neuromuscular mgmt week 5

prognosis

prediction of the likely course, duration, and outcome of a patient's condition after an initial assessment and throughout the course of treatment

guides intervention/proper setting/goal setting/discharge planning/realistic expectations

what are five reasons as to why it is important to predict prognosis for someone who had a stroke?

neurologic condition has stabilized

when should you use the orpington prognostic scale?

proprioception/balance/cognition/motor deficit

what three things does the orpington prognostic scale measure?

1.6/6.8

what is the lowest possible score for the orpington prognostic scale? what is the highest?

increased

with the orpington prognostic scale, higher scores indicate __________ deficits

what score on the orpington prognostic scale indicates a high likelihood of returning home?

YES

does the orpington prognostic scale predict discharge?

3.2-5.2

what score on the orpington prognostic scale indicates a better response to continued rehabilitation?

>5.2

what score on the orpington prognostic scale indicates dependency with an increased risk of institutionalization?

functional independence measure

what test must you be certified in order to administer?

old age/woman/comorbidities/ischemic stroke/right hemisphere/depression/neglect/aphasia/incontinence

what are nine negative personal predictors of stroke recovery?

stroke severity

what is the most important predictor of initial stroke recovery?

unilateral spatial neglect

what is an independent predictor of poor functional recovery of a stroke?

severity of UE motor impairment/function

what is the most predictive factor of UE recovery following a stroke?

what walking speed after a stroke predicts household walking?

0.4-0.8 m/s

what walking speed after a stroke predicts limited community walking?

>0.8 m/s

what walking speed after a stroke predicts unlimited community walking?

walking endurance (6MWT)

what was the strongest individual predictor of community walking activity after a stroke?

>205 m

what distance on the 6MWT discriminated between home and community ambulators?

>288 m

what distance on the 6MWT discriminated between limited and unlimited community ambulators?

>0.49 m/s

what walking speed on the 6MWT discriminated between home and community ambulators?

>0.93

what walking speed on the 6MWT discriminated between limited community and unlimited community ambulators?

TWIST tool

developed to predict when people who have had a stroke will likely regain independent walking within the first 6 months post stroke

age/knee extension strength/balance

what were three key predictors in the TWIST tool for regaining independent walking after a stroke?

statement/practice patterns/classifications/diagnosis systems

what are four different locations that a physical therapy diagnosis can come from?

NO

is it typically relevant to write a goal about a body function and structure impairment?

T

T/F: in general, the prognosis for full UE recovery after a stroke is poor

index/middle finger active extension against gravity (at 3 weeks)

what UE functional movement was strongly predictive of recovery of grasp at 13 weeks?