Week 6

Question 1

Clinical reasoning in neurological physiotherapy

Answer 1

1. Initial physio assessment
2. Problem list, assimilation of assessment findings
3. SMART goals
4. Treatment planning and implementation
5. Reassessment and measure outcomes

Question 2

ICF

Answer 2

International classification of functioning

Health condition

1. Body function and structure (impairments)
2. Activities (limitations)
3. Participation (restrictions)

• Environmental factors
• Personal factors

Question 3

Neurological assessment

Answer 3

Subjective assessment

• Gathering information from client’s records
• Interview with client and relatives/carers
• Gathering information from multi-disciplinary team

Objective examination

• General observations
• Risk assessment (transfer method)
• Activity limitations and impairments
• Analysis of everyday tasks (several repetitions, level of independence, kinematic deviations, compensatory movements)
• Impairment assessment
• Objective outcome measurement

Question 4

Possible impairments/reasons for kinematic deviation

Answer 4

• Weakness
• Decreased co-ordination
• Decreased sensation – tactile sensation, proprioception
• Visual, vestibular or perceptual impairments
• Motor planning impairments
• Difficulty initiating movement
• Spasticity
• Pain
• Decreased joint ROM
• Decreased muscle or neural length

Question 5

Impairment assessment

Answer 5

• Strength (ROM, MMT, control, speed, endurance)
• Flexibility – joint ROM, muscle length and neural length
• Spasticity
• Sensation
• Vision
• Co-ordination
• Vestibular impairment
• Motor planning impairment (apraxia)
• Perceptual impairment
• Cranial nerves impairment
• Pain
• Cardiorespiratory endurance

Question 6

Long term goals

Answer 6

• Relate to the participation restriction domain of the ICF
• Greater than a month

e.g. I will be able to walk independently indoors on firm surfaces prior to discharge home from rehabilitation in 4 weeks

Question 6

Short term goals

Answer 6

Establish short term goals that will facilitate achievement of long term goals
Short term goals relate to the activity limitation domain of the ICF

e.g. Sit symmetrically with feet supported with SBA for 1 minutes in 2 week