treatment

Question 1

how can we challenge balance?

Answer 1

take away senses
reduce the BOS
raise the centre of gravity
encourage automatic reactions
add reactive or proactive
add dual tasking

Question 2

what are the benefits of standing

Answer 2

increased weight bearing
psychological benefits
increased bone density
respiratory benefits
pressure relief
bladder/bowel sensation
visual stimulation
increased motor recruitment
cardiovascular benefits
strengthen lower limb and trunk

Question 3

what should you consider before standing a patient

Answer 3

environment
your positioning
patients weight
patients sitting balance
patients lower limb strength
patients engagement in physio
patients ability to follow instructions
equipment available
your ability and experience

Question 4

name some standing aids

Answer 4

tilt table
oswestry standing frame
standing hoists

Question 5

what do falling patients do

Answer 5

fall towards affected side due to weakness

Question 6

what do fixing patients do

Answer 6

patient leans towards their unaffected side

Question 7

what do pushing patients do?

Answer 7

patient pushes with unaffected side towards their affected side

Question 8

what are the benefits of FES for gait?

Answer 8

improves walking speed
walking requires less effort, less tiring
more normal gait pattern
reduced compensations
reduced spasticity
ability to walk longer distances
improved safety with reduced incidence of falls
improved confidence
increased independence with ADLs

Question 9

what are the uses for FES

Answer 9

strengthen and/or maintain muscle bulk
facilitating voluntary muscle contraction
gaining/maintaining ROM
increase sensory awareness
reduce spasticity
as an orthotic substitute to produce functional movements

Question 10

what are the clinical applications of FES

Answer 10

foot drop
hemiplegic shoulder pain
paraplegia

Question 11

what are the contraindications of FES

Answer 11

abnormal skin sensation
current or recent bleeding/haemorrhage
compromised circulation
application over the anterior aspect of the neck or carotid sinus
area of active tuberculosis
area of tumour or suspected malignancy
patients with pacemakers
skin allergies to electrodes, gel or tape

Question 12

why do we need a stable trunk

Answer 12

maintaining a vertical position
to provide a stable base to enable upper limbs to be moved
to provide a stable base to enable lower limbs to be moved
to provide a stable base to enable the head to be moved

Question 13

what are some considerations for sit to stand facilitation

Answer 13

side of weakness
balance
anxiety/fear of falling

Question 14

what are some considerations for CIMT

Answer 14

requires a lot of commitment from the patient
need wrist extension and finger extension

Question 15

how long are you recommended to do mirror therapy

Answer 15

10 minutes every day

Question 16

what are the three types of cueing

Answer 16

kinaesthetic (tapping, facilitation, rocking on sit to stand, dancing arms linked)
visual (line on the floor, markers to step over)
auditory (music, metronome, counting, verbal prompting)

Question 17

what are the aims of positioning

Answer 17

respiratory function
tonal management
joint positioning
patient comfort
communication
nutrition
balance
fatigue management
patient preference
cardiovascular function
prevention of contractures
pressure relief

Question 18

what are some contraindications to PROM

Answer 18

post injury (where area is inflamed)
early fractures
pain (beyond tolerance)
incomplete muscle or ligament tears where further damage may occur
hypermobile joints
where circulation may be damaged

Question 19

what are soft tissue mobs used for

Answer 19

reduce swelling
increase sensory input
provides elastic stretch to soft tissues
often used clinically prior to exercise and therapy

Question 20

what do you have to be aware of when splinting

Answer 20

skin integrity
patient comfort
patient compliance

Question 21

what are some contraindications for stretching

Answer 21

bony block
recent fracture
acute inflammatory process
acute pain
hypermobility
shortened soft tissue enable a patient with paralysis to perform specific functional skills otherwise not possible