Test 1: Neuro Screen and Models Flashcards
3 components of EBP
best available evidence
clinical expertise
patient values
what is at the “top of the hierarchy” of evidence
CPGs
what are CPGs
sysetmatically developed statesments that guide clinicians in using the best available clinical evidence
bridge gap between recommendation and evidence
importance of a conceptual framework for clinicians
clinicians faced with lots of decisions
act as tool for organization/decision making
what are the components of the Schenkman model for patient centered care affect the patient
Exam
Systems Review
Interview history
Diagnosis/prognosis
POC interventions
Outcome
What does HOAC stand for
Hypothesis oriented algorithm for clinicians
in every step of the model, clinician poses a hypothesis and then proceeds to collect info to support or refute that hypothesis
hypotheses in the clinic help determine the relationship between
functional limitations and the underlying impairment
in order to clarify the causes of functional movement problems, this requires the clinician to
1- generate alternative hypothesis about potential cause
2- determine crucial tests and expected outcomes that would rule out 1 or more hypothesis
3- carry out tests ‘
4- continue process of gathering and testing and refining ones understandign
where to start when forming a hypothesis
chart review and pt interview
determine health status/ health conditions
what is a systems review important for
step 2 after interview
quick scan
determine what areas are intact and which are dysfunctional
confirm need for futher test
motor control is governed by what 3 overall factors
task
environment
individual
individual generates movement to meet the demands of the task being performed within a specific environment
what do you observe for initial conditions in the movement continuum
posture
ability to interact with environment
environmental context
what do you observe for preparation in the movement continuum
identification of stimulus
response selection
response programming
what do you observe for iinitiation in the movement continuum
timing
direction
smoothness
what do you observe for execution in the movement continuum
amplitude
direction
speed
smoothness
what do you observe for termination in the movement continuum
timing
stability
accuracy
difference between PT diagnosis and MD diagnosis
PT typically includes level of impairment, activity limitation, and participation restrictions
MD diagnosis refers to identification of a disease, disorder, or condition primarily at the cellular, tissue, or organ level
what is a prognosis
predicted optimal level of improvement in function and amount of time needed to reach that level
Current level of function vs predicted level of function
rehab potential
describe the task, practice, and feedback for the cognitive stage of learning
task = closed, stable, discrete
practice = massed, low variability
feedback = constant extrinsic cues and immediate feedback, KP and KR
describe the task, practice, and feedback for the associative stage of learning
task = stable vs unstable, closed vs open, introduce whole
practice = massed vs distributed, high variability
feedback = fading/variable cues, KP and KR, and delayed feedback
describe the task, practice, and feedback for the autonomous stage of learning
task = unstable, open, whole
practice = should not matter, high variability
feedback = summative for KR and bandwidth only for safety
how might a short and long term goal timeline look in inpatient rehab
average hospital stay is 14 days
LTG = at discharge; can go up to 1 month
STG = i.e. for next session; can go up to ~ 2 weeks
ABCDE of goals
actor (patient)
behavior (task/movement)
condition (environment activity is preformed)
degree (specific conditions)
expected time (time frame for goals)
what are you screening for in a neuro screen
sensation
muscle tone/strength
functional movement/coordination
coordination (i.e. finger to nose)
DTRs/clonus
UMN S&S
why perform neuro screen
red flags
decide referral
form differential dx
establish baseline
observe for changes
components of a neuro review
1-cognitive status
2- CN screen
3- AROM
4- resistance to PROM (tone)
5- sensation
6- perception
7- Gross muscle testing
8- coordination screening
9- DTRs
10- static/dynamic balance
11- gait screen
