Special Considerations for Mobility

somatosensory deficits

pain

visual deficits

speech and language

motor deficitis

perceptual and cognitive dysfunction

DIRECT general impairments and functional limitations

Deconditioning

Limitations in ADLs

Participation restrictions in home, work, and community

INDIRECT general impairments and functional limitations

C1-C8

involvement/impairment

Tetraplegia

• Injury to cervical segments of cord ____

• UE _____

T1 and below

Upper extremity

Paraplegia

• Injury below the cervical segments (typically ____)

• ____ function preserved

S4-S5

ASIA impairment categories (complete)

• no ___ function

• May include "Zone of Partial Preservation" - when there is preserved sensation or motor function below the NLI, but no sacral sparing

ASIA impairment categories

Incomplete - sensory function preserved below injury (including S4-5), but no motor function

Incomplete - some motor function preserved, more than half the "key" muscles <3/5

Incomplete - some motor function preserved, at least half the "key" muscles greater than or equal to 3/5

protein

skin inspections

shearing and trauma

The role of PT in pressure ulcer prevention:

• Adequate nutrition (especially ___!)

• Daily ______

• Proper transfer technique to prevent ___ & ___

• Timing and technique for weight shifts + reminders early in rehab

• Seating and positioning

20-30 minutes

2 minutes

Patient should be independent to initiate a weight shift every ____ minutes for at least __ minutes

•  lean

• Anterior lean

• Tilt back (PWC)

• Wheelchair pushups

lateral

anterior

Patient should be independent to initiate a weight shift every 20-30 minutes for at least 2 minutes

• ___ lean

• ____ lean

• Tilt back (power wheel chair)

• Wheelchair pushups

closed reduction

Fracture manipulated back into place without surgery (cast)

open reduction

surgical realignment (internal and external fixation)

90 degrees

internal

adduction

6 weeks

POSTERIOR HIP APPROACH

PRECAUTIONS

• No flexion of the hip joint greater than ___ degrees

• No ___ rotation of the hip joint past neutral

• No ____ of the hip joint past neutral

• Strict adherence typically for first ___ weeks post-surgery with guarded progression after

effusion

Fluid accumulation within a body cavity or joint

edema

Fluid accumulation in the interstitial spaces (the spaces between cells) within tissues