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Neuro E&I

Transfers & Mat Mobility: Post-CVA

QuestionAnswer
What level of assist for STS is needed in order for pts. to leave a nursing home? Min. A for STS. Normally perform the task ~4x/day
What are the two basic phases for the STS task? Which is 30% and 70%? Pre-Extension Phase: 30% -feet placement and weight shift Extension Phase: 70% -extension of hips, knees, and ankles. Knee starts extension but everything finishes simultaneously. Tibia translates anteriorly. Whole movement typically last 1.6 seco
Describe muscle activity during the pre-extension phase 1. Tibialis Anterior fires. Active throughout whole ROM 2. Iliopsoas (trunk flexion)
Describe muscle activity during the extension phase 1. Rectus Femoris, Vastus Lateralis 2. Biceps Femoris at hip and knee 3. Gluteus Maximus 4. Gastroc/Soleus
3 General Mechanical Requirements to completing the STS task successfully 1. Sufficient speed/momentum to propel COBM forward over feet 2. Sufficient LE force to raise and support body into standing 3. Postural stability as thighs come off of sitting surface.
Discuss the three physical factors that can limit the STS task 1. Foot Position 2. Trunk Position 3. Muscle Weakness (which muscles?)
Which impairments may affect foot position? 1. Decreased ROM primarily seen with gastroc tightness in the seated position 2. Lack of proprioception/sensation 3. Bracing ex. KAFO 4. Weakness to position foot in 15º of DF All are valid. However, soleus tightness is more of an issue in the seated position since the gastroc is place on slack in knee flexion.
What would limit a person from creating velocity during trunk movement? Limit by fear of falling. Give them target or table for safety and support.
List environmental factors for the STS task 1. Chair Height 2. Compliance of Cushion 3. Depth of Chair 4. Availability of Arm Rests
How does foot position affect the STS task? Effects how far the COM has to move. If too far anteriorly, COM has to move more anteriorly.
How does trunk position affect the STS task? Trunk flexion needs to generate enough momentum for standing
Which is not an impairment that limits trunk flexion? 1. Hip pain 2. Decreased extensor tone 3. Decreased hip flexion PROM 4. THA precautions 5. TLSO Decreased Extensor Tone. Need to have selective LB tightness in order to transfer energy of momentum
Name the three PRIMARY groups of muscles that are primary responsible for weakness in the STS task Knee Extensors, Hip Flexors, PF
Which is/are not considered a typical ADAPTATION to performing the Stand to Sit Task? 1. WB on both legs 2. Shift stronger foot farther back to bear more weight 3. Use of UE’s for support or momentum 4. Decrease BOS of feet Adaptations 1 and 4 are wrong. Patients with CVA will adapt by WB only on stronger leg and increase their BOS.
Name two outcome measurements for the STS task? 1. FIM: functional independent measure 2. TUG
True or False: When training for COMPENSATION is your goal for bed mobility/transfers in the CVA patient, you should only practice bed mobility/transfers on the unaffected side to avoid injuring the affected side. FALSE. Even though compensation is a goal, you should still practice bed mobility/transfer to both sides
Out of these 4 Training Schedules, which is the eventual goal for all practice? 1. Part Practice 2. Whole Practice 3. Blocked Practice 4. Random Practice Eventual goal is Whole Practice. -Part Practice is good for early learning stages -Random practice is good for retention
What three factors will determine ease of scooting in bed? 1. Rails vs. No Rails 2. Hip Extensors Strength 3. Bed Compliance
Created by: Phillypino