Unit 7 Flashcards
Typical PT problem List for CVA
*hint…10
- Altered Muscle Tone 2. Decreased ROM
- Decreased Strength 4. Decreased Balance
- Altered Sensation 6. Decreased Coordination
- Decreased Functional Mobility.
- Increased risk for falling
- Increased pain (shoulder).
- Need for client/family education
Problem 9 (Increased Shoulder Pain)
70% shoulder pain (stroke px’s) within the first year
Highly preventable
Details of Subluxation…
- Early stages (flaccid), post CVA (no muscle tone).
- Weight of the arm causes the humorous to sublux from the glenoid fossa.
- Decreased sensation
Treatment for subluxation…
- Best treatment is preventative, proper handling & positioning of joint and support.
- Positioning & protecting the arm is key.
- Affected arm should NOT be abducted of flexed 70 degrees
Adhesive Capsulitis…
- Shoulder tone decreases + spasticity is present.
- Shoulder ROM becomes more difficult.
- If shoulder doesn’t move, capsule tightens causing painful, restrictive = frozen shoulder
TX - Best treatment is preventable
- Frozen shoulder tx stretching, heat, exercises & meds
Constraint induced Movement Therapy CIMT
- Clients learn not to use their affected extremity after repeated failures.
- Some recovery of movement occurs, clients do not restart using affected extremity (learned non-use)
- Clients forced to use the affected the affected extremity at least partially reversed.
- May use sling on non-affected arm
- Therapy might include repetitive practice of skills using affected arm.
Typical PT problem List for BI
*hint…11
- Decreased LOC 2. Decreased Cog.
- Behavioural challenges
- Decreased communication
- Altered tone 6. Decreased Strength
- Decreased ROM 8. Decreased balance
- Decreased Sensation
- Decreased functional mobility
- Need for client & family education
Common complications post brain injury
Increased Intra-cranial pressure (ICP)
What are the S+S of increased ICP?
- Vomiting
- Decreased responsiveness
- Irritability
- Change in vital signs (Increased HR or BP).
- Severe headache
Implications for Treatment for ICP:
HOB cannot be too high or too low.
Tx might include craniotomy
What does HO stand for?
Heterotrophic Ossificans
What is HO?
Calcification (bone formation) in the soft tissues + muscles surrounding joints.
Cause - Unknown
RF: Long duration of coma + prolonged immobility
S+S of HO?
- Decreased ROM (with a very firm end feel).
- Pain with Movement
- Palpable hard mass in the muscle
Treatment of HO?
- Exacerbated vigorous ROM activities.
- Oral medication (to break down calcium).
PT problem List for SCI
- Decreased ROM 2. Decreased strength
- Increased spasticity 4. Decreased Sensation
- Decreased respiratory function
What are the 6x complications + important safety considerations for clients with SCI?
SAP BIP
- Instability
- Pressure Ulcers
- Autonomic Dysreflexia
- Postural Hypotension
- Bowel + Bladder Dysfuntion
- Sexual Dysfunction
C3 + above Complete SPI
- Needs assistant to breath.
- Dependent for all functional mobility
FI: Cranial Nerves
PI: Neck flexors + extensors
C4 Complete SPI
- Dependent for all functional mobility
- Sip n Puff power chair
FI: Neck flexors + extensors
PI: Diaphragm
C5 Complete SPI
- Manual or power chair
- some sitting balance
FI: Diaphragm
PI: Deltoids + Biceps
C6 Complete SPI
- Sliding board independently
- Manual chair
- Functional grasp + hand use (Tenodesis grip)
FI: Deltoids + Biceps
PI: Pec + Teres Major
C7 Complete SCI
- Capable of living alone
- Independent in rolling + sitting.
FI: Pec + Teres Major
PI: Triceps
C8 & T1 Complete SCI
FULL INNERVATION
Triceps
- Functional grasp for fine motor control
- Independent in sliding board transfers + manual chair use
T2 - T6 Complete SPI
FI: U/E Musculature
PI: Intercostals
T7 - T12 Complete SPI
FI: U/E Musculature
PI: Intercostals
L1 - L2 Complete SPI
Manual w/c for most mobility
FI: U/E Musculature
PI: iliopsoas
L3 - L5 Complete SPI
FI: U/E Musculature
PI: Adductors
Problem list for Progressive Neuro Disorders
- Decreased strength + endurance
- Decreased ROM
- Decreased Co-ordination
- Decreased sensation
- Decreased Balance
- Increased Fatigue
Tx for manage fatigue?
- Relaxations Techniques
- Rest breaks
- Breathing exercises.
- Assistive Devices
Tx for Progressive Neuro Conditions
- Focus on maintaining function not necessarily increasing
- Focus on Max quality of life
