VCU DPT - Neuro PT (12. Principles of Intervention)

a PT needs to _______ and ______ problem solving process with patients, who are learning new skills/learning how to do them differently

enchance

facilitate

the learner must do WHAT in the task to actual learn, instead of just receiving repetitive stimuli

be an ACTIVE PARTICIPANT

- must be actively engaged

describe what an intervention is when it is focused on 'remediation'

we are enhancing skills and resources OR reversing impairments

returning patient to PLOF

an intervention with a remediation/recover focus assumes WHAT

potential for change in the system and person

- neuroplasticity

describe an intervention that is focused on compensation

when it is used

we are altering the task or enviro for patient success

used if remediation is not possible OR it is early on for satefy

you would use an intervention focused on ______________ if remediation is not possible, or you are very early and have concern for safety

compensation

using a walker to widen a patients base of support in early ambulation has a focus of _____________

COMPENSATION

_______ interventions create a new normal for the patient

_______ interventions get patient back to old normal

compensatory

remediation

________ interventions help manage anticipated problems

prevention

what is an intervention focused on making sure there are no secondary issues

prevention

giving a patient ankle pumps to avoid DVTs is a __________ focused intervention

prevention

is there overlap in the types of interventions (compensatory, prevention, remediation)?

if yes, explain how to distinguish?

if no, why not

YES

a similar intervention can be given to patient, but what matters is the INTENTION of why

a) if you give a patient a walker to ambulate to promote walking endurance, this is an example of a _______ intervention

b) if you give a patient a walker to get them moving and decrease chance of blood clots, this is an example of a __________ intervention

c) if you give a patient a walker to practice walking, as they will use this device permanently upon discharge, this is an example of a ________ intervention

a) remediation

b) prevention

c) compensatory

every PT intervention should create ____________

neuroplasticity

as skill is acquired, _____ assistance is provided and _________ error augmentation

less

more

our PT goal is to have patient improve through ___________

motor learning and neuroplasticity

with ___________, the patient is given verbal/physical assistance throughout an entirety of a task

- max/total assist

guidance

in guidance, the therapist is doing __________ of the problem solving for the patient

most/ALL

a patient receiving max assist in gait from a PT is in the _______ stage

guidance

a patient with solid bracing or e-stim during gait is in the _________ stage

guidance

when do you use guidance? what is its main purpose

early on in learning

demonstrates what needs to happen (or when someone needs significant assistance)

you can use ___________ early on in learning, demonstrates what needs to happen, or if you want to fine tune a learned skill

guidance

you should NOT use guidance WHEN

later in learning, when skill is understood

remove as soon as possible!!!!!

remove guidance ?????

as soon as possible

describe 'assist as needed' in terms of assistance and cues

when the PT gives physical/verbal cues at certain times in the action

min-mod assist, and only in part of task

assistive devices such as a stance control KAFO or overhead harness for loss of balance are used during the ________ stage

assist as needed

e-stim that can be graded with activation of patient is considered to be in the ________ stage

assist as needed

during 'assist as needed', the therapist is doing _______ of the problem solving for the patient

SOME

at what stages of learning do you provide "assist as needed"?

what is benefit?

mid-stage learning

help correct movements, only give support in certain parts of movement

when do you NOT want to use assist as needed

later in learning, when skill is understood

remove assistance as soon as possible!

when do you remove assistance from 'assist as needed'?

ASAP

________ is when you transition the problem solving fully to the patient's internal error detection/problem solving

unassisted

when do you use 'assistance'

mid to late stage learning

CGA, supervision, stand by assist, mod I are all ___________

unassisted

when do you NOT use 'unassisted'

early in learning or unsafe to perform unassisted

you should use _________ or _________ in early stages of learning

you should use ___________ or _______ in mid-late stages of learning

guidance, assist as needed

unassisted, error augmentation

in 'unassisted,' the therapist is doing ______ of the problem solving for the patient

NONE

describe 'error augmentation'

the therapist creates more problems for the problem solver the solve

- frequency, type, magnitude

accentuating the problem, and allowing the person to perform skill in variety of conditions, is ____________________

error augmentation

when do you use error augmentation

late stage learning

when is it not appropriate to use error augmentation

early in learning and unsafe to perform

learner is not familar with skill

learner not able to peform in straight forward conditions

you should not use _______ when:

early in learning and unsafe to perform

learner is not familar with skill

learner not able to peform in straight forward conditions

error augmentation

in error augmentation, the therapist is ___________ of the problem solving for the patient

increasing the workload

a patient needs a lot of assistance, there is low task variability, and they have a device to provides all stability and most motion

what stage are they in

guidance