40 Questions
Following reduction of the fracture site, the spine is immobilized for a period of time through the use of spinal ______ and recumbent positioning.
orthoses
The goal of fracture/spinal injury site management is to stabilize the spinal column to prevent further damage to the ______.
cord
A ______ orthosis is commonly used to immobilize the spine in patients with cervical injuries.
Halo
The ______ lumborum is one of the muscles involved in strong hip flexion.
Quadratus
The ______ femoris is one of the muscles involved in knee extension.
Rectus
A ______ is a device used to assist mobility in patients with strong hip flexion and weak knee extension.
Wheel chair
The ______ tibialis is one of the muscles involved in ankle stabilization.
Posterior
Management of SCI begins at the location of the ______.
accident
The patient is not likely to have adequate ______ and head control to maintain an upright posture without support.
neck
Use of a ______ table is also advantageous because it allows early weight-bearing through the LEs.
tilt
Sensory stimulation is an intervention used to increase the level of ______ and elicit movement in individuals in a coma or persistent vegetative state.
arousal
Multisensory stimulation involves the presentation of sensory stimulation in a highly structured and ______ manner.
consistent
During this type of intervention, the patient should be closely monitored for any changes in ______.
behavior
The many cognitive, physical, and/or behavioral impairments that affect activity levels and social ______ often necessitate multiple episodes of physical therapy care over the patient’s lifetime.
participation
These barriers may include ______, confusion, physical aggression, memory deficits, and limited attention span.
disorientation
In these cases, the therapist must utilize observation skills as the patient moves to gain insight to the extent of the ______ structure/function impairments and activity restrictions.
body
The ______ muscle strength is scored using the 6-point ordinal scale.
key
Sensory level is defined in terms of ______ function.
sensory
Sensory level is determined by testing the patient's sensitivity to ______ touch and pinprick on the left and right side of the body.
light
For the purpose of determining motor and neurological level, the ______ muscle is defined as having intact innervation if it has a manual muscle test score of at least 3/5.
key
The ______ scale is used to determine the functional outcomes of patients.
ASIA
Patients with C3 and higher level injuries need ______ support.
ventilator
C4 level patients can manage ______ respiration.
spontaneous
Mouth bars can be used for some activities such as page turning and ______.
writing
Wheelchairs must have high ______ supports and a safety belt which is able to stabilize the body and is available for a reclining or tilting position.
back
Battery powered wheelchairs must have a ______, tongue, breath or jaw control.
head
Range of motion (ROM) and ______ exercises are important in the acute stage to prevent elbow flexion and supination contractures.
stretching
Patients can use a battery powered wheelchair with a ______ modification and can push a manual wheelchair with special gloves.
joystick
Active ______ extension is possible and hand grip can be achieved with a tenodesis effect.
wrist
A dynamic ______-driven orthosis is helpful for reading books, eating, teeth and hair care activities in the cases of weak proximal muscles and strong distal muscles.
triceps
Transfers are achieved by the assistance of ______ board.
transfer
The elbow extension in ______ level and finger flexor muscle strength in C8 level is sufficient.
C7
PT Interventions to Improve Sensory Function include ______ & superficial and deep pressure, etc.
stretching, stroking, iceing, vibration
PT Interventions to Improve Flexibility & Joint Integrity include ______ mobilization and ROM exercise.
soft tissue, joint
PT Interventions to Improve Strength include ______ of agonist and antagonistic muscle.
strengthening
PT Interventions to Manage Spasticity include ______ stretch and slow iceing of spastic muscle.
sustained
PT Interventions to Improve Movement Control include ______ of desired movement patterns.
dissociation, selection
PT Interventions to Improve Postural Control & Functional Mobility include ______ to sit and sit to supine.
supine
In pusher syndrome, passive correction often ______.
fails
In pusher syndrome, sitting on the ______ side can be used to correct.
normal
Study Notes
Locomotion and Muscle Strength
- Locomotion involves the use of wheelchairs, bilateral knee-ankle orthoses, and crutches, with strong hip flexion and knee extension.
- Key muscles involved in locomotion include iliopsoas, quadratus lumborum, rectus femoris, sartorius, extensor digitorum, medial hamstring, posterior tibialis, quadriceps, and tibialis anterior.
Medical and Rehabilitation Management
- Early medical and rehabilitation management is crucial in the acute stage of spinal cord injury (SCI).
- Techniques used in stabilizing, moving, and managing the patient immediately following the trauma can influence prognosis significantly.
- Fracture stabilization aims to prevent further damage to the cord, and can be achieved through conservative or operative methods.
- Immobilization involves the use of spinal orthoses and recumbent positioning to stabilize the spine.
Immobilization Devices
- Cervical orthoses, such as the halo orthosis and Minerva, limit cervical motion in all planes.
- Thoracolumbosacral orthoses (TLSO) are used to immobilize the spine in patients with thoracic or lumbar injuries.
Sensory Stimulation
- Sensory stimulation is an intervention used to increase the level of arousal and elicit movement in individuals in a coma or persistent vegetative state.
- Multisensory stimulation involves the presentation of sensory stimulation in a highly structured and consistent manner, targeting the auditory, olfactory, gustatory, visual, tactile, kinesthetic, and vestibular systems.
Physical Therapy Management
- Physical therapy management of moderate to severe traumatic brain injury involves multiple episodes of care over the patient's lifetime.
- Goals and interventions focus on the patient's abilities and personal goals, regardless of the setting.
- Examination may involve observation skills, as patients may be unable to cooperate with standardized tests and measures.
Functional Outcomes
- Functional goals are determined by the calculation of the patient's ASIA scale, taking into consideration medical and social status, and the individualized rehabilitation plan.
- Expected functions of motor complete injury patients at the end of the first year according to the level of injury are:
- C1-C4 levels: completely dependent, need ventilator support, and have limited mobility.
- C5 level: active wrist extension, hand grip, and independence in activities like nutrition, care, and hygiene.
- C6 level: independence in activities like nutrition, care, and hygiene, and ability to use a dynamic triceps-driven orthosis.
- C7-C8 levels: sufficient elbow extension and finger flexor muscle strength, with intensive rehabilitation.
Physical Therapy Interventions
- Improve Sensory Function: positioning, repeated sensory stimuli, stretching, stroking, superficial and deep pressure, icing, vibration, and bilateral UE.
- Flexibility and Joint Integrity: soft tissue and joint mobilization, ROM exercises, AROM, PROM, and stretching programs.
- Improve Strength: graded exercise programs using free weights, therabands, sand bags, and isokinetic devices.
- Manage Spasticity: sustained stretch, slow icing, rhythmic rotations, weight-bearing exercise, prolonged and firm pressure application, and slow rocking movement.
- Improve Movement Control: dissociation, selection of desired movement patterns, and task-oriented exercises.
- Postural Control and Functional Mobility: rolling, supine to sit, sitting, bridging, sit to stand, and transfer exercises.
This quiz covers the functions of various muscles in relation to locomotion, including hip flexion, knee extension, and trunk control. It also touches on the use of orthoses and assistive devices.
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