neuro eval lecture 4.0

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shmvii
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170497
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neuro eval lecture 4.0
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2012-09-22 10:34:54
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neuro eval lecture
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neuro eval lecture 4.0
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  1. transfers def 
    a movement or series of movements organized to get from one position to another  (ROM, strenght, control, sensation, etc can limit these)
  2. 4 types of transfers
    • sit <---> sit
    • sit <---> stand
    • supine <---> sit
    • supine <---> sidelying
  3. steps  in sit ---> stand
    • ITs (ischial tuberosities) to edge of mat
    • trunk flexion -  "nose over toes" or even "face past toes"
    • knee flexion past 90 degrees - "feet under you and back"
    • ankle dorsiflexion past 90
    • forward/diagonal wt shift
    • extension of trunk, hips, knees, while ankles push towards plantarflexion - "straighten out yr hips + knees"
    • stabilize in standing
  4. stand ---> sit
    steps
    • reverse of sit ---> stand, an "unwinding"
    • stand by chair,
    • reach towards the ground,
    • bend knees and hips


    note - sometimes pt is too week for sit to stand, but the eccentrics of stand to sit are possible, so you'll have the pt practice this to build strength and gain familiarity w the proccess
  5. hands in sit <---> stand
     don't use if possible. If necessary, try to only use them for getting up, not down
  6. 4 ways to alter difficulty of sit <---> stand
    • use of hands,
    • height of seated surface,
    • stability of sitting surface
    • angle of sitting surface

    (cushy chairs that angle down in back make it hard for anyone to get up)
  7. 30 second sit to stand test -- the test and the basic scoring
    • hands free, do as many sit --> stands w/o assist in 30 sec
    • <8 reps correlates w high falls risk for community dwelling elderly and CVA
    • note - this test assesses for quantity, not quality
  8. 3 types of maneuvers in bed mobility
    • supine <---> sidelying
    • sidelying <---> prone
    • sidelying <---> sit
  9. 3 considerations for bed mobility
    • log vs segmental rolling
    • use of hands
    • initiate from...?

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