Test 2 Flashcards
The rehabilitation FOR focuses on what 2 things?
Compensation, adaptation
Intervention approach is integrated with __________ and ____________
Theory, evidence
4 steps in the OT intervention plan
- Develop the plan
- Consider potential discharge needs
- Select outcome measures
- Make recommendations or referral to others as needed
Intervention approaches
Create/promote, establish/restore, maintain, modify, prevent
Types of OT interventions
Occupations and activities, preparatory methods and tasks, education and training, advocacy, group intervention
What may be observed during the intervention session, unknown if it will be replicated by client/family in number of contexts
Performance
The result of processes associated with practice or experience that leads to relatively permanent changes
Learning
Learning is inextricably linked to _____, specifically the encoding and retrieval of information
Memory
Best therapeutic use of context
Real-life contexts, varied contexts
Best use of feedback for retention?
summary feedback, faded feedback
Best client learning for practice?
Focus on tasks, random practice, whole tasks
4 stages of client change
Contemplation, determination, action, maintenance
4 stages of therapist behavior during the client stages of change
Verbal strategy, verbal strategy, action strategy, action strategy
How will you know if your client has successfully learned a new skill?
Transfer skill across contexts
The process of setting up, arranging, and bringing food or fluid to the mouth
Feeding
The ability to keep and manipulate food or fluid in the mouth and swallow it
Eating
Eating is often used interchangeably with what?:
Swallowing
5 phases of feeding and eating
Pre-oral phase, oral-preparatory phase, oral phase, pharyngeal phase, esophogeal phase
Necessary motor skills in feeding/eating
posture, mobility, coordination, strength, effort, energy
What process performance skills are necessary for feeding and eating?
Energy- paces, attends Knowledge- Uses, handles, chooses Temporal organization- initiates Organizing space and objects Adaptation
Contextual factors
Cultural, physical, social, personal, spiritual, temporal, virtual
Client factors/body function categories
Mental, sensory, neuromusculoskeletal, cardio-respiratory
Phase 1 of cardiac rehab
Inpatient cardiac rehab
Phase 2 of cardiac rehab
outpatient cardiac rehab
Phase 3 of cardiac rehab
Community based cardiac rehab
Goal of community-based cardiac rehab
Continue education and support within a community setting
Symptoms of activity/exercise intolerance
chest/arm pain, excessive fatigue, SOB, lightheaded/dizzy, nausea and vomiting, unusual weight gain
Core concept of CBT
Thinking and feeling influences behavior
Behavioral strategies for behavioral change
Activity scheduling, social skills, assertiveness, graded tasks, behavioral rehearsal, role modeling
Behavioral strategies for cognitive change
Behavioral experiments, role playing, role reversal, educational techniques
Cognitive and behavioral strategies
Coping skills training, assertiveness training, stress management skills, time management skills, anger management skills, conflict management, energy conservation, managing pain
Primarily cognitive strategies for building knowledge
Reading, films and visuals, educational modules, educational groups, worksheets/homework
Cognitive strategies for problem solving
Brainstorming, cost-benefit analysis, role playing, coaching, co-op
Cognitive strategies for changing thinking
Testing cognition, thought stopping, identifying distortions or thinking errors, mental imagery techniques, socratic questioning
complete and permanent loss of ability to send sensory and motor nerve impulses and, therefore, complete and usually permanent loss of function below the level of the injury
Complete SCI
partial damage to the spinal cord, some motor and sensory function may remain
Incomplete SCI
Inflammation and stiffness of the joints
Arthritis
Joint specific
“Wear-and-tear” arthritis
Degenerative joint disease
Affects weight-bearing joints (hands, knees, feet, hips, spine)
Osteoarthritis
Causes of OA
Hereditary
Lifestyle
Obesity
Overuse of joints
OA symptoms
Acute or insidious pain
Crepitus
Night pain
Process of destruction in OA
Breakdown of articular cartilage in joints
Synovial fluid enters the cracks, causing them to widen
Bone is left exposed/unprotected
New bone and cysts form, causing osteophytes
Systemic (autoimmune) Chronic Inflammatory Slow onset Any joint can be affected- knee is most common, followed by hand and hip
Rheumatoid Arthritis
1 episode ending within 2-5 years; not recurring (20% of cases) arthritis
Monocyclic
Fluctuating disease activity; can last many years (75% of cases) arthritis
Polycyclic
Rapid increase in severity; unremitting (5% of cases) arthritis
Progressive
RA symptoms
Pain and swelling, general inflammation
Early morning stiffness
Fatigue
Malaise
a general feeling of discomfort, illness, or uneasiness whose exact cause is difficult to identify
Malaise
RA causes
Hereditary
Hormonal
Environment
Lifestyle
RA process
Body attacks the joints causing inflammation, which causes the tissues that line the joints to thicken, resulting in swelling and pain in and around the joints.
Causes cartilage loss, lessening of joint space, instability of joints, loss of mobility.
Joint deformity can occur.
lubricates joints and helps them stay smooth
Synovium
Guillain-Barre Symptoms
Tingling sensation in fingers and toes; weakness in legs that spreads to the upper body; aching or cramp-like pain in muscles; difficulty with bowel and bladder control; unsteady gait; difficulty breathing; increased heart rate; overall muscle weakness/paralysis
Parkinson’s symptoms
Tremors or shaking in the hands; slowed body movements; unstable posture; muscle rigidity; changes in speech; trouble with balance; memory problems
ALS symptoms
Trouble walking (tripping, falling); lower extremity and hand weakness; slurred speech, muscle cramps/twitching; trouble holding head up
MS symptoms
Fatigue; numbness in arms, legs, face, and body; difficulty walking; muscle spasms; muscle weakness; blurry vision; dizziness; bowel/bladder incontinence; sexual dysfunction; changes in cognition
COPD precautions
Heavy lifting or pushing; chores such as shoveling, mowing, or raking; pushups, sit-ups, or isometric exercises, which involve pushing against immovable objects; outdoor exercises when the weather is very cold, hot, or humid; walking up steep hills; if you are short of breath during any activity or have increased fatigue, slow down your activity level or rest; keep your feet raised or elevated when resting.
Open heart surgery precautions
Protect breastbone after surgery; do not lift more than 5-8 pounds; do not push or pull with your arms; do not reach behind your back or reach both arms out to the side; do not reach both arms overhead
Causes complete and permanent loss of ability to send sensory and motor nerve impulses, complete and usually permanent loss of function below injury
Complete SCI
Partial damage to SC, some motor and sensory function remains
Incomplete injury
Tetraplegia replaces what term?
Quadraplegia
Results in functional impairment in the arms, legs, trunk, and pelvic organs
Tetraplegia
Motor and sensory impairment at the thoracic, lumbar, or sacral segments of the cord
Paraplegia
An area of the skin supplied by nerves from a single spinal root
Dermatome
Each of the muscle blocks along either side of the spine in vertebrates, gives rise to skeletal muscles
Myotome
Diagnoses by physician according to motor and sensory level
Neurological level
Refers to the level of greatest vertebral damage
skeletal level
Refers to lowest segment at which strength of 3+/5 on MMT and sensation is intact
Functional level
The most common form of cervical spinal cord injury. It is characterized by loss of motion and sensation in arms and hands. It usually results from trauma which causes damage to the neck, leading to major injury to the central grey matter of the spinal cord.
central cord syndrome
caused by damage to one half of the spinal cord, resulting in paralysis and loss of proprioception on the same (or ipsilateral) side
Brown-sequard syndrome
medical condition where the anterior spinal artery, the primary blood supply to the anterior portion of the spinal cord, is interrupted, causing ischemia or infarction of the spinal cord in the anterior two-thirds of the spinal cord
Anterior cord syndrome
symptoms that occur when the nerves in the conus medullaris malfunction. The malfunction is caused by a structure (e.g. hematoma, tumor, etc.) that places pressure on the conus medullaris. The conus medullaris is the end of the spinal cord, which is located in the lower back.
Conus Medullaris Syndrome
Symptoms include low back pain, numbness and/or tingling in the buttocks and lower extremities (sciatica), weakness in the legs, and incontinence of bladder and/or bowels.
Cuada equina syndrome
syndrome in which there is a sudden onset of excessively high blood pressure. It is more common in people with spinal cord injuries that involve the thoracic nerves of the spine or above (T6 or above).
Autonomic dysreflexia
occurs when a person’s blood pressure falls when suddenly standing up from a lying or sitting position.
Orthostatic hypotension
Occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs.
Deep vein thrombosis
Presence of bone in soft tissue where bone normally does not exist.
Heterotopic Ossification
Difficulty with swallowing at any stage or the inability to swallow
Dysphagia
Conditions that could result in dysphagia
CVA, TBI, brain tumor, anoxia, Guillian-Barre syndrome, huntington’s disease, alzheimer’s disease, MS, ALS, parkinson’s disease, myasthenia gravis, quadraplegia
Stages of swallowing
Preoral/anticipatory, oral preaparatory, oral, pharyngeal, esophogeal
Psychological, social, and environmental factors involved in eating
Preoral/anticipatory
Food is chewed by teeth and manipulated by lips, cheek, and tongue to form a bolus
Oral preparatory
Voluntary stage of swallowing requiring alertness
Oral stage
Involuntary stage of swallowing that begins when a bolus passes into the pharynx
Phrayngeal
Stage of swallowing that starts when the bolus enters the esophagus
Esophogeal
