COTA Exam
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| Static Splint | prevents movements and often promotes functional position, prevents deformity |
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| Dynamic Splint | assists an individual with movements and may include pulleys, springs, screws, hooks, elastics, and other outriggers to assist in desired motions |
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| Splinting for Hygiene | hands that remain fisted are at high risk for skin breakdown. the inability to extend fingers makes nail clipping difficult. long or sharp nails can cut the skin and may lead to infection | splints are frequently fabricated to protect palm and prevent skin breakdown |
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| Splinting for Protection | may be used after a surgical procedure or to prevent a child or adolescent from self-abuse or interferring behavior |
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| Compliance | provide child and caregiver with education regarding purpose of splint and goals, provide written, verbal, and pictoral instructions, use positive reinforcement for following splinting protocol | make necessary adjustments, demonstrate proper splint application, label splint clearly, correlate splint-wearing schedule with facility shift changes |
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| Skin Integrity | skin breakdown can lead to pressure sores (decubitus ulcers), which can develop relatively quickly when the skin is compromised | to prevent skin breakdown: locate bony prominences (ie: ulnar styloid process), use self-sticking foam or gel padding, use stockinettes under splints, and carefully inspect skin |
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| Decubitus Ulcers | Stage 1: redness of the skin Stage 2: skin loss involving the top 2 layers of the skin - the epidermis and dermis. may appear as a blister or small, open sore | Stage 3: involves damage to the epidermis, dermis, and deeper tissue Stage 4: extends down to muscle and bone | moisture, impaired sensory perception, low levels of physical activity, decreased mobility, inadequate nutrition, and poor overall skin care may increase the likelihood of decubitus ulcers
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| Cerebral Palsy Hemiplegia (involvement on one side of the body) | functional splints that facilitate proper positions of arms, such as wrist/hand immobilization splints, Joe Cool splints, and thumb abduction splints |
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| Cerebral Palsy Quadriplegia (all four extremities involved) | wrist/hand immobilization splints, antispasticity ball splints, neoprene splints, Carrot splints, Pucci splints, and Cone splints |
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| Duchenne Muscular Dystrophy | functional splints that promote stability in weak joints for increased function, such as wrist/hand immobilization splints and ring splints |
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| Rett Syndrome | splints designed to protect clients from self-abusive behaviors such as elbow sleeve |
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| Osteogenesis Imperfecta | splints designed to protect clients from frequent fractures due to decreased stability and structure of the bones, such as nonarticular humerus splints and wrist/hand immobilization splints for infants |
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| Arthrogryposis (stiff joints and abnormally developed muscles) | functional splints fabricated to promote engagement in functional activities and prevent further contractures, such as wrist/hand immobilization splints, neoprene splints, and elbow extension mobilization splints |
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| Brachial Plexus Palsy | functional splints fabricated to inhibit stretching and facilitate protection of the muscles and nerves such as wrist/hand immobilization splints, neoprene splints, and shoulder abduction immobilization splints |
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| Juvenile Rheumatoid Arthritis | to promote ROM for engagement in functional activities and for protection and to decrease deformities, such as wrist/hand immobilization splints, ring splints, neoprene wrist splints, MP joint extension mobilization splints, and Dynasplints |
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| Splinting Evaluation | the OT receives the referral and assesses the need for and determines the type of splint to be used. The role of the COTA is to be determined by their experience. The ultimate responsibility falls on the OTR | factors to consider: anatomical structures, abnormal tone, time frames for healing, swelling, compliance, sensory factors, cognition and developmental age, latex allergies and precautions, home environment |
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| Fabrication Tips | the type of material that the OTR decides to use will depend on the client's age, muscle tone, level of cooperation, and level of pain | the thinnest materials (1/16" to 3/32") often provide adequate positioning while minimizing weight |
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| Splints/Orthosis | devices that immobilize, restrain, or support a part of the body | a splint is often temporary, where an orthotic device is usually more permanent |
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| Splinting for Position | can decrease or prevent contractures, aid in elongating soft tissue (decreasing existing contracture), provide stability to an unstable joint, improve joint alignment, provide rest for affected structures |
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