Term
| Rancho Los Amigos Scale evaluates what? |
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Definition
| Cognitive function in TBI pts <1yr from injury. |
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Term
| A RLA score of what indicates low level of function? |
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Definition
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Term
| A RLA score of what indicates intermediate level of function? |
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Definition
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Term
| A RLA score of what indicates high level of function? |
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Definition
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Term
| RLA analyzes behavior at three levels. What are they? |
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Definition
| objective measurements of functional skills, strategies used to accomplish functional skills, and underlying sensory motor or cognitive impairments that limit performance. |
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Term
| What are some objective measurements of functional skills? |
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Definition
| gait, balance, ADLs, response to feedback, somatosensory and verbal responses. |
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Term
| When assessing impairments of strength w/ RLA, how must you do it? |
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Definition
| you have to look at function. You can't use a grade of 1-5. Can they reach over their head, flex and ext knees in standing, lean fwd and to the side and recover? etc... |
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Term
| What is the difference between hypertonicity and contracture? |
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Definition
| W/ hypertonicity they can get through range. if it's a contracture they cannot. |
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Term
| Disinhibition is common in TBI pts. What is it? |
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Definition
| They say what they want to say - no filter. |
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Term
| Describe RLA levels I-III (low level function) |
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Definition
| I: No Response II: Generalized response (any kind of stim will evoke the same type of response. non-specific to type of stim.) III: Localized Response (Response is more stim-specific). |
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Term
| What are the goals of PT Tx w/ RLA levels I-III? (5) |
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Definition
| 1. Prevent complications (contracture, skin breakdown, blood clots, pulmonary infection.) 2. Increase interaction w/ the environment 3. Active movement and increased response to stim 4. Any kind of communication 5. Family education (positioning, TBI info, ROM) |
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Term
| What are the 5 major components of your eval of the level I-III TBI pt? |
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Definition
| PROM, Spontaneous Activity, Response to Stim, Muscle tone and Reflexes, Presence of gross motor skills as postural reactions. |
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Term
| What are the goals (2) and Tx (4) for decr ROM in the TBI pt? |
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Definition
| Goal: Prevent and correct contracture. Tx: Repositioning, PROM/AAROM, Splinting, Serial Casting. |
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Term
| What do you need to be careful about when Tx of decr ROM in TBI pts? |
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Definition
| Need to monitor positioning devices to make sure no dmg is occuring. |
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Term
| How long should Tx sessions be kept to in order to avoid over-fatigue? |
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Definition
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Term
| What do you want to get from the level I pt? |
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Definition
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Term
| what do you want to get from the level 2 pt? |
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Definition
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Term
| What kind of stimuli can you use to arouse low-level pts? (6) |
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Definition
| Auditory, visual, olfactory, gustatory, tactile, vestibular. |
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Term
| Types of olfactory stimuli: |
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Definition
| cinnamon stick, familiar perfume/cologne |
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Term
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Definition
| swab, lemon stick, lollypop; stuff you can control |
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Term
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Definition
| rubbing, stroking, tapping, prom, textures, have pt touch own body parts |
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Term
| how can you encourage weight bearing? |
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Definition
| put pt in sitting. Place hands on bed/mat, feet on floor, approximation thru the knees |
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Term
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Definition
| Confused, agitated. They can follow 1-step commands inconsistently. No day-day carryover. |
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Term
| What is the Tx program like for the level 4 pt? |
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Definition
| Structure and predictability are critical. NEED to use activities pt likes! Provide orienting information every time you see them.Provide lots of info but do not challenge them, and don't ask lots of questions b/c Frustration levels run high. AIM FOR SUCCESS. |
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Term
| How does the RLA level 5 pt present? |
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Definition
| Confused and inappropriate. They are aware of their surroundings, but personally and socially inappropriate behaviors persist. Perseveration on basic needs. Incontinent. Confusion of past and present, objects often used inappropriately, decreased initiation of activities - need cues. Can follow simple commands, minimal carryover maybe present. |
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Term
| How does the level 6 pt present? |
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Definition
| Confused but appropriate. Consistent w/ simple requests, require some cues and structure still, continent, limited/no insight to disabilities and rehab. Residual memory deficits, but not confabulatory. Increased memory - recognize staff, have better carryover. Appropriate use of objects and they may appear more or less cognitively aware than they really are. |
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Term
| Why might the level 6 pt appear more or less cognitively aware than they really are? |
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Definition
| Because of musculuskeletal deficits, positioning or lack of verbal communication. |
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Term
| What are the major Tx goals for level 4-6? (5) |
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Definition
| Increased physical performance, Increased endurance, cognitive status, Increasingly complex commands, Increase awareness of surroundings and influence of environment on them. |
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Term
| What are the cognitive goals for levels 4-6? (4) |
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Definition
| Appropriate behavior, self-initiated behavior, improve orientation and improve responses to commands. |
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Term
| What level does a pt need to be in order to become increasingly aware of their environment through treatment strategies? |
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Definition
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Term
| At what level can you begin strenth, stretching and sequencing acitivites? |
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Definition
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Term
| At what level do you want your pt to begin providing orientation information for you? |
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Definition
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Term
| ROM Tx changes when a pt gets to level 4-6 range. How? |
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Definition
| Want more pt participation. Not just PROM anymore. |
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Term
| Why do you need to be careful about positioning devices in level 4 pts? |
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Definition
| Because pts who are agitated have a lot of extraneous movements and the devices may come off or become displaced, which places them at risk of injuring themselves. |
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Term
| Family education is important at level 4. Why? |
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Definition
| Because the pt is agitated, and this is disturbing and stressful for family members. They need to know that it's normal and desirable to reach the agitation stage. |
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