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OCCU Neuro > UE Assessment and Management > Flashcards

UE Assessment and Management Flashcards

(44 cards)

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1
Q

what is assessment used to determine?

A
  1. What an individual wants and needs to do
  2. What the individual is currently able to do
  3. What supports and barriers influence occupational performance and participation
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2
Q

what is the purpose of assessing?

A
  1. Establish baseline
  2. Establish goals
  3. Inform intervention planning process
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3
Q

do functional UE impairments happen in one or both upper extremities?

A

both!

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4
Q

what can perceptual impairments interfere with?

A

UE function

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5
Q

what are examples of perceptual impairments?

A

Visual field deficits, neglect, visual extinction, agnosia

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6
Q

functionally, what do we see difficulties with when someone has perceptual impairments?

A
  • Locating target
  • Identifying target (agnosia)
  • Planning and executing reach and grasp (apraxia)
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7
Q

what are some OPC examples that are focused on motor control?

A

paresis
timing impairments
loss of individuation
excessive use of trunk

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8
Q

every plan for OT evaluation includes what?

A

he analysis of occupational performance. This includes:

  • Identification of strengths
  • Potential problems
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9
Q

what is activity analysis?

A

observation

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10
Q

what re methods of evaluation?

A
  1. activity analysis
  2. standardized vs non-standardized assessment tools
  3. interviews
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11
Q

what is a low level arm CMSA?

A

stages 1-2

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12
Q

what is a CMSA stage 1-2 arm movement and function?

A

incompletely selective movements (small amplitude, non-functional)

primarily used for stabilization tasks

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13
Q

what is an intermediate level arm CMSA?

A

stagers 3-5

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14
Q

what is a CMSA stage 3-5 arm movement and function?

A

biomechanical and muscle imbalances with incompletely selective movements

transitioning from stabilization to manipulation tasks

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15
Q

what is a high level arm?

A

stages 6-7

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16
Q

what is a CMSA stage 6-7 arm movement and function?

A

selective movements but lacks strength, dexterity, or coordination necessary for normal function

primarily used for manipulation tasks with emphasis on speed, accuracy, and quality of movements

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17
Q

what assessment do we as OTs use to assess and stroke patient?

A

Chedoke arm and hand activity inventory (CAHAI)

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18
Q

what is the benefit of the CAHAI?

Study These Flashcards
A

Real life bilateral activity measure that clients determined as meaningful

19
Q

what is the CAHAI designed specifically for?

20
Q

how many tasks does the CAHAI evaluate?

Study These Flashcards
A

7-13 functional tasks

21
Q

what influences our upper extremity interventions?

Study These Flashcards
A
  1. Severity of sensorimotor impairments
  2. Time post-stroke
  3. Recovery prognosis (finger extension and shoulder abduction)
  4. Client’s needs and goals
  5. Evidence of effectiveness
  6. Clinical resources available
22
Q

how do we manage a category 1 (severally impaired) UE?

Study These Flashcards
A

gentle, pain free weight bearing

23
Q

how do we manage a category 2 (moderately impaired) UE?

Study These Flashcards
A

transitioning from stabilization to manipulation tasks

24
Q

how do we manage a category 3 (mildly impaired) UE?

Study These Flashcards
A

Primarily used in manipulation tasks with emphasis on speed, accuracy,
quality of movement

25
what are some examples of interventions for a low functioning (severely impaired) UE?
* Align posture in sitting/standing, ensure limb is protected * Develop sitting/standing tolerance for future UE function * Gentle weight-bearing +/- facilitation * Active-assisted ROM * Scapular mobilizations * Mirror therapy * Motor imagery
26
how should the arm be supported while sitting?
sitting all the way at the back of the chair hand and elbow should be well supported on a table neutral should position (not adducted)
27
how should a low functioning arm be supported in standing?
using a sling
28
when are slings only recommended?
Slings are ONLY recommended for people with flaccid shoulders (stage 1 and 2) Slings are ONLY recommended during transitional movements
29
how should the UE be handled?
supporting the arm proximally and distally do not passively flex the shoulder past 80 degrees without performing scapular mobilizations
30
when is scapular rotation the greatest?
between 80-140 degrees
31
what movements does the scapula do?
elevates, depresses, abducts, adducts, rotates and tilts
32
what are interventions we can do with a moderately impaired EU pretty much anywhere?
Stabilizing activities Task-oriented training Facilitation in weight bearing
33
what are some interventions for a mildly impaired UE?
Task-oriented training CIMT Fine motor training Strength training Video gaming
34
what is the dose for original CIMT?
therapy for 6 hours/day, 5 days a week for 2-3 weeks the less affective arm is constrained for 90% of waking hours
35
what is the dose for modified CIMT?
varies considerably 30 mins-3 hours therapy per day, 5 days per week Less affected limb constrained for < 6 hours per da
36
what is the 10-10 eligibility criteria for CIMT?
10 degrees active finger and wrist extension intact cognition and minimal spasticity
37
what is the recovery -intervention guidelines for stage 3 or less CMSA?
minimize pain and joint contractures
38
what is the recovery -intervention guidelines for stage 4 or higher CMSA?
aggressive restorative therapy
39
how else can stroke impairments be categorized?
6 months or less post stroke or more than 6 months post stroke
40
what are general UE management principles?
Training needs to be meaningful, engaging, repetitive, progressively adapted, task-specific and goal-oriented Encourage use of affected limb during functional tasks. Training should be designed to simulate partial or whole skills
41
what is Graded, Repetitive Arm Supplementary Protocol (GRASP)?
* Arm and hand exercise home program * three different levels
42
how can we prevent shoulder subluxations?
positioning: * Elevate arm when at rest * Support arm during wheelchair use * Risk of trauma secondary to impaired sensation, cognition or perception * Reminder to others about careful handling of arm
43
what should we avoid as OTs when working with stroke survivors?
letting their arm hand tugging up on shoulder during transfers overhead pulleys
44
what are potential predictors of UE recovery?
Initial grade of UE paresis 30% show severe UE motor impairments

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