Neuro-Rehab Occupational Therapy Placement Prep

Comprehensive vocabulary and key concepts for final-year Occupational Therapy students preparing for a neuro-rehabilitation placement.

CNRU

Neurological Rehabilitation Unit; a goal-focused unit for patients with brain or spinal cord injuries needing support to rebuild function, confidence, routine, and independence.

OT Mindset in Neuro-Rehab

Focuses on what matters to the person, their current capabilities, safety concerns, the underlying impairments causing occupational problems, and necessary interventions or equipment.

Power

Muscle strength measured using the MRC scale; weakness can affect grip, transfers, standing, dressing, and mobility.

Tone

Muscle tightness or floppiness. High tone affects hygiene and dressing, while low tone (hypotonia) can affect stability and arm safety.

Sensation

Feeling, including light touch, pin-prick, and vibration; reduced sensation increases risks of burns, pressure damage, and dropping items.

Coordination

Smooth, accurate movement; impairment affects fine motor tasks like buttons, cutlery, and handwriting.

Gait

A person's walking pattern; assessment helps identify falls risk and discharge planning needs.

Upper Motor Neuron (UMN) Pattern

Neurological problem usually in the brain or spinal cord (e.g., stroke, SCI) characterized by increased tone (spasticity), brisk reflexes, and specific weakness patterns.

Lower Motor Neuron (LMN) Pattern

Neurological problem in nerve roots or peripheral nerves (e.g., neuropathy) characterized by reduced/absent tone and reflexes, and muscle wasting.

Pronator Drift

A test where the patient holds arms out palms up with eyes closed; a palm-down drift suggests an upper motor neuron problem on the opposite side.

MRC Scale Score $0$

No contraction.

MRC Scale Score $1$

Flicker or trace contraction.

MRC Scale Score $2$

Movement with gravity eliminated.

MRC Scale Score $3$

Movement against gravity.

MRC Scale Score $4$

Movement against gravity and resistance.

MRC Scale Score $5$

Normal power.

Proprioception

Joint position sense; knowing where a limb is without looking, which is vital for reaching, dressing, and safe positioning.

Dysmetria

Inaccurate reaching or missing a target, which impacts daily tasks like reaching for a toothbrush or cup.

Intention Tremor

A tremor that worsens as the hand approaches a target, affecting feeding, drinking, and grooming.

Dysdiadochokinesia

Difficulty with rapid alternating movements; affects the speed and sequencing of hand tasks.

Romberg Test

A balance screen performed with feet together and eyes closed; unsteadiness suggests poor proprioception or vestibular function.

Ankle Clonus

Rhythmic beats after quick ankle dorsiflexion; more than $5$ beats is abnormal and suggests UMN involvement.

Babinski Sign

An abnormal plantar reflex where the big toe extends and spreads, suggesting an UMN lesion.

Executive Dysfunction

Difficulties with planning, sequencing, and problem-solving, which impact tasks like money management and meal preparation.

Reduced Insight

A brain injury symptom where the patient may not recognize their own risks or support needs, impacting discharge safety.

Fatigue Management

OT strategies in neuro-rehab including pacing, rest breaks, and energy conservation to manage therapy tolerance and ADL participation.

Myotome $C5$

Involved in shoulder abduction (axillary nerve); important for dressing and reaching.

Myotome $C7$

Involved in elbow extension (radial nerve); important for pushing up from a chair and transfers.

Myotome $L4-L5$

Involved in ankle dorsiflexion (tibialis anterior); critical for foot clearance and falls prevention.

Stocking Distribution

A distal sensory loss pattern indicating neuropathy, requiring attention to foot care and falls risk.