significant cardiac disease
behavioral concerns
pregnancy
>300 lbs, >6ft 1 in

Question 17

what is the ReWalk

Answer 17

exoskeleton device
sit, stand, walk, turn and climb/descend stairs
independently operated

Question 18

prerequisits for reWalk trials

Answer 18

hands/shoulders can support crutches or a walker
healthy bone density
no unhealed fx
adequate standing tolerance
no cardiac, respiratory, autonomic comorbidities of concern
160cm-190cm (5’3”-6’2”)
cannot exceed 100kg (220lbs)

Question 19

indications for bodyweight suppport treadmill

Answer 19

incomplete B, C, D

Question 20

what will the bodyweight suppport treadmill do

Answer 20

promote spinal cord learning/activation of spinal locomotor pools

Question 21

dosage for bodyweight suppport treadmill

Answer 21

4day/wk
20-30mins
8-12 wks

Question 22

progression for bodyweight suppport treadmill

Answer 22

decrease BWS
increase speed
eliminate manual assist
over ground locomotor training

Question 23

what should ramps be

Answer 23

1 ft for every 1” in height

Question 24

doorframe width

Answer 24

width of WC +6”

Question 25

is it easier for WC pt to push or pull door

Answer 25

pull

Question 26

what does return to work look like

Answer 26

at 1 year - 12% employed
at 20 years - 33% employed