Term
| What are the two types of neuro casting? |
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Definition
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Term
| What is the major difference between serial and inhibitive casting? |
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Definition
| The goals. The goal of serial casting is to gain ROM. The goal for inhibitive casting is to put the patient in better biomechanical alignment so their function can improve. |
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Term
| What are the down sides of casting? |
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Definition
| It is labor intensive, and has risks so it's not the first choice of intervention. |
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Term
| What is the goal for serial casting, and with what types of patients is it used? |
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Definition
| Goal = gain ROM for pts who aren't able to do active stretching, or if you are not gaining any ROM with them. |
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Term
| Describe thes serial casting process. |
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Definition
| Several different casts are made. They are casted in a stretched (but not end-range) position and maintain it for several days. The cast is taken off to see if ROM is gained, and re-cast them in a more lengthened position than the last time. |
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Term
| What is the theory behind serial casting? |
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Definition
| Muscle fibers adapt to the length the fibers are placed at. So if you stretch the muscle w/ prolonged stretching the muscle will gain length, thus increasing ROM. |
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Term
| How do you tell if serial casting is effective for the pt? |
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Definition
| If you do two casts and they don't gain, casting is ineffective. Don't do more than two. |
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Term
| Who is appropriate for serial casting? |
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Definition
| Someone whose function will be improved by gaining ROM, someone who has the potential to increase ROM. |
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Term
| What is the expected gain from serial casting dependent on? |
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Definition
| The length of time the contracture has been present. The older the contracture is, the longer it will take to work out, so weekly gains may be smaller than w/ an older contracture. |
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Term
| What are the two most common joints and directions to be serial casted? |
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Definition
| ankle plantar flexion and elbow flexion. |
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Term
| Describe the evaluation for serial casting. |
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Definition
| Look at active and passive ROM. Precise ROM measurements are critical before and after casting. Look @ skin condition and check for end feel. Check sensation to see if there'll be a problem feeling in the cast. |
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Term
| If a patient is lacking sensation in the cast area, can you still cast them? |
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Definition
| Yes, but just be conscious of it - might need to change the cast more often. |
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Term
| Once full range has been attained with casting, what is the next step? |
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Definition
| Maintain the range with something else. Can use a night splint or AFO. |
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Term
| What is the major contraindication to casting? |
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Definition
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Term
| What are the precautions to serial casting? (2) |
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Definition
| Decreased sensation and wounds. |
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Term
| what is the goal of inhibitive casting? |
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Definition
| put pt in better biomechanical alignment so their function can improve. |
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Term
| For what patient populations is inhibitive casting most commonly used? (2) |
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Definition
| In pts w/ motor control deficits or those dominated by a synergy pattern. |
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Term
| Give an example of inhibitive casting use in a pt w/ LE extensor patterns. |
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Definition
| Cast them in ankle DF. This allows better control of the knee and hip, because you can break up the synergy in the whole extremity by breaking it up at one joint. Once the synergy is broken, you can work on motor control of hip and knee. |
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Term
| At what joint is inhibitive casting most commonly used? |
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Definition
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Term
| Who is appropriate for inhibitive casting? (3) |
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Definition
| 1. Pts w/ tone problems that limit function. 2. Pts w/ motor control probs that limit function. 3. Pts w/ fluctuating tone (these guys are excellent candidates). |
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Term
| What is fluctuating tone? |
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Definition
| Tone that is position-dependent. So if you can't get a pt in neutral DF in one position, you may be able to achieve it in another position. |
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Term
| What is the theory behind inhibitive casting? |
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Definition
| W/ the cast, you don't change tone. But you can work past it to gain control while the tone pattern is broken up. |
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Term
| How long can you leave an inhibitive cast on? |
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Definition
| up to two weeks if the pt has full sensation and no other compounding problems. |
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Term
| What are the two questions you need to ask yourself when considering casting? |
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Definition
| 1. What are your goals? Make sure you choose the appropriate type of casting to achieve them. 2. Will the casting impact function? If the answer is no, don't waste your time doing a cast. |
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