lvl 2 fw veterans home

Anterior hip precautions:

Avoid excessive rotation

Prevent leg extension

Do not cross legs

What could an OT do with a patient who just had a hip replacement?

Bed mobility, w/c transfers, ADLs such as dressing and grooming

Posterior hip precautions:

No internal rotation

Don’t cross legs

When transferring, extend leg in front of you

No bending past 90

Avoid low furniture

With bed mobility and hip precautions, what can use to prevent leg from crossing midline?

Abduction wedge/ pillows between legs

Can be helpful to raise bed prior to transfer

T or F: You should try to transfer on affected side

T

Spinal precautions: bed mobility technique

Log roll

Sternal precautions transfer to wheelchair:

Push/pull, open chest, cant lift anything greater than 10 pounds

When transferring, what general technique would you use and explain it.

Pivot transfer with gait belt.

Remember rock 3 times

NWB transfer:

Use a walker or stand pivot modified technique

TTWB transfer

Use a walker, or modified stand pivot technique

Important information for general transfers:

-make sure patient is scooted forward

-w/c is locked

-sway 3 times to help patient prepare

Goni: Elbow flexion

0-150

Lateral epicondyle of humerus-axis

Should be reading the larger number

Elbow extension:

0 or 180

If patient cant fully extend, it will be around -80 degrees (example)

Shoulder abduction: Goni

Axis: acromion process

Stationary: parallel to trunk

Movable: side of humerus

0-170

Shoulder internal rotation:

Axis: olecranon process of elbow

Stationary: forearm

Movable: forearm

0-60

Shoulder external rotation:

Axis on olecranon

Stationary: in line with ulna

Movable in line with ulna

0-80

Forearm supination

Have client hold pencil

Axis of 3 phalynx

stationary bar perp to floor

Movable: in line with pencil

80-90

Forearm pronation

Pencil

0-80/90

Wrist flexion

Axis lateral side of wrist

Stationary: along radius

Movable: metacarpal of index finger

0-80

Wrist extension

0-70

Ulnar deviation

In line with 3rd finger

0-30

Radial deviation

0-20

Shoulder flexion

0-170

Axis humeral head

Shoulder extension

Axis: humeral head

0-60

MMT grade 5

Normal

Grade 4 Good

Against, full, moderate

3+ fair plus

Against full, slight

3 fair

Against, full, no pressure

3- fair minus

Against, more than 50%, none

2+ poor plus

Gravity minimized, full, slight

2 poor

Gravity minimized, full, no pressure

2-poor minus

Gravity minimized, partial rom, no pressure

1 trace

Against or gravity minimized, no motion, contraction observed

0 zero

Against gravity or gravity minimized, no motion or movement

How will the OT use the KATZ assessment ?

Skilled observation to determine independence in different areas

How interpret the KATZ assessment results

Dependence gets zero points

Independent gets 1 point, 6 is high zero is low

FIM: Functional Independence Measure Setup

Skilled observation of functional tasks

Ex: show me how you dress, eat, bath

What is the FIM typically used for?

Determining patient progress

FIM scoring

7 level scale

7-complete independence

6- modified independence

5- supervision/ set up

4- minimal contact assistance

3- moderate assistance

2- maximal assistance

1- total assistance

0- activity does not occur

Possible OT interventions for patients with COPD

Teaching pursed lip breathing and diaphragmatic breathing techniques

Energy conservation strategies: taking breaks, body positioning

Task modifications to make them easier

Assistive devices such as canes or walkers

Possible interventions for Parkinson’s

Memory aides, lists, digital reminders

Task simplification

Pegboard for working on balance/ ambulation

Have pt practice with adaptive equipment

Putty activity to work on hand strength

Occupational therapy interventions for fractures

Eval

Pain management

Elevation/compression

Massages

PREs

Teaching one handed strategies

Assistive devices

Neuromuscular reeducation

Buttoning, picking up small items

Interventions for congestive heart failure

Energy conservation techniques

Exercise

Pneumonia interventions:

Postural training

Breathing techniques

Occupational therapy interventions with stroke patients

CIMT

PREs

Memory: Matching blocks, spot the difference

Memory card games

Ball activities

Fx resistance training

Fine motor tasks