Fall Risk Assessment and Chronic Fatigue

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Questions and Answers

What type of fall is most likely to occur in a new environment?

Controlled falls

Unexplained falls (correct)

Balance-related falls

Disease-related falls

Which of the following is NOT a factor in the Falls Risk Assessment Tool that indicates high risk of falling?

History of stroke

Balance problems

Ability to walk independently (correct)

Recent falls

Which tool is NOT considered reliable for assessing fall risk in older adults?

Dynamic Gait Index

Berg Balance Scale

Personal Health Questionnaire (correct)

TUG

What common issue may contribute to falls specifically in individuals with Parkinson's disease?

Freezing of gait Signup and view all the answers

Dizziness might contribute to falls as a result of which condition?

Orthostatic hypotension Signup and view all the answers

What is a distinctive feature of fatigue associated with Chronic Fatigue Syndrome (CFS)?

It results in post-exertional malaise. Signup and view all the answers

Which of the following is NOT considered a sensory or cognitive impairment associated with CP?

Obesity Signup and view all the answers

Which method is commonly used in the diagnosis of Chronic Fatigue Syndrome (CFS)?

Evaluation of clinical history and symptoms Signup and view all the answers

Which of the following conditions is characterized by prolonged disabling fatigue not relieved by sleep?

Chronic Fatigue Syndrome Signup and view all the answers

Which of these impacts is NOT commonly associated with CP?

Infection Signup and view all the answers

What is a common medication prescribed to prevent seizures in patients with TBI?

Anticonvulsants Signup and view all the answers

Which outcome measure is NOT typically used for assessing functional performance in TBI patients?

Hand grip dynamometers Signup and view all the answers

What is a consideration during exercise testing for clients with TBI?

Joint morphology Signup and view all the answers

Which of the following is a recommended strategy to enhance exercise compliance in TBI patients?

Shorten aerobic session durations to 20 minutes Signup and view all the answers

Which type of exercise should primarily target large muscle groups for individuals with TBI?

Circuit training Signup and view all the answers

What is the recommended approach regarding resistance weights in strength training for TBI patients?

Consider 1RM as correct form, not weight removal Signup and view all the answers

Why are objective measurements preferred over RPE in assessing exercise intensity for TBI patients?

RPE can be invalid due to cognitive deficits Signup and view all the answers

In the context of exercise prescription for TBI, what is one key aspect to consider for individuals with hypotonia or spasticity?

Utilize wrist wraps and Velcro fasteners during exercises Signup and view all the answers

Which psychological medication may be prescribed to reduce feelings of fear in TBI patients?

Anti-anxiety medication Signup and view all the answers

What environmental factors should be considered during the rehabilitation of TBI patients?

Family/carer involvement Signup and view all the answers

What is the first step in the process of customizing treatment intervention techniques?

Clinical problem identification Signup and view all the answers

What does the exercise program card primarily help with?

Documenting exercise efficacy and components Signup and view all the answers

Which of the following is NOT a focus in developing an exercise intervention plan?

Eliminating psychological challenges Signup and view all the answers

Which framework is emphasized for comprehensive care in rehabilitation?

Biopsychosocial framework Signup and view all the answers

How should information on exercises be presented in an exercise program card?

In tables for clarity Signup and view all the answers

What is the role of referrer reports in healthcare delivery?

To optimize healthcare delivery and care coordination Signup and view all the answers

What should be avoided when writing referrer reports?

Reiterating provided information Signup and view all the answers

What does a continuous, interconnected thought process imply in clinical reasoning?

It involves a series of cognitive steps Signup and view all the answers

What is a key aspect of Home Exercise Programs (HEPs)?

They provide options for varied environments and supervision levels. Signup and view all the answers

Which of the following is NOT included in the layout and expectations of an exercise program?

Clear nutritional guidelines Signup and view all the answers

What is the primary characteristic of complete spinal cord injury (SCI)?

Absence of motor and sensory function below the injury site Signup and view all the answers

Which syndrome results in the loss of proprioception and fine touch while preserving motor function and crude touch?

Posterior cord syndrome Signup and view all the answers

Which myotome is responsible for the function of wrist extensors?

C6 Signup and view all the answers

What is the significance of the 'golden window' in spinal cord injury management?

Rate of functional recovery is fastest within this period Signup and view all the answers

Which mechanism is NOT typically associated with intrinsic causes of spinal cord injury?

Car accident Signup and view all the answers

What type of spinal cord injury is defined as impairment of function primarily in the upper extremities?

Central cord syndrome Signup and view all the answers

What is a major limitation for individuals with higher lesions (tetraplegia) when exercising?

Limited peak heart rate response Signup and view all the answers

What is the common age demographic affected by spinal cord injuries?

15-25 years old Signup and view all the answers

Which of the following is a medical emergency associated with spinal cord injuries?

Autonomic dysreflexia Signup and view all the answers

Which spinal cord injury classification describes a sensory incomplete injury?

B Signup and view all the answers

What type of lesion is characterized by ipsilateral paralysis and contralateral loss of crude touch, pain, and temperature sense?

Brown-Sequard’s Syndrome Signup and view all the answers

What is a common cardiovascular response for individuals with low-level spinal cord lesions during exercise?

Near normal cardiovascular responses Signup and view all the answers

Which of the following is NOT a typical aftereffect associated with spinal cord injuries?

Enhanced muscle elasticity Signup and view all the answers

What segment of the spinal cord correlates with the innervation of ankle plantar flexors?

S1 Signup and view all the answers

What contributes to the interaction that results in disability?

Barriers to participation and impairments. Signup and view all the answers

Which type of barrier is characterized by low expectations and stereotypes about people with disabilities?

Attitudinal barriers Signup and view all the answers

What is a common consequence of falls in older adults?

Leading cause of hospitalizations Signup and view all the answers

What age-related change significantly impacts balance?

Loss of peripheral sensation and motor units Signup and view all the answers

Which condition is characterized by clouded vision due to changes in the lens of the eye?

Cataracts Signup and view all the answers

What does the Berg Balance Scale primarily assess?

Functionality in mobility and fall risk Signup and view all the answers

Which of the following is NOT a typical cause of falls in the elderly?

Excessive muscular strength Signup and view all the answers

How does hydrotherapy affect cardiovascular function during immersion?

Increases venous return Signup and view all the answers

What is a key focus of the Physiological Profile Assessment (PFA)?

Direct assessment of sensorimotor abilities Signup and view all the answers

Which of the following is a sign of poor mobility function on a screening tool?

Completing 5 repetitions of sitting to standing in more than 12 seconds Signup and view all the answers

What characteristic change occurs in the vestibular system with age?

Reduced sensation from inner ear structures Signup and view all the answers

Which screening tool indicates a fall risk based on the number of falls in the past year?

QuickScreen Clinical Falls Risk Assessment Signup and view all the answers

What is a common risk associated with hydrotherapy for individuals with certain health conditions?

Potential adverse effects from water immersion Signup and view all the answers

Which strategy is NOT effective in fall prevention among older adults?

Engaging in multi-tasking activities Signup and view all the answers

Study Notes

Neuromuscular Rehabilitation

Neuroplasticity is the ability of the nervous system to adapt to intrinsic and extrinsic stimuli by reorganizing its structure, function, and connections.
Neuroplasticity can occur at molecular, cellular, system and behavioural levels.
This process can occur during development, in response to the environment, during disease and after therapy.
The brain is composed of approximately 85 billion neurons and 85 billion glial cells.
Neurons form networks responsible for specific functions, making approximately 10,000 synapses each.
Key brain regions and their roles are described in the context of localizationism, including motor, sensory, language, cognitive, and emotions.
The cerebellum has a significant role in motor coordination.
Historical developments in understanding brain plasticity are outlined with relevant dates and scientists.
This includes early evidence of brain change (1793), dynamic/adaptive interpretations (1890), and the demonstration of anatomical brain plasticity (1964).
Mechanisms of neuroplasticity involve molecular changes in channels, cellular changes in synapse formation, and physiological/anatomical changes in neural networks, leading to improved motor/functional performance.
Specific applications of neuroplasticity include cerebellar agenesis, neurotrophins and stroke, hemispherectomy and blindness.
Studies demonstrate brain reorganization following sensory loss or impairment, with the remaining regions processing sensory information from the other side.
In blindness the visual cortex has adopted the function of processing tactile information when reading braille.
Chronic pain after limb amputation (phantom limb) is a possible maladaptive example of neuroplasticity due to reorganization in the somatosensory cortex.
Clinical decision making in neurorehabilitation involves identifying the appropriate examination methods and interventions for a consumer.
The process includes information gathering and analysis, and a dynamic, interconnected process of clinical reasoning.
A rehabilitation role includes exercise intervention planning, motivation, and positive life impacts for the consumer.
A biopsychosocial framework is important and a diagram illustrating the process is provided.
Exercise Programs should provide comprehensive documentation of components, completion, and effectiveness.
They enable efficient supervision by various clinical staffs.
Layouts typically include identifying information, primary conditions, goals, exercises, intensity, duration, progression, and regression. Neuro rehabilitation can deviate from standard FITT format.
Telehealth/virtual exercise training is crucial for outreach, and often a mandatory component of different funding/insurance services.
Social aspects of disability cover types of disability, diversity, and prevalence.
Various classifications are outlined differentiating through physical characteristics, cognitive functions, perception, or neurological function.
Statistical data for prevalence and sociodemographic implications are provided for Australia.
Different models of disability are described (medical, social, moral), including views toward disability and individuals with disability as defined by impairment and limitations or factors both intrinsic and extrinsic.
Assessments to assess fall risks and balance includes neurological changes with aging (sensorimotor changes—muscle loss, peripheral sensation decline, executive function, and attention), cognitive changes, vision, sensation/proprioception, vestibular sensation.
Gait and balance assessments evaluate sensory input, central processing, and motor response, essential for maintaining body position and stability, and essential for preventing falls in older adults.
Several assessments of neurological aspects like vision, proprioception, and vestibular sensation, gait, balance, reaction time, and cognitive are listed.
Specific exercise programs, including standing balance tests (tandem stance, one-leg stand), sit-to-stand tasks, walking tests (6m walk test, timed up and go/TUG), and the Berg Balance Scale, are detailed.
Complementary assessments to consider include cognitive function, fear of falling, and environmental conditions.
Technology, in the form of virtual reality or tele-rehabilitation, is used for enhancing motor skills and improving balance.
Robot-assisted training uses technology to support body weight during tasks, helping functional movement.
Virtual reality (VR) interventions are beneficial for improving arm function, postural control, balance, and gross motor functions in people with cerebral palsy, stroke, Parkinson's disease, and spinal cord injuries.
Hydrotherapy benefits from buoyancy to reduce load on joints, drag for resistance, and temperature variations that can reduce pain and improve the effectiveness of exercise.
The application of water in therapy should consider different temperatures, activities types, and conditions, and can aid in pain relief, reduction on joint strain, improved mental health, relaxation, and post-exertional recovery.
Hydrotherapy can apply to conditions including cardiac rehab, MS, spinal cord injuries, and arthritis.
Aquatic exercises are also suitable for people with impaired posture and/or decreased balance.
Traumatic brain injuries (TBI) involve primary and secondary injuries, which can cause edema, intracranial pressure, and chemical changes.
Severity of injury is assessed by the Glasgow Coma Scale and duration of post-traumatic amnesia.
Multiple sclerosis (MS) is defined by chronic neurodegenerative disease affecting the central nervous system (CNS), leading to demyelination (the loss of myelin sheath).
Various types of MS range from relapsing-remitting (RRMS) to primary progressive (PPMS) and secondary progressive forms (SPMS), based on clinical presentation and progression.
Many factors are associated with the condition, including genetics, environmental conditions, and/or autoimmune diseases.
Treatments for MS include disease-modifying therapies (DMTs), which often have substantial side-effects, and autologous hematopoietic stem cell transplants, which are high risk but may show promising outcomes.
Chronic Fatigue Syndrome (CFS) is characterized by prolonged, disabling fatigue affecting ADLs that is not alleviated by rest, not a result of difficult activity and was not tolerated prior to onset, leading to significant functional impairment.
The condition is often associated with multiple accompanying symptoms in varying systems and may be diagnosed by clinical history, examination, and investigation, given that there is no definitive way to diagnose conditions of this type.
A lack of consensus among healthcare professionals is evident in the lack of a clear, universally recognized diagnostic approach.
Risk factors are listed, including infections, psychological distress, and environmental influences or genetic predispositions.
Exercise, combined with psychological interventions, plays a significant role in the management of CFS.
Parkinson's Disease (PD) is a neurodegenerative disease affecting neurons in the substantia nigra part compacta, characterized by resting tremors, rigidity, postural instability, and bradykinesia (slow movement).
It's a progressive disorder with motor and non-motor symptoms.
Exercise plays a role in the management of PD, targeting motor impairments and maintaining/improving motor skills.
Various exercise types are discussed and their potential benefits and limitations for improving motor symptoms and quality of life are documented.
Assessment of PD includes the Hoehn and Yahr stages, and common assessments such as Postural Gait and Stability (PIGD), balance scales, gait assessments, falls efficacy scale (FES-I), and the MDS-UPDRS.
Freezing of gait (FOG) is a crucial concern with PD, leading to balance problems.
Visual cueing, both for FOG and broader gait control, can assist the patient to maintain some functionality
Practical applications in cueing are discussed, covering visual, auditory, and somatosensory stimuli.
Dementia is described as a progressive neurodegeneration disorder affecting cognition, and ultimately impacting functionality.
Risk factors, diagnosis, and prevention are provided.
Subtypes, including Alzheimer's disease, vascular dementia, frontotemporal dementia, and dementia with Lewy bodies, are distinguished, with respect to differences in specific symptoms and progression.
Exercise plays an important role in maintaining/improving cognitive functions.
Multiple sclerosis (MS) often results in symptom complexity due to its chronic, progressive nature and varying types, with high incidence amongst individuals living further from the equatorial latitudes within their populations.
Diagnostic stages, characteristics and progression, along with disease-modifying therapies (DMTs), that target the underlying conditions and managing secondary symptoms, are discussed.
Stroke is a vascular event where blood flow to the brain is interrupted.
Different types of stroke are identified (ischemic and hemorrhagic), based on their cause.
Risk factors, symptoms, and assessment, including the Glasgow Coma Scale (GCS), are presented, with implications and considerations for exercise prescription and management.
Consequences may be varied including motor, sensory, cognitive and functional limitations, impacting various aspects of daily living.

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Description

Test your knowledge on fall risk factors and the assessment tools used for evaluating those at risk, particularly in new environments. Additionally, explore the relationship between Parkinson's disease and falls, as well as the characteristics of Chronic Fatigue Syndrome. This quiz covers essential concepts in health and safety related to these conditions.