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Therex Skills

Therapeutic Skills & Exercise II

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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