neuro summary 5-10 exam.pdf

5.5 Bed Mobility: Hemiparetic Interventions Techniques in hooklying Unilateral hookyling - limb that is paretic (should be the one in that position) - manually facilitate WB (stimulates proprioception for limbs that are hyper/hypotonic) Bilateral hooklying - bridging - scooting - lower trunk rot Fir...

5.5 Bed Mobility: Hemiparetic Interventions Techniques in hooklying Unilateral hookyling - limb that is paretic (should be the one in that position) - manually facilitate WB (stimulates proprioception for limbs that are hyper/hypotonic) Bilateral hooklying - bridging - scooting - lower trunk rot First Video Rhythmic initiation for LTR facilitation into hookyling - both knees bent up - pt do as much alone be med and lat PROM/AAROM/AROM/RESIST/ both directions for antagonist - bend good knee, facilitate w/ HS tendon on opp side reversal - apply WB so prevent from sliding Lower trunk rot - dont do entire ROM bc want pelvis on table, can do PNF patterns Second Video Bilateral bridging/scoot in bed facilitate into hookyling if needed w/ glutes on less involved side WB sit beside, put hand on glutes of more involved side and use own hip to push pt up bridge while scoop, tuck chin, push up precautions skin/sores 3rd video Techniques for Rolling/ S/L to sit hemi side facilitate into hook lying may be done to both sides push down into leg while scoot utilizes a hooklying position for roll protract scap for protection elbow prop method for UE WB (when rolling have pt hold onto arm and use toward paretic side) shoulder to roll encourage active participation from the pt!! (avoid facilitation until absolutely needed) toward involved side sidelying to sit bring legs off bed, PT help facilitate at HS, help w/ hip flexion and lower leg down prop sit elbow by shortening laterally on lower PT push down onto involved leg sit to S/L prop sit onto elbow bring uninvolved leg up and help w/ trunk push up on shoulder/axilla and bring elbow up and over protect pt shoulder have pt push elbow into bed and sit up other leg slowly lower down, can use other arm to protect shldr toward less involved side harder bc arm cant reach and pull facilitate one leg into hooklying pt protect shldr by holding onto arm w/ other hand PT grab scap and push down while roll over PT facilitate at HS/hip flexors to get left leg off table elbow prop and use involved side to help push w/ that elbow too facilitate both arms to push into sitting (at triceps) Summary supine hookyling is a good starting pt bridging and scooting required for preparation rolling twd either paretic/non paretic sides utilize WB/ forced use as much as possible compensation doesn’t need to be taught 3rd video 5.6 Bed Mobility - Paraparetic Interventions Rolling and Supine to Sit w/ paraparesis/paraplegia recovery based interventions - utilized for certain diagnosis that have good prognosis for recovering fxn of impaired extremities - MS, GB, TBI, complete SCI - can use same techniques from lecture 5.5 - emphasizes re-establishing fxn of involved limbs compensatory based interventions - utilized w/ AISA a spinal cord injuries - utilized w/ conditions w/ poor prognosis for recovery - utilized if safety is of utmost concern Video one Momentum to offset lack of muscle activity of impaired extremities during rolling/sitting Muscle subsitution for prox muscles to crawl toward LE for upright sitting Paraplegia can use UE to roll Struggle w/ rolling can use arms as momentum to rock over or bend knee to increase leverage cross ankles if knee bend too easy but still need assistance Prone to long sit crawl into C position to roll into long sit - crawl into flexion, hook under legs, and use elbow to prop hips back and use other arm to push into LS PT can stabilize at pelvis Chart Referring to Case: C5 Asia A SCI motor recovery of LL disease progression: doesn’t progress but healing is poor = LOW presented w/ sacral ulcer = comorbidities good support system = closer to recovery but still compensatory strategies needed most likely need momentum base, crawl but can still improve muscles! Interventions for bed mobility augmented/recovery-based - PNF: ability to resist mvmt - facilitation of the task: learn techniques and improve - motor control/motor learning: learn and improve compensatory/maintenance - preservation of current ROM & strength - head hips/angular momentum: SCI/paraplegia/ later MS, early GB - muscle substitution: ALS, chronic demyelinating, SCI - use of equipment: improve QOL Summary recovery vs compensatory/maintenance requires a thorough examination requires awareness of diagnosis requires awareness of associated condition