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Therex Skills
Therapeutic Skills & Exercise II
| Question | Answer |
|---|---|
| Complete Evaluation | Identifies problems that can be managed by physical therapy, promotes health & well being, identifies potential life threatening or emergency conditions |
| Evaluation | 'comprehensive screening & specific testing process leading to a diagnostic classification or as appropriate to a referral to another practitioner' |
| Initial evaluation (PTA Role) | PT does but you can greet |
| Interim evaluation (PTA Role) | your are responsible for collecting data & give to PT |
| Discharge evaluation (PTA Role) | collects data & special tests, PT makes assessment |
| Neuromuscular Evaluation | patient history, systems review, test & measures |
| Patient History (PTA Role) | past events, chron. order, history, physical any of these given from patient must be reported to PT |
| Systems Review (PTA Role) | clearing potentially involved systems, can not make that call just collect data & report to staff (PT) |
| Test & Measures | Largest part of getting information (PT does initial test & updates goals) PTA continues to take tests |
| Common Tests & Measures | Vital signs, Observation, Arousal, Attention, Cognition, Sensation, Motor Exam (MMT), Coordination, Balance, Functional Ability |
| Vital Signs | BP, HR, RR, Sp02, Temperature |
| Observation | Visual, general & ease of movement, general affect & communication |
| Arousal | Level of Consciousness (alert, lethargic, obtunded, stuporous, comatose, vegetative state |
| Attention | awareness of the environment & ability to focus |
| Cognition | Orientation (most frequent test), Memory, Following commands, Higher cognitive functions, Standardized assessments |
| Sensation | Exteroceptive & proprioceptive, combined sensations |
| ROM | normal vs abnormal, functional implications, cause of limitations (tone or strength issue) |
| Strength | Measurable force exerted by a mm or a group of mm to overcome a resistance in one maximal effort. (strength & tone are NOT the same thing) |
| Tone | resting activity of muscle, can very weak & high tone |
| Nervous system can effect.... | strength issue, may not be able to fix |
| Endurance - (use 'Function') | Ability to sustain forces repeatedly or generate forces over a period of time. Will affect functional ability. |
| Tone | readiness of muscle to contract |
| Alpha Motor Neuron | must be excitory to have tone |
| Deep Tendon Reflexes | Checking integrity of arch. Hyperreflexia (not getting inhibitory thru), Hyporeflexia (not getting excitory thru) |
| Synergy | stereotypical movements that may be present & elicited in a patient w/neurological insults |
| Developmental reflexes | premitive reflexes, most not present in adults (normal=protection, keeping upright) |
| Coordination | separate from strength & ROM, it can affect it though. related to balance |
| Balance | state of postural stability or equilibrium in which the COG is maintained within the boundaries of the BOS |
| Balance feedback | info about state of system (slipped on ice - now do something) |
| Balance feedforward | anticipatory impulses sent prior to movement & help prepare for movement (what body does before stepping on ice) |
| Sensory Influences (Somatosensory) | weight bearing & positions of body party |
| Sensory Influences (Vision) | providing info - staying upright |
| Sensory Influences (Vestibular) | inner ear info, head position relative to gravity & movement of head |
| Limit of Stability (LOS) | maximum angle of vertical that can be tolerated without LOB |
| Sitting Strategies | Knee, Trunk, Abdomen, neck |
| Standing Strategies | ankle 1st, hip flex 2nd, step 3rd |
| Balance Assessment | Static & dynamic sitting & standing tested, can be coordination component (equilibrium tests) |
| Balance Assessments used | Romberg, Sharpened Romberg, Berg, Tinnetti, CTISB |
| Functional Ability | Bed mobility, sitting, transfers, standing, ADL, IADL, locomotion |
| Locomotion | assist, device, context, deviations from normal, distance, speed, time elapsed, stride length, step length, stance time, BOX |
| Historical Perspective for Interventions | Functional movement under rigid hierarchial control (CNS controls movement based on sensory input it receives) |
| Motor Learning, Control & Neuroplasticity | Current (neurophysiology) |
| Motor Learning (PTA Facilitates) | process of an individual acquiring, modifying & retaining motor memory patterns so that programs can be reused & modified during functional activities |
| Principles of Motor Learning | acquiring the capability for a skilled action, experience or repetition, cannot be measured directly, produces relatively permanent changes |
| Component affecting motor learning | difficulty of task, practice context, schedule of practice, stage of motor learning, feedback, motivation |
| Most common motor learning | whole to part to whole |
| motor control | process of how an individual controls movement already acquired (which muscles in what order) |
| Stages of Motor Control (Stage 1) | Mobility (erratic movements) |
| Stages of Motor Control (Stage 2) | Stability (ability to hold position in antigravity, WB position |
| Stages of Motor Control (Stage 3) | Controlled mobility (proximal mobility combined with distal stability |
| Stages of Motor Control (Stage 4) | Skill (most mature movement, proximal segments stable, distal segments free) |
| Neuroplasticity | brains ability to adapt & use cellular adaptations to learn or relearn functions previously lost due to cellular death by trauma or disease at any age |
Created by:
jklincoln
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