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?

<p>It helps to maximize patient participation and function (B)</p> Signup and view all the answers

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

<p>Cosmetic surgery techniques (D)</p> Signup and view all the answers

What are the responsibilities of an orthotist during patient care?

<p>Evaluating functional and cosmetic needs of patients (C)</p> Signup and view all the answers

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

<p>Understanding of musculoskeletal pathology (B)</p> Signup and view all the answers

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

<p>It allows for a more comprehensive approach to patient care (C)</p> Signup and view all the answers

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

<p>To educate on the use and care of orthoses (A)</p> Signup and view all the answers

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

<p>Monitoring cardiovascular health post-amputation (A)</p> Signup and view all the answers

How does amputation primarily affect cardiovascular workload?

<p>It decreases total muscle mass, lowering oxygen demand (A)</p> Signup and view all the answers

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

<p>Increased risk of wound healing problems (A)</p> Signup and view all the answers

What is a common psychological impact of limb loss?

<p>Emotional and mental stress (A)</p> Signup and view all the answers

How does reduced upper body muscle mass affect pulmonary function?

<p>It compromises respiratory function (B)</p> Signup and view all the answers

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

<p>Improved exercise tolerance (D)</p> Signup and view all the answers

Why is understanding cardiopulmonary adaptations critical after limb loss?

<p>To optimize health and activity levels (B)</p> Signup and view all the answers

What effect can anxiety and depression have on physiological functions?

<p>They can elevate heart rate and blood pressure. (D)</p> Signup and view all the answers

What is a primary benefit of cardiovascular training?

<p>Improves exercise tolerance and reduces fatigue. (B)</p> Signup and view all the answers

Which adaptation is associated with strength training for amputees?

<p>Increased muscle mass in the affected limb. (D)</p> Signup and view all the answers

Why is psychological support important for amputees?

<p>It can positively impact their mental well-being and cardiopulmonary function. (B)</p> Signup and view all the answers

How does the level of amputation influence cardiovascular challenges?

<p>Above-knee amputations typically have a greater impact than below-knee amputations. (D)</p> Signup and view all the answers

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

<p>Road burn abrasions (B)</p> Signup and view all the answers

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

<p>He had a transfemoral amputation (A)</p> Signup and view all the answers

What does self-efficacy in movement refer to?

<p>Confidence in one’s ability to move. (B)</p> Signup and view all the answers

What role does prosthetic design play in rehabilitation?

<p>It can influence energy expenditure and gait patterns. (A)</p> Signup and view all the answers

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

<p>Burr hole drainage (C)</p> Signup and view all the answers

What distinguishes goal-directed movement?

<p>It can be accomplished in many different ways. (A)</p> Signup and view all the answers

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

<p>High-dose broad-spectrum antibiotics (B)</p> Signup and view all the answers

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

<p>Level 7 (C)</p> Signup and view all the answers

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

<p>Serosanguineous drainage (D)</p> Signup and view all the answers

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

<p>Dizziness (D)</p> Signup and view all the answers

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

<p>Long-distance running (C)</p> Signup and view all the answers

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

<p>It maximizes the brain's potential for plasticity. (C)</p> Signup and view all the answers

How does task-specific training contribute to rehabilitation?

<p>It practices real-world activities relevant to individual goals. (C)</p> Signup and view all the answers

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

<p>It keeps the brain engaged and promotes skill refinement. (A)</p> Signup and view all the answers

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

<p>Improving sensory feedback from the residual limb. (A)</p> Signup and view all the answers

Which advanced technology is mentioned as beneficial in rehabilitation?

<p>Virtual reality and robotic training systems. (D)</p> Signup and view all the answers

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

<p>To maximize innate capabilities and achieve optimal outcomes. (D)</p> Signup and view all the answers

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

<p>Disruption of motor control and function (A)</p> Signup and view all the answers

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

<p>Reduced level of consciousness. (C)</p> Signup and view all the answers

What role does repetition play in motor learning for amputees?

<p>It helps in mastering movement patterns (A)</p> Signup and view all the answers

What describes the role of neuroplasticity in rehabilitation?

<p>It allows for the formation of new neural connections. (B)</p> Signup and view all the answers

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

<p>Reorganize and adapt its neural connections (D)</p> Signup and view all the answers

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

<p>It fosters engagement and drives progress (C)</p> Signup and view all the answers

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

<p>Sensory remapping (B)</p> Signup and view all the answers

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

<p>By remapping existing motor commands (B)</p> Signup and view all the answers

What is one common misconception about motor learning in amputees?

<p>Motor learning should be fast and immediate (D)</p> Signup and view all the answers

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

<p>It helps achieve smaller, manageable goals (D)</p> Signup and view all the answers

Flashcards

Rehabilitation healthcare team

A group of healthcare professionals who work together to meet patients' physical rehabilitation needs, including physicians, prosthetists, orthotists, physical therapists, occupational therapists, nurses, and social workers.

Orthotists and Prosthetists

Professionals who design, fabricate, and fit orthoses (braces) and prostheses (artificial limbs).

ICF

International Classification of Functioning, Disability, and Health (WHO). A framework to help improve patient participation and function and reduce disability.

Orthotist's role

To evaluate patient needs, design orthoses, select materials, and fabricate/fit orthoses.

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Prosthetist training

Requires additional academic year beyond a bachelor's degree, studying kinesiology, biomechanics, and health care issues.

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Orthotist training type

Requires additional academic year beyond a bachelor's degree, focusing on musculoskeletal and neuromuscular conditions and health care.

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Orthotist profession

Specialists in designing and fitting braces for people with neuromuscular and musculoskeletal issues.

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Professional training requirement

Bachelor's degree from an accredited institution, with a focus on scientific subjects.

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Prosthetist's Role

Designs, fabricates, and fits prostheses for patients with limb loss, considering function and aesthetics.

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Cardiopulmonary System Impact

Faces challenges & adaptations after limb loss, requiring tailored rehabilitation for amputees.

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Reduced Cardiovascular Workload

Following limb loss, decreased muscle mass reduces need for oxygen, decreasing heart rate and cardiac output at rest.

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Altered Blood Flow

Amputation disrupts normal blood flow, potentially causing poor circulation in remaining limb & fluid accumulation.

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Pulmonary Function Changes

Reduced upper body muscle mass due to inactivity or compensatory movements compromise respiratory function & oxygen intake.

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Psychological Stress Impact

Emotional/mental impact of amputation influences cardiovascular and respiratory functions.

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Exercise Capacity

Reduced ability of the body to adjust to physical activity after limb loss, leading to fatigue.

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Cardiopulmonary Training

Regular aerobic exercise helps improve the heart and lungs' efficiency in utilizing oxygen, leading to improved exercise tolerance, reduced fatigue, and better blood pressure management.

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Strength Training Impacts

Building muscle, particularly in the upper body and the remaining limb, increases metabolic demands, thus stimulating the cardiopulmonary system, leading to better overall fitness and exercise capacity.

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Prosthetic Training's Effect

Learning to use a prosthetic limb requires coordination and effort, leading to adaptations in the amputee's cardiovascular and respiratory systems to handle the increased workload, resulting in improved function and independence.

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Psychological Support's Role

Managing stress and anxiety through psychological support benefits amputees by positively impacting their physical health and cardiopulmonary function.

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Amputation Level's Impact

The extent of limb loss significantly affects cardiovascular and respiratory challenges, with above-knee amputations typically having a greater impact compared to below-knee amputations.

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Pre-existing Conditions & Adaptation

Prior cardiovascular or respiratory problems can complicate the rehabilitation process, requiring personalized strategies.

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Prosthetic Design Matter?

The type and quality of a prosthetic limb influence energy expenditure and gait patterns, impacting the cardiopulmonary system.

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Why Do We Move?

Movement is goal-directed, aiming to complete tasks or activities of daily living. There are many ways to achieve a task, and the nervous system adapts movement based on available resources and the environment.

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Motor Learning After Amputation

The process of the brain adapting and learning new movement patterns after limb loss, involving redefining sensory feedback, coordinating muscle recruitment, and finding new strategies for balance and locomotion.

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Practice Makes Perfect (Amputation)

Repetitive, task-specific practice is crucial for motor learning in amputees. Rehabilitation programs break down complex tasks into smaller steps, providing feedback and guidance to promote proper form and technique.

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Motivation in Rehabilitation

Motivation and engagement are vital for successful rehabilitation. Programs should include activities and goals meaningful to the individual, fostering a sense of accomplishment and driving continued progress.

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Neuroplasticity

The brain's ability to reorganize neural connections and adapt to new experiences. After amputation, the brain repurposes areas once devoted to the missing limb for other functions.

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Sensory Remapping

The brain learning to interpret new sensory feedback from the residual limb or prosthesis, integrating it into existing motor commands.

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What is Rehab Goal for Motor Learning?

To help amputees relearn movement patterns, improve motor control, and gain independence with a prosthesis or residual limb.

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How does brain reorganize after limb loss?

Areas of the brain once controlling the missing limb are repurposed for other functions or strengthened connections to remaining limbs.

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How does Sensory Feedback change after amputation?

The sensory feedback from the residual limb or prosthesis is different from the lost limb, requiring the brain to learn to interpret new signals.

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Neural Plasticity in Rehabilitation

The brain's ability to adapt and create new connections, even after injury. This allows amputees to learn to control their remaining limb or prosthesis.

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Early Intervention for Amputees

Starting rehabilitation as soon as possible after amputation maximizes the brain's ability to adapt and speeds up motor learning.

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Task-Specific Training

Rehabilitation that focuses on practicing real-world activities that are important to the individual's goals.

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Variability and Challenge in Training

Introducing changes and increasing the difficulty of exercises during rehabilitation keeps the brain engaged and speeds up adaptation.

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Sensory Integration in Rehabilitation

Using techniques that enhance sensory feedback from the remaining limb or prosthesis to help the brain better understand and control it.

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Technology for Rehabilitation

Using advanced technologies like virtual reality and robotic systems to create immersive and challenging environments for faster learning and brain adaptation.

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Tailoring Rehabilitation Programs

Creating individual rehabilitation programs that are specific to the needs of each amputee to achieve the best possible outcomes.

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Empowering Amputees

Helping amputees regain independence and control over their lives through effective rehabilitation.

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What is a subdural hematoma?

A collection of blood that forms beneath the dura mater, the tough membrane that surrounds the brain.

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What type of surgery was performed on P.G.'s right lower extremity?

A transfemoral amputation, which involves removing the entire leg at the thigh.

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What's an intramedullary rod?

A metal rod inserted into the hollow space inside a bone, like the tibia, to stabilize a fracture.

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What's the Rancho Los Amigos Scale?

A scale used to assess a person's cognitive function after brain injury, ranging from Level I (no response) to Level VIII (purposeful, independent behavior).

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What does 'bulbou's' mean when describing a residual limb?

Describes a limb that is swollen or enlarged, often due to fluid buildup.

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What is serosanguineous drainage?

A type of drainage containing both serum (clear fluid) and blood.

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What is regranulation?

The process of new skin formation, often observed during wound healing.

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What is the meaning of 'dependent' when referring to a limb?

This refers to a limb being positioned below the heart, making it more prone to swelling.

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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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RHS 422 Lecture 2 PDF

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.

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