RHS 422 Lecture 2 Overview

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Questions and Answers

What is the primary role of orthotists in rehabilitation?

Performing surgical procedures

Designing and fitting custom-made orthoses (correct)

Providing psychological support to patients

Administering medication to patients

Which team members are typically included in a rehabilitation healthcare team?

Doctors and psychologists

Only physicians and nurses

Physical therapists and occupational therapists (correct)

Nutritional experts and pharmacists

What prerequisites are required to enter professional training programs in orthotics or prosthetics?

A master's degree in psychology

High school diploma with no specific courses

A certificate in health administration

A bachelor's degree with science courses (correct)

How does the World Health Organization's ICF framework help health professionals?

It helps to maximize patient participation and function Signup and view all the answers

Which subject is NOT typically included in the academic training for orthotists and prosthetists?

Cosmetic surgery techniques Signup and view all the answers

What are the responsibilities of an orthotist during patient care?

Evaluating functional and cosmetic needs of patients Signup and view all the answers

Which aspect is critical in the training of orthotists and prosthetists?

Understanding of musculoskeletal pathology Signup and view all the answers

What is the significance of the rehabilitation healthcare team in meeting patient needs?

It allows for a more comprehensive approach to patient care Signup and view all the answers

What is the primary role of an orthotist in patient care?

To educate on the use and care of orthoses Signup and view all the answers

Which of the following is NOT a responsibility of a prosthetist?

Monitoring cardiovascular health post-amputation Signup and view all the answers

How does amputation primarily affect cardiovascular workload?

It decreases total muscle mass, lowering oxygen demand Signup and view all the answers

What potential issue arises from altered blood flow after an amputation?

Increased risk of wound healing problems Signup and view all the answers

What is a common psychological impact of limb loss?

Emotional and mental stress Signup and view all the answers

How does reduced upper body muscle mass affect pulmonary function?

It compromises respiratory function Signup and view all the answers

Which of the following challenges is NOT associated with limb loss?

Improved exercise tolerance Signup and view all the answers

Why is understanding cardiopulmonary adaptations critical after limb loss?

To optimize health and activity levels Signup and view all the answers

What effect can anxiety and depression have on physiological functions?

They can elevate heart rate and blood pressure. Signup and view all the answers

What is a primary benefit of cardiovascular training?

Improves exercise tolerance and reduces fatigue. Signup and view all the answers

Which adaptation is associated with strength training for amputees?

Increased muscle mass in the affected limb. Signup and view all the answers

Why is psychological support important for amputees?

It can positively impact their mental well-being and cardiopulmonary function. Signup and view all the answers

How does the level of amputation influence cardiovascular challenges?

Above-knee amputations typically have a greater impact than below-knee amputations. Signup and view all the answers

What type of injuries were noted on P.G.'s left anterior thorax and thigh?

Road burn abrasions Signup and view all the answers

What was the final decision regarding P.G.'s right lower limb?

He had a transfemoral amputation Signup and view all the answers

What does self-efficacy in movement refer to?

Confidence in one’s ability to move. Signup and view all the answers

What role does prosthetic design play in rehabilitation?

It can influence energy expenditure and gait patterns. Signup and view all the answers

What procedure was performed to address P.G.'s subdural hematoma?

Burr hole drainage Signup and view all the answers

What distinguishes goal-directed movement?

It can be accomplished in many different ways. Signup and view all the answers

What medication was P.G. started on in the operating room?

High-dose broad-spectrum antibiotics Signup and view all the answers

At what Rancho Los Amigos Scale level is P.G. currently functioning?

Level 7 Signup and view all the answers

What type of drainage was observed from the residual limb's suture line?

Serosanguineous drainage Signup and view all the answers

What symptom did P.G. experience when seated upright with his left lower extremity dependent?

Dizziness Signup and view all the answers

What was one of P.G.'s hobbies before the accident?

Long-distance running Signup and view all the answers

What is a key benefit of starting rehabilitation early after amputation?

It maximizes the brain's potential for plasticity. Signup and view all the answers

How does task-specific training contribute to rehabilitation?

It practices real-world activities relevant to individual goals. Signup and view all the answers

What is the role of variability and challenge in rehabilitation tasks?

It keeps the brain engaged and promotes skill refinement. Signup and view all the answers

Which strategy is important for enhancing control over the residual limb or prosthesis?

Improving sensory feedback from the residual limb. Signup and view all the answers

Which advanced technology is mentioned as beneficial in rehabilitation?

Virtual reality and robotic training systems. Signup and view all the answers

Why is it essential to tailor rehabilitation programs to individual needs?

To maximize innate capabilities and achieve optimal outcomes. Signup and view all the answers

What is the primary challenge faced by individuals after limb amputation?

Disruption of motor control and function Signup and view all the answers

What is a common initial condition of a patient like P.G. after severe injuries?

Reduced level of consciousness. Signup and view all the answers

What role does repetition play in motor learning for amputees?

It helps in mastering movement patterns Signup and view all the answers

What describes the role of neuroplasticity in rehabilitation?

It allows for the formation of new neural connections. Signup and view all the answers

In the context of rehabilitation, what does neuroplasticity allow the brain to do?

Reorganize and adapt its neural connections Signup and view all the answers

Why is motivation considered a key factor in motor learning for amputees?

It fosters engagement and drives progress Signup and view all the answers

What process allows the brain to adjust to the sensory feedback from a residual limb or prosthesis?

Sensory remapping Signup and view all the answers

How does the brain manage control over a prosthetic limb after amputation?

By remapping existing motor commands Signup and view all the answers

What is one common misconception about motor learning in amputees?

Motor learning should be fast and immediate Signup and view all the answers

Which of the following best describes the importance of breaking down tasks in rehabilitation?

It helps achieve smaller, manageable goals Signup and view all the answers

Study Notes

RHS 422 Lecture 2

Lecture delivered by Dr. Mai Aldera
Course focuses on rehabilitation healthcare team, including orthotists and prosthetists, the role of cardiopulmonary and cardiovascular systems during functional activities, motor control, learning and neural plasticity in rehabilitation, along with case examples and questions.

Course Outlines

Characteristics of the rehabilitation healthcare team
Roles and responsibilities of orthotists and prosthetists
Role of cardiopulmonary and cardiovascular systems during functional activities
Motor control, learning, and neural plasticity in rehabilitation
Case examples and associated questions

Characteristics of Rehabilitation Healthcare Team

Health professionals work in healthcare settings to meet the physical rehabilitation needs of diverse patient populations
The World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) provides a disablement framework that enables health professionals to maximize patient/client participation and function while minimizing disability

Rehabilitation Team Members

Physicians, prosthetists, orthotists, physical therapists, occupational therapists, nurses, and social workers
Provide necessary knowledge and skills for effective patient management

Orthotists and Prosthetists: Professional Role and Responsibility

Entry into professional training requires a bachelor's degree with a strong emphasis on prerequisite science courses.
Orthotics and prosthetics education requires an additional academic year
Necessary technical courses, research methodology, kinesiology, biomechanics, musculoskeletal and neuromuscular pathology, communication and education, and current health care issues are also studied.
Orthotists provide care to individuals with neuromuscular and musculoskeletal impairments that lead to functional limitations and disabilities.
Design, fabricate, and fit orthoses (or custom-made braces)
Evaluate patient's functional and cosmetic needs
Select appropriate components for orthosis fabrication
Fit and align the orthosis
Educate the patient and care providers on proper orthosis use, care, and evaluation for continued appropriateness.
Prosthetists provide care to patients with partial or total limb absence.
Create designs to fit the individual's specific functional and cosmetic needs.
Select appropriate materials and components
Construct necessary casts, measurements, and modifications
Evaluate the prosthesis fit and function
Educate the patient on prosthesis care

Role of Cardiopulmonary and Cardiovascular Systems During Functional Activities

The cardiopulmonary system plays a crucial role in amputee patients, impacting their well-being following limb loss.
Understanding these changes and tailoring rehabilitation strategies accordingly is crucial for optimizing health and activity levels.
Cardiopulmonary and cardiovascular system adaptations are essential for optimizing health and activity levels
Potential challenges: reduced cardiovascular workload, altered blood flow, pulmonary function changes, and psychological stress
Adaptations: cardiovascular training, strength training, prosthetic training, and psychological support are key to handling rehabilitation challenges

Motor Control, Learning, and Neural Plasticity in Rehabilitation

Movement is goal-directed, to accomplish a task or ADL.
There are various ways to accomplish tasks, depending on available resources.
Each person has their preferential way of moving, but it is not always optimal.
Motor control, learning, and neuroplasticity are crucial in the rehabilitation process after amputation.
Embracing change: the loss of a limb presents significant challenges, leading to disruption in motor control and function.
Motor learning: relearning patterns, practice making perfect, and the power of motivation are key factors in motor learning.
Neuroplasticity: the brain's remarkable ability to change and reorganize neural connections through appropriate training and stimulation.

The Rehabilitation Advantage

Early intervention
Task-specific training
Variability and challenge
Sensory integration
Technology to the rescue

Case Example

P.G., a 23-year-old man, sustained severe injuries to both lower extremities and a closed-head injury following a motorcycle accident.
Experienced distal right femur fracture, left tibia and fibula fractures, subdural hematoma, and right femoral artery rupture.
Underwent transfemoral amputation of the right lower extremity, internal fixation of the tibia and fibula.
Receives high-dose broad-spectrum antibiotics, ventilator weaned and functioning at a Rancho Los Amigos Scale level of 7.

Questions to Consider

Clinical specialists and health professionals for patient care
Priorities, roles, and responsibilities for each team member
Similarities and differences in roles
Team challenges, changes in roles, application of ICF (International Classification of Functioning) model, clinical practice guidelines relevant to patient management.

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Description

Explore the key aspects of rehabilitation healthcare, focusing on the roles of orthotists and prosthetists. Understand the importance of the cardiovascular systems and motor control in functional activities during rehabilitation. This lecture provides an insightful perspective on neural plasticity with relevant case examples.