The document provides information on assessing patients with spinal cord injuries. It discusses assessing incidence rates, relevant history, physical and neurological examinations, muscle performance, pain, range of motion, reflexes, aerobic capacity, arousal, gait, motor function, and more. Assessment tools mentioned include the ASIA impairment scale, manual muscle testing, pain scales, goniometry to measure range of motion, deep tendon reflex testing, and tests of cognition, balance, and mobility.
The document provides an overview of coordination and its assessment. It defines coordination as the ability to execute smooth, accurate movements through integration of the motor, cerebellar, vestibular and sensory systems. Coordination involves appropriate speed, direction, muscle tension and synergist influences. Coordination deficits are often related to conditions involving the cerebellum, basal ganglia or dorsal columns. Common tests of coordination include finger-to-nose, heel-to-knee, rapid alternating movements and Romberg's test. Treatment focuses on techniques like PNF, balance exercises, and Frenkel's exercises to improve coordination.
Muscle energy techniques (MET) involve voluntary muscle contractions by the patient against a counterforce applied by the practitioner. The goal is to move restrictive barriers and normalize muscle and fascial restrictions. Key elements include controlled joint positioning, patient-applied muscle contractions in a specific direction, and operator counterforce. MET can be used to lengthen shortened muscles, strengthen weakened muscles, reduce pain and edema, and increase joint mobility. It relies on principles like post-isometric relaxation and reciprocal inhibition. Careful technique and patient/practitioner coordination are important for success. MET can help many somatic dysfunctions but requires an understanding of indications and contraindications.
Spinal cord injuries can be either traumatic, from events like car accidents or falls, or non-traumatic, from conditions that damage the spinal cord. They are classified as either tetraplegia or paraplegia depending on whether the arms or legs are affected. Physiotherapy focuses on managing symptoms, preventing complications, and improving function through exercises for mobility, transfers, wheelchair skills, and more. The goal is to maximize independence and allow patients to safely perform daily living activities. Prognosis depends on the completeness of the injury and potential for recovery decreases over time as improvement plateaus.
This document outlines the components of performing a coordination examination, including the purposes, relevant anatomy, testing protocols, and specific tests. It discusses testing coordination through non-equilibrium tests done in sitting and equilibrium tests of balance done standing. Tests examine abilities like finger-to-nose coordination, rapid alternating movements, and balance on one leg. Performance is graded on a scale of 1 to 5. Select tests are highlighted as useful for evaluating particular coordination impairments involving tremors, dysmetria, or other issues.
This document provides an overview of assessments used in physiotherapy for patients with spinal cord injuries. It lists the key areas that should be assessed, including pain, range of motion, muscle performance, reflexes, aerobic capacity, cognition, gait, motor function, self-care, ventilation, integument, and community reintegration. For each area, it identifies specific assessment tools and how they are administered to evaluate patients and monitor treatment progress. The goal is to thoroughly examine patients with spinal cord injuries across various physical, neurological, and functional domains.
Voluntary Control and Assessment Physiotherapy Perspective.pptxSusan Jose
This document discusses voluntary control of movements and assessment methods. Voluntary control is the ability to produce and control movements volitionally and adapt to tasks and the environment. Normal synergy involves linked muscles acting cooperatively, while abnormal synergy is stereotypical and non-adaptable. Assessment can be qualitative using grading scales or quantitative using tools like the Fugl-Meyer Assessment which evaluates motor function, sensation, balance, and range of motion. The Trunk Impairment Scale assesses trunk control in sitting and coordination. Good assessment informs effective treatment.
The document discusses postural control and balance, defining it as the ability to control body position in space. It describes static and dynamic postural control, and notes an intervention program should be based on an accurate evaluation. The summary provides exercises to improve postural alignment, control of movement, adaptation to tasks/environments, and fall prevention. A balance training program incorporates steady state, anticipatory and reactive exercises focusing on static and dynamic postural control.
The document provides an overview of coordination and its assessment. It defines coordination as the ability to execute smooth, accurate movements through integration of the motor, cerebellar, vestibular and sensory systems. Coordination involves appropriate speed, direction, muscle tension and synergist influences. Coordination deficits are often related to conditions involving the cerebellum, basal ganglia or dorsal columns. Common tests of coordination include finger-to-nose, heel-to-knee, rapid alternating movements and Romberg's test. Treatment focuses on techniques like PNF, balance exercises, and Frenkel's exercises to improve coordination.
Muscle energy techniques (MET) involve voluntary muscle contractions by the patient against a counterforce applied by the practitioner. The goal is to move restrictive barriers and normalize muscle and fascial restrictions. Key elements include controlled joint positioning, patient-applied muscle contractions in a specific direction, and operator counterforce. MET can be used to lengthen shortened muscles, strengthen weakened muscles, reduce pain and edema, and increase joint mobility. It relies on principles like post-isometric relaxation and reciprocal inhibition. Careful technique and patient/practitioner coordination are important for success. MET can help many somatic dysfunctions but requires an understanding of indications and contraindications.
Spinal cord injuries can be either traumatic, from events like car accidents or falls, or non-traumatic, from conditions that damage the spinal cord. They are classified as either tetraplegia or paraplegia depending on whether the arms or legs are affected. Physiotherapy focuses on managing symptoms, preventing complications, and improving function through exercises for mobility, transfers, wheelchair skills, and more. The goal is to maximize independence and allow patients to safely perform daily living activities. Prognosis depends on the completeness of the injury and potential for recovery decreases over time as improvement plateaus.
This document outlines the components of performing a coordination examination, including the purposes, relevant anatomy, testing protocols, and specific tests. It discusses testing coordination through non-equilibrium tests done in sitting and equilibrium tests of balance done standing. Tests examine abilities like finger-to-nose coordination, rapid alternating movements, and balance on one leg. Performance is graded on a scale of 1 to 5. Select tests are highlighted as useful for evaluating particular coordination impairments involving tremors, dysmetria, or other issues.
This document provides an overview of assessments used in physiotherapy for patients with spinal cord injuries. It lists the key areas that should be assessed, including pain, range of motion, muscle performance, reflexes, aerobic capacity, cognition, gait, motor function, self-care, ventilation, integument, and community reintegration. For each area, it identifies specific assessment tools and how they are administered to evaluate patients and monitor treatment progress. The goal is to thoroughly examine patients with spinal cord injuries across various physical, neurological, and functional domains.
Voluntary Control and Assessment Physiotherapy Perspective.pptxSusan Jose
This document discusses voluntary control of movements and assessment methods. Voluntary control is the ability to produce and control movements volitionally and adapt to tasks and the environment. Normal synergy involves linked muscles acting cooperatively, while abnormal synergy is stereotypical and non-adaptable. Assessment can be qualitative using grading scales or quantitative using tools like the Fugl-Meyer Assessment which evaluates motor function, sensation, balance, and range of motion. The Trunk Impairment Scale assesses trunk control in sitting and coordination. Good assessment informs effective treatment.
The document discusses postural control and balance, defining it as the ability to control body position in space. It describes static and dynamic postural control, and notes an intervention program should be based on an accurate evaluation. The summary provides exercises to improve postural alignment, control of movement, adaptation to tasks/environments, and fall prevention. A balance training program incorporates steady state, anticipatory and reactive exercises focusing on static and dynamic postural control.
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
The document describes the Motor Re-Learning Program (MRP), an approach to improving motor control after stroke. The MRP focuses on relearning daily activities through task-oriented practice and is based on theories of distributed motor control. The summary is:
1. The MRP involves analyzing tasks, practicing missing components, practicing whole tasks, and transferring learning to other contexts.
2. Intervention follows four steps - analyzing the task, practicing missing components, practicing the whole task, and transferring learning.
3. The program evaluates and improves functions like upper limb use, sitting, and walking through identifying normal movement and compensatory strategies.
The document provides information on performing a sensory examination, including testing superficial sensations like pain, temperature, and touch. It also describes evaluating deep sensations such as proprioception, vibration, and kinesthesia. Finally, it discusses assessing combined cortical sensations including stereognosis, graphesthesia, and two-point discrimination. The examination involves testing various areas of the body using specific tools and techniques, and having the patient respond verbally or by physical demonstration to identify sensations.
This presentation will give an basic insights about the spinal mobilisation and various manual therapy techniques used on Lumbar spine especially Maitland & Mulligan techniques.
Physiotherapy management of Multiple sclerosisKeerthi Priya
This document provides an overview of the physical therapy management of multiple sclerosis. It discusses assessing patients through examinations of vital signs, cognition, sensation, motor function, posture, balance, gait, locomotion, aerobic capacity, and functional independence. Short term goals include minimizing progression, preventing complications, and maintaining respiratory and functional abilities while long term goals focus on decreasing spasticity and improving strength, range of motion, balance, and activities of daily living. Management techniques for weaknesses, spasticity, ataxia, fatigue, locomotion, and swallowing are outlined, including exercises, stretches, electrical stimulation, and energy conservation methods.
The document provides an overview of the McKenzie method for assessing and treating musculoskeletal pain. It describes the key concepts of centralization and peripheralization and how patients' pain responses to specific movements can help classify their condition as a postural syndrome, dysfunction syndrome, or derangement syndrome. Treatment generally involves repeated movements and positioning to encourage centralization of pain. Precautions are taken to avoid worsening a patient's pain. The McKenzie method examines both spinal and extremity issues through detailed mechanical diagnosis and management.
The document provides information on functional re-education exercises that progress a patient from lying down positions to standing and walking. It begins with exercises in supine positions like bridging and progresses to side lying, prone, quadruped, sitting and eventually standing and walking. Each position includes descriptions of how to achieve it, example exercises to improve strength, coordination and proprioception, and the functional goals of that position. The overall goal of the functional re-education program is to make the patient independent through systematic strengthening and training of positions and movements.
This document provides information on myofascial release (MFR). It discusses the history and concept of MFR, describing it as a technique that addresses tightness and restrictions in the fascia through the application of gentle, sustained pressure. The document outlines the layers and components of fascia, and how MFR is believed to work by converting restricted fascia back to a more gel-like state, allowing collagen and elastin fibers to rearrange and adhesions to release. MFR aims to restore normal play and function to the myofascial system.
Co-ordination Exercise,Definitions,Nervous control,Motor pathway,Cerebral cortex,Kinesthetic sensation,Causes of Incoordination,Flaccidity
Spasticity ,Cerebellar ataxia,Loss of kinesthetic sensation,Types of coordination,Posterior column,Test for Incoordination.
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
Balance is the ability to control body position to maintain upright posture. It involves integration of sensory inputs and motor outputs. Balance training progresses from simple to complex tasks in positions like lying, sitting, kneeling, and standing static and dynamic exercises before walking, stairs, and community tasks. Assessment evaluates vision, sensation, vestibular function, range of motion, strength, and limits of stability. Treatment addresses sensory, strategy, musculoskeletal, and environmental factors through exercises, modifications, and assistive devices.
This document discusses fatigue, including its definition, types, causes, symptoms, and assessment. It defines fatigue as tiredness or diminished energy that interferes with normal activities. Fatigue can be acute or chronic, and local or general. Common causes include lack of sleep, stress, illness, and advancing age. Symptoms include forgetfulness and lack of interest. Assessment involves history, physical exam, and potentially blood tests and imaging. Tests evaluate things like anaerobic capacity, aerobic capacity, and muscle strength and fatigue. Questionnaires can also assess fatigue severity.
This document provides information on preoperative and postoperative physiotherapy assessment for pulmonary surgery patients. The preoperative assessment involves collecting subjective and objective information on the patient's medical history and functional status to create a treatment plan and reduce complications. The postoperative assessment examines the surgery details and any complications while monitoring pain, breathing, circulation, mobility and other factors to aid the patient's recovery. Physiotherapy focuses on regaining strength, mobility and functional independence through techniques like breathing exercises and range of motion.
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Introduction to muscle energy techniques (METs)Fared Alkordi
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
This scale is used to categrise spinal cord injury patients. it helps prognosticate the spinal cord injuires. it also helps define the treatment protocols for spinal cord injury patients. American Spinal Cord Injury Association made this scale so as to make a standardization in assesemnent technique in acute spinal cord injury patients.
Kinesio tape was developed in the 1970s by a Japanese chiropractor and aims to enhance sports performance and treat orthopedic and neurological conditions. It is applied to the skin over muscles and joints to provide support without restricting range of motion while stimulating the sensory motor system to increase blood flow and facilitate or inhibit muscle contraction depending on the taping technique used. Studies have shown Kinesio taping can provide pain relief and faster recovery for various injuries like groin pain, back pain, and ankle sprains when applied by a certified physiotherapist.
Muscle re-education aims to regain normal muscle function through therapeutic techniques. It involves developing motor awareness, voluntary control, strength, endurance and safe, acceptable movement patterns. Key techniques to activate denervated or weak muscles include passive motion, cutaneous stimulation, electrical stimulation and EMG biofeedback. A thorough patient evaluation is required to determine the appropriate re-education program based on factors like joint mobility, alignment and available motor and sensory pathways.
The document describes how to plan and implement an objective structured clinical examination (OSCE) for assessing pediatric nursing students. It discusses:
- The OSCE model based on Miller's hierarchy of clinical competence using simulated practice.
- Skills that can be assessed including clinical skills, decision making, communication, and time management.
- Locations for the OSCE including clinical areas with real patients or simulated labs.
- Steps for planning including time allotted, staffing needs, station types and content, and evaluation criteria.
- Types of stations such as manned stations where students perform skills and unmanned stations involving cases, images, and written responses.
- Examples of station content covering various pediatric topics, skills
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
The document describes the Motor Re-Learning Program (MRP), an approach to improving motor control after stroke. The MRP focuses on relearning daily activities through task-oriented practice and is based on theories of distributed motor control. The summary is:
1. The MRP involves analyzing tasks, practicing missing components, practicing whole tasks, and transferring learning to other contexts.
2. Intervention follows four steps - analyzing the task, practicing missing components, practicing the whole task, and transferring learning.
3. The program evaluates and improves functions like upper limb use, sitting, and walking through identifying normal movement and compensatory strategies.
The document provides information on performing a sensory examination, including testing superficial sensations like pain, temperature, and touch. It also describes evaluating deep sensations such as proprioception, vibration, and kinesthesia. Finally, it discusses assessing combined cortical sensations including stereognosis, graphesthesia, and two-point discrimination. The examination involves testing various areas of the body using specific tools and techniques, and having the patient respond verbally or by physical demonstration to identify sensations.
This presentation will give an basic insights about the spinal mobilisation and various manual therapy techniques used on Lumbar spine especially Maitland & Mulligan techniques.
Physiotherapy management of Multiple sclerosisKeerthi Priya
This document provides an overview of the physical therapy management of multiple sclerosis. It discusses assessing patients through examinations of vital signs, cognition, sensation, motor function, posture, balance, gait, locomotion, aerobic capacity, and functional independence. Short term goals include minimizing progression, preventing complications, and maintaining respiratory and functional abilities while long term goals focus on decreasing spasticity and improving strength, range of motion, balance, and activities of daily living. Management techniques for weaknesses, spasticity, ataxia, fatigue, locomotion, and swallowing are outlined, including exercises, stretches, electrical stimulation, and energy conservation methods.
The document provides an overview of the McKenzie method for assessing and treating musculoskeletal pain. It describes the key concepts of centralization and peripheralization and how patients' pain responses to specific movements can help classify their condition as a postural syndrome, dysfunction syndrome, or derangement syndrome. Treatment generally involves repeated movements and positioning to encourage centralization of pain. Precautions are taken to avoid worsening a patient's pain. The McKenzie method examines both spinal and extremity issues through detailed mechanical diagnosis and management.
The document provides information on functional re-education exercises that progress a patient from lying down positions to standing and walking. It begins with exercises in supine positions like bridging and progresses to side lying, prone, quadruped, sitting and eventually standing and walking. Each position includes descriptions of how to achieve it, example exercises to improve strength, coordination and proprioception, and the functional goals of that position. The overall goal of the functional re-education program is to make the patient independent through systematic strengthening and training of positions and movements.
This document provides information on myofascial release (MFR). It discusses the history and concept of MFR, describing it as a technique that addresses tightness and restrictions in the fascia through the application of gentle, sustained pressure. The document outlines the layers and components of fascia, and how MFR is believed to work by converting restricted fascia back to a more gel-like state, allowing collagen and elastin fibers to rearrange and adhesions to release. MFR aims to restore normal play and function to the myofascial system.
Co-ordination Exercise,Definitions,Nervous control,Motor pathway,Cerebral cortex,Kinesthetic sensation,Causes of Incoordination,Flaccidity
Spasticity ,Cerebellar ataxia,Loss of kinesthetic sensation,Types of coordination,Posterior column,Test for Incoordination.
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
Balance is the ability to control body position to maintain upright posture. It involves integration of sensory inputs and motor outputs. Balance training progresses from simple to complex tasks in positions like lying, sitting, kneeling, and standing static and dynamic exercises before walking, stairs, and community tasks. Assessment evaluates vision, sensation, vestibular function, range of motion, strength, and limits of stability. Treatment addresses sensory, strategy, musculoskeletal, and environmental factors through exercises, modifications, and assistive devices.
This document discusses fatigue, including its definition, types, causes, symptoms, and assessment. It defines fatigue as tiredness or diminished energy that interferes with normal activities. Fatigue can be acute or chronic, and local or general. Common causes include lack of sleep, stress, illness, and advancing age. Symptoms include forgetfulness and lack of interest. Assessment involves history, physical exam, and potentially blood tests and imaging. Tests evaluate things like anaerobic capacity, aerobic capacity, and muscle strength and fatigue. Questionnaires can also assess fatigue severity.
This document provides information on preoperative and postoperative physiotherapy assessment for pulmonary surgery patients. The preoperative assessment involves collecting subjective and objective information on the patient's medical history and functional status to create a treatment plan and reduce complications. The postoperative assessment examines the surgery details and any complications while monitoring pain, breathing, circulation, mobility and other factors to aid the patient's recovery. Physiotherapy focuses on regaining strength, mobility and functional independence through techniques like breathing exercises and range of motion.
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Introduction to muscle energy techniques (METs)Fared Alkordi
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
This scale is used to categrise spinal cord injury patients. it helps prognosticate the spinal cord injuires. it also helps define the treatment protocols for spinal cord injury patients. American Spinal Cord Injury Association made this scale so as to make a standardization in assesemnent technique in acute spinal cord injury patients.
Kinesio tape was developed in the 1970s by a Japanese chiropractor and aims to enhance sports performance and treat orthopedic and neurological conditions. It is applied to the skin over muscles and joints to provide support without restricting range of motion while stimulating the sensory motor system to increase blood flow and facilitate or inhibit muscle contraction depending on the taping technique used. Studies have shown Kinesio taping can provide pain relief and faster recovery for various injuries like groin pain, back pain, and ankle sprains when applied by a certified physiotherapist.
Muscle re-education aims to regain normal muscle function through therapeutic techniques. It involves developing motor awareness, voluntary control, strength, endurance and safe, acceptable movement patterns. Key techniques to activate denervated or weak muscles include passive motion, cutaneous stimulation, electrical stimulation and EMG biofeedback. A thorough patient evaluation is required to determine the appropriate re-education program based on factors like joint mobility, alignment and available motor and sensory pathways.
The document describes how to plan and implement an objective structured clinical examination (OSCE) for assessing pediatric nursing students. It discusses:
- The OSCE model based on Miller's hierarchy of clinical competence using simulated practice.
- Skills that can be assessed including clinical skills, decision making, communication, and time management.
- Locations for the OSCE including clinical areas with real patients or simulated labs.
- Steps for planning including time allotted, staffing needs, station types and content, and evaluation criteria.
- Types of stations such as manned stations where students perform skills and unmanned stations involving cases, images, and written responses.
- Examples of station content covering various pediatric topics, skills
This document provides guidelines for assessing limb muscle strength in critically ill patients using the Medical Research Council (MRC) Scale. It describes evaluating a patient's level of cooperation, assessing muscle strength on a 0-5 scale against gravity for each major muscle group, and calculating a total MRC sum score. Proper patient positioning, standardized testing procedures, encouragement, and accounting for delays in muscle contraction are emphasized to obtain accurate strength measurements.
1. Spinal cord injuries have an annual incidence of 15-40 cases per million people, with motor vehicle accidents and falls being the most common causes.
2. The American Spinal Injury Association (ASIA) impairment scale is the most widely used classification system for spinal cord injuries, grading injuries as complete or incomplete.
3. Common spinal cord syndromes include anterior cord syndrome (involving motor and pain pathways), posterior cord syndrome (involving proprioception and touch), and Brown-Sequard syndrome (unilateral involvement of pathways on one side of the spinal cord).
functional scales for balance 3rd year bpth .pptxARWASINNAR
The document provides information on several functional assessment scales used in rehabilitation including the Berg Balance Scale, Barthel Index, Glasgow Coma Scale, Modified Ashworth Scale, and Mini Mental State Examination. It describes the objectives, components, scoring, interpretation, uses, and limitations of each scale to evaluate balance, activities of daily living, level of consciousness, spasticity, and cognitive function respectively.
The document discusses frontal subcortical circuits and their assessment. It describes the five main frontal-subcortical circuits, including the motor circuit, oculomotor circuit, dorsolateral prefrontal circuit, anterior cingulate circuit, and orbitofrontal circuit. It then examines each circuit in more detail, outlining their anatomical components and behavioral syndromes associated with dysfunction. A number of bedside assessment tests are also presented to help evaluate specific circuits.
Thank you for the summary. I don't have any additional questions. The summary effectively captured the key points about spinal cord injuries, assessment, and management.
Spinal injuries commonly occur in motor vehicle crashes, falls, and sports. Proper assessment and management is important to prevent permanent paralysis from secondary injury to the spinal cord. A full neurological exam assesses mental status, motor function, sensation, and reflexes. Secondary injuries from hypotension and hypoxia can be prevented by maintaining adequate oxygenation, circulation, and minimizing time on scene during transport to a suitable hospital.
Lecture 11 Neurologic system disorders.pptxMesfinShifara
The document provides information on assessing neurologic system disorders including:
1) It describes the anatomy and physiology of the nervous system and its role in controlling body functions.
2) It outlines the elements of a neurologic examination including tests of mental status, cranial nerves, sensory function, motor skills, and gait.
3) Several common diagnostic methods for neurologic disorders are discussed such as CT scans, MRI, EEG, and lumbar puncture.
This document provides a literature review of neuropsychological and neurocognitive tests used to detect post-concussive abnormalities following a concussion. It discusses common concussion symptoms and sideline assessment tools like the Standardized Assessment of Concussion and Balance Error Scoring System. Popular testing methods reviewed include ImPACT, which assesses cognition, and the Concussion Resolution Index, a computerized neuropsychological test. Return-to-play guidelines are also investigated to help determine when an athlete can safely return to competition following a concussion.
This document provides guidance on assessing patients with spinal cord injuries. It outlines how to take a thorough history including injury details, symptoms, and rehabilitation. The assessment involves observing the patient, palpating for issues like edema, and examining motor function, sensation, reflexes, and functional abilities. Common scales for assessing spinal cord injuries are described, including the ISNCSCI for determining neurological level and the ASIA Impairment Scale for classifying injury severity. The SCIM is also summarized as a measure of independence in self-care, respiration/sphincter control, and mobility.
Rivermead Assessment of Somatosensory Performancestanbridge
The Rivermead Assessment of Somatosensory Performance (RASP) is a standardized test used to assess somatosensory functioning through 7 subtests involving discrimination of sensations like touch, pressure, temperature, and proprioception. It is comprised of standardized instruments that comprehensively measure somatosensory functions across 10 body areas. The RASP provides reliable and quantifiable data to inform rehabilitation for patients with somatosensory impairments from conditions like stroke, MS, or head injuries.
This document outlines a skills lab for physiotherapy students on neurological rehabilitation. It includes:
- An agenda with times for welcoming, preparation, demonstration, and goodbye.
- Details and goals for 4 case studies to be demonstrated - on gait rehabilitation, home safety/ADLs, transfer training, and balance training.
- Feedback forms addressing therapeutic alliance, movement analysis, environment, and more.
- Evaluation criteria for age-specific balance tests.
- Instructions for how students can prepare for the exam, including accessing case details and evaluation materials.
This document provides an overview of concussion including:
- Definitions of concussion and its symptoms and signs in the acute phase.
- Risk factors, assessment tools like SCAT3, and typical findings.
- Management including return to play guidelines in a 5-step progression and treatment of post-concussion syndrome.
- Rare and serious conditions like second impact syndrome and chronic traumatic encephalopathy are also discussed.
Concussion Inservice - Oct. 2015 Final Copy Zachary Lynch
This document provides an overview of concussions, including their pathophysiology, symptoms, assessment tools, management, and risk reduction. It discusses that concussions are classified as mild traumatic brain injuries that result in functional changes rather than structural damage. While often considered mild, they still affect over 1 million people in the US each year. Proper evaluation involves assessing symptoms, cognitive functioning, and exertion during recovery to ensure full resolution before allowing a gradual return to play through stages to avoid reinjury. Strict protocols are necessary to prevent further injury like second impact syndrome.
The document discusses the effectiveness of electromyography-triggered neuromuscular electrical stimulation (EMG-triggered NMES) for stroke rehabilitation. It summarizes several peer-reviewed studies that found EMG-triggered NMES improved motor function and capabilities for individuals more than 1 year post-stroke. The studies showed EMG-triggered NMES was more effective than regular therapy or electrical stimulation alone and improved strength, range of motion, flexibility and motor skills. The document also provides specifications and safety information for a NeuroMove device that provides EMG-triggered NMES therapy.
The document discusses the effectiveness of electromyography-triggered neuromuscular electrical stimulation (EMG-triggered NMES) for stroke rehabilitation. It summarizes several peer-reviewed studies that found EMG-triggered NMES improved motor function and capabilities for individuals more than 1 year post-stroke. The studies showed EMG-triggered NMES was more effective than regular therapy or electrical stimulation alone and improved strength, range of motion, flexibility and motor skills. The document also provides specifications and safety information for a NeuroMove device that provides EMG-triggered NMES therapy.
The document discusses the effectiveness of electromyography-triggered neuromuscular electrical stimulation (EMG-triggered NMES) for stroke rehabilitation. It summarizes several peer-reviewed studies that found EMG-triggered NMES improved motor function and capabilities for individuals more than 1 year post-stroke. The studies showed EMG-triggered NMES was more effective than regular therapy or electrical stimulation alone and improved strength, range of motion, flexibility and motor skills. The document also provides specifications and safety information for a NeuroMove device that provides EMG-triggered NMES therapy.
Similar to Assessment of Spinal cord injury.pptx (20)
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
2. OBJECTIVES
At the end of lecture student should be able to assess a spinal cord injury patient under
following headings
Incidence
Patient Assessment
Relevant History
Physical examination
Neurological examination
Muscle Performance
Pain
Range of motion
Reflexes
Aerobic capacity / Endurance
Arousal, Attention and cognition
Gait, Locomotion and balance
Motor Function
Self care and Home Management
Ventilation and Integument
3. INCIDENCE:
• Approximately 55% of spinal injuries occur in
the cervical region
• 15% in the thoracic region
• 15% at the thoracolumbar junction
• and 15% in the lumbosacral area.
Approximately 10% of patients with a cervical
spine fracture have a second, noncontiguous
vertebral column fracture
4. INCIDENCE Contd:
•Approximately one-third of patients with upper
cervical spine injuries die at the injury scene
from apnea caused by loss of central innervation
of the phrenic nerves caused by spinal cord
injury at C1.
•When a fracture-dislocation in the thoracic spine
does occur, it almost always results in a complete
spinal cord injury because of the relatively
narrow thoracic canal.
5. Patient Assessment
•The spine should initially be immobilized on
the assumption that every trauma patient
has a spinal injury until proven otherwise.
•In unconcious patient, definitive clearance
of the spine may not be possible in the
initial stages and spinal immobliziation
should be maintained, until MRI or
equivalent can be used to rule out unstable
spinal injury.
6. Patient Assessment
•Patients who have no findings on
examination, demonstrate no decreased
level of consciousness, and have no
distracting injuries can undergo clearance of
the spine by clinical means alone.
•Although plain radiographs of the spine are
acceptable, the high-quality images and rapid
availability associated with CT have made this
the modality of choice in most emergency
departments.
7. Relevant history
•The mechanism and velocity of injury
•Presence of spinal pain
•Onset of neurological symptoms
•Duration of neurological symptoms
8. PHYSICAL EXAMINATION
• Initial Assessment
The primary survey followed by carefull systems examination.
• Identification of shock
Three categories of shock may occur in spinal trauma:
1.Hypovolaemic shock
2.Neurogenic shock
3.Spinal shock
• Spinal Examination:
The entire spine must be palpated and the overlying skin is inspected
and formal log roll should be performed to achievethis.
9. PHYSICAL EXAMINATION Contd.
Neurogenic shock results from impairment of the descending sympathetic
pathways in the cervical or upper thoracic spinal cord. This condition
results in the loss of vasomotor tone and in sympathetic innervation to
the heart.
Neurogenic shock loss of symapathetic
innervation
of heart
Loss of vasomotor tone
Vasodilatation of blood vessels
Hypotension Bradycardia or
Normal heart rate
Beacause of cervical cord injury above the level of sympathetic outflow
(C7/T1)
Warm Peripheries
10. PHYSICAL EXAMINATION contd.
The classic presentation of neurogenic
shock is hypotension in the
setting of warm well perfused extremities in
the paralyzed patient
Spinal shock. There is initial loss of all neurological
function below the level of the injury
Paralysis
Hypotonia Areflexia
Usually lasts 24 hours following spinal cord injury.
Once it has resolved the bulbocavernosus reflex
returns.
11. NEUROLOGICALEXAMINATION
• The American Spinal Injury Association (ASIA) neurological
evaluation system is an internationally accepted method of
neurological evaluation.
• This is a system of tests used to define and describe:
• Extent
• Severity
• Future Rehabilitation
• Recovery needs
15. THE ASIA/ISCoS EXAM
Steps in Classification
1.Determine sensory levels of injury for right and left side
2.Determine motor levels of injury for right and left side.
3.Determine neurological level of injury.
4.Determine whether the injury is Complete or Incomplete.
5.Determine Asia Impairment Scale (AIS) Grade:
16. THE ASIA/ISCoS EXAM
Level of Neurological Impairment
The ASIA neurological impairment scale is based on the Frankel
classification of Spinal Cord Injury
• A- Complete
• B- Sensation present, Motor absent
• C- Sensation present, Motor present but not useful
(MRC grade <3/5)
• D- Sensation present, Motor useful (MRC grade <3/5)
• E- Normal Function
19. • The sensory levels are scored on a 0 to 2 scale for
each dermatome.
• If body is divided into two identical halves there are
28 key sensory points to be tested.
• Each dermatome is tested for light touch and pinprick
sensations and labeled as NT (not testable) if cannot
be tested.
32. Unless specified, each question should only be asked once
Name and Address for subsequent recall test
1. “I am going to give you a name and address. After I have said it, I want you to repeat it.
Remember this name and address because I am going to ask you to tell it to me again in a
few minutes: John Brown, 42 West Street, Kensington.” (Allow a maximum of 4 attempts).
Time Orientation Correct
Incorrect
2. What is the date? (exact only)
33. GPCOG SCREENING TEST contd.
Clock Drawing – use blank page Correct
Incorrect
3. Please mark in all the numbers to indicate
the hours of a clock (correct spacing required)
4. Please mark in hands to show 10 minutes past
eleven o’clock (11.10)
Information
5. Can you tell me something that happened
in the news recently?
(Recently = in the last week. If a general answer is given,
eg “war”, “lot of rain”, ask for details. Only specific answer scores).
34. GPCOG SCREENING TEST contd.
Recall
6. What was the name and address I asked you to remember
John
Brown
42
West (St)
Kensington
(To get a total score, add the number of items answered correctly)
Total correct (score out of 9)
If patient scores 9, no significant cognitive impairment
and further testing not necessary.
If patient scores 5-8, more information required. Proceed
with Step 2, informant section.
If patient scores 0-4, cognitive impairment is indicated.
Conduct standard investigations.
35. MEMORY IMPAIRMENT SCREEN
Instructions for Administration
1. Show patient a sheet of paper with the 4 items to be recalled in 24-point
or greater uppercase letters (on other side), and ask patient to read the
items aloud.
2. Tell patient that each item belongs to a different category. Give a
category cue and ask patient to indicate which of the words belongs in the
stated category (eg, “Which one is the game?”). Allow up to 5 attempts.
Failure to complete this task indicates possible cognitive impairment.
3. When patient identifies all 4 words, remove the sheet of paper. Tell
patient that he or she will be asked to remember the words in a few
minutes.
4. Engage patient in distractor activity for 2 to 3 minutes, such as counting
to 20 and back, counting back from 100 by 7, spelling WORLD backwards.
5. FREE RECALL — 2 points per word: Ask patient to state as many of the 4
words he or she can recall. Allow at least 5 seconds per item for free recall.
Continue to step 6 if no more words have been recalled for 10 seconds.
6. CUED RECALL — 1 point per word: Read the appropriate category cue for
each word not recalled during free recall (eg, “What was the game?”).
36. MEMORY IMPAIRMENT SCREEN contd.
Word Cue Free Recall (2
points)
Cued Recall (1
point)
Checkers Game
Saucer Dish
Telegram Message
Red Cross Organization
SCORING
The maximum score for the MIS is 8.
• 5-8 No cognitive impairment
• ≤ 4 Possible cognitive impairment
37. ENVIROMNETAL OR WORK BARRIERS
GAIT, LOCOMOTION AND BALANCE
• Wheelchair Skill test
• Modified functional Reach test
• Berg Balance scale
• Walking index for spinal cord injury
• Spinal Cord injury Functional ambulation Inventory
• 6 min walk test
• Neuromuscular Recovery scale
38. WHEELCHAIR SKILL TEST
The wheelchair is among the most important therapeutic
devices used in rehabilitation.
WST is practical, safe, well tolerated by wheelchair users, has
good reliability and validity, and is useful to clinicians.
This scale includes 32 items, adminster time is 30 minutes.
Score Score What this means
Pass 2 Task independently and safely accomplished without
any difficulty.
Pass with difficulty 1 The evaluation criteria are met, but the subject
experienced some difficulty worthy of note.
Fail 0 Task incomplete or unsafe
Not possible NP My wheelchair does not allow this skill. (Only for skills
where a NP score is noted as a possibility in the script.)
Testing error TE Testing of the skill was not sufficiently well observed to
provide a score
39.
40. BERG BALANCE SCALE
• The Berg balance scale is used to objectively determine a patient's ability (or
inability) to safely balance during a series of predetermined tasks.
• It is a 14 item list with each item consisting of a five-point ordinal scale ranging
from 0 to 4, with 0 indicating the lowest level of function and 4 the highest level
of function and takes approximately 20 minutes to complete.
• It does not include the assessment of gait.
• Scoring: A five-point ordinal scale, ranging from 0-4. “0” indicates the lowest
level of function and “4” the
• highest level of function. Score the LOWEST performance. Total Score = 56
• Interpretation: 41-56 = independent
• 21-40 = walking with assistance
• 0 –20 = wheelchair bound
41.
42. WALKING INDEX FOR SPINAL CORD INJURY
The WISCI/WISCI II scale was developed as a research tool in clinical trials
to measure improvements in walking in persons with acute and chronic
spinal cord injury. It is not intended to be used in a clinical setting.
The development of this assessment index required a rank ordering along
a dimension of impairment, from the level of most severe impairment (0)
to least severe impairment (20) based on the use of devices, braces and
physical assistance of one or more persons. The order of the levels
suggests each successive level is a less impaired level than the former.
Physical assistance:
‘Physical assistance of two persons’ is moderate to maximum
assistance.
‘Physical assistance of one person’ is minimal to moderate assistance.
‘Contact guarding’ is minimal assistance
Braces: ‘Braces’ means one or two braces, either short or long leg.
(Splinting of lower extremities for standing is considered long leg
bracing).
‘No braces’ means no braces on either leg.
Walker: ‘Walker’ is a conventional rigid walker without wheels.
Crutches: ‘Crutches’ can be Lofstrand (Canadian) or axillary.
Cane: ‘Cane’ is a conventional straight cane.
43. Level Description
• 0 Unable to stand and/or participate in assisted walking.
• 1 Ambulates in parallel bars, with braces and physical assistance of two persons, but less than 10 meters.
• 2 Ambulates in parallel bars, with braces and physical assistance of two persons, 10 meters.
• 3 Ambulates in parallel bars, with braces and physical assistance of one person, 10 meters.
• 4 Ambulates in parallel bars, no braces and physical assistance of one person, 10 meters.
• 5 Ambulates in parallel bars, with no braces and no physical assistance, 10 meters.
• 6 Ambulates with walker, with braces and physical assistance of one person, 10 meters.
• 7 Ambulates with two crutches, with braces and physical assistance of one person, 10 meters.
• 8 Ambulates with walker, no braces and physical assistance of one person, 10 meters.
• 9 Ambulates with walker, with braces and no physical assistance, 10 meters.
• 10 Ambulates with one cane/crutch, with braces and physical assistance of one person, 10 meters.
• 11 Ambulates with two crutches, no braces and physical assistance of one person, 10 meters.
• 12 Ambulates with two crutches, with braces and no physical assistance, 10 meters.
• 13 Ambulates with walker, no braces and no physical assistance, 10 meters.
• 14 Ambulates with one cane/crutch, no braces and physical assistance of one person, 10 meters.
• 15 Ambulates with one cane/crutch, with braces and no physical assistance, 10 meters.
• 16 Ambulates with two crutches, no braces and no physical assistance, 10 meters.
• 17 Ambulates with no devices, no braces and physical assistance of one person, 10 meters.
• 18 Ambulates with no devices, with braces and no physical assistance, 10 meters.
• 19 Ambulates with one cane/crutch, no braces and no physical assistance, 10 meters.
• 20 Ambulates with no devices, no braces and no physical assistance, 10 meters.
44. SIX MINUTE WALK TEST
Clinician-administered may be performed either indoors or
outdoors, along a long, flat, straight, and hard surface.
6 minutes is required for the actual test 5-10 minutes is
required to set up and explain the test to the patient
the American Thoracic Society (ATS) recommends that the
walking course should be:
30 meters in length
marked at every 3 meters
marked with a cone at turn-around points
Scoring:
Total distance walked (rounding to the nearest meter) and the
number and duration of rests during the test is reported.
Physiological measures such as dyspnea and fatigue level can be
measured using the Borg Scale and pulse oximetry (baseline
heart rate and oxygen saturation) can also be recorded at the
beginning and end of the test
47. The Spinal Cord Injury Spasticity
Evaluation Tool:
The Spinal Cord Injury Spasticity Evaluation Tool (SCI-SET) is a self-report
questionnaire that assesses the impact of spasticity on daily life in people
with SCI. It requires participants to recall their past 7 days when rating
spasticity on a scale ranging from -3 (extremely problematic) to +3 (extremely
helpful).
Scoring: • Total score (-3 to +3) is generated by summing all the responses
from the applicable items then dividing the sum by the number of applicable
items
48. SELF CARE AND HOME MANAGEMENT
• Functional Independence Measure
• Spinal cord injury independence measure
• Quadriplegia Index of function
• Capabilities of upper extremity instrument
53. BRADEN SCALE SCORING:
Scoring: The Braden Scale is a summated rating
scale made up of six subscales scored from 1-3 or
4, for total scores that range from 6-23.
A lower Braden Scale Score indicates a lower level
of functioning and, therefore, a higher level of risk
for pressure ulcer development.
A score of 19 or higher, for instance, would indicate
that the patient is at low risk, with no need for
treatment at this time.
The assessment can also be used to evaluate the
course of a particular treatment.
54. WORK COMMUNITY AND LEISURE
INTEGRATION OR REINTEGRATION
• Craig Handicap Assessment and Reporting technique
• Assessment of life habits
• Reintegration to Normal living index
57. CASE 1
The presence of paraplegia or quadriplegia is
is presumptive evidence of spinal instability.
58. CASE 2
Patients who are awake, alert, sober, and neurologically normal, and
have no neck pain or midline tenderness, or a distracting injury.
Remove the c-collar and palpate the spine. If there is no significant
tenderness, ask the patient to voluntarily move his or her neck from
side to side then flex and extend
If no pain, c-spine films are not necessary.
59. CASE 3
Patients who are awake and alert, neurologically normal, cooperative, and do not
have a distracting injury and are able to concentrate on their spine, but do have
neck pain or midline tenderness
Where available, all such patients should undergo multi-detector axial CT from the
occiput to T1 with sagittal and coronal reconstructions.
Lateral, AP,and openmouth odontoid x-ray examinations of the c-spine
• If these films are normal, remove the c-collar.
• if any of these films are suspicious, obtain consultation from a spine specialist.
60. CASE 4
Patients who have an altered level of consciousness or are too young to
describe their symptoms
Where available, all such patients should undergo multi-detector axial CT
from the occiput to T1 with sagittal and coronal reconstructions.
Where not available, all such patients should undergo lateral, AP, and
open-mouth odontoid films with CT supplementation through suspicious
areas.
If the entire c-spine can be visualized and is found to be normal, the
collar can be removed after appropriate evaluation
61. CASE 5
When in doubt
leave the collar on.
•Backboards: Patients who have neurologic deficits (e.g.,
quadriplegia or paraplegia) should be evaluated quickly and
removed from the backboard as soon as possible. A paralyzed
patient who is allowed to lie on a hard board for more than 2
hours is at high risk for pressure ulcers.