Unit 2

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Author:
ANNichols
ID:
62512
Filename:
Unit 2
Updated:
2011-01-30 16:34:51
Tags:
Cognitive
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Description:
Principles of Rehab
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  1. Critical Development Period
    -4 months
    Midline development of the hands
  2. Critical Development Period
    -5 Months
    no head lag in in pull to sit or supported sit (pull to sit from supine)
  3. Critical Development Period
    -Six months
    Rolling, integration, of most primitive reflexes
  4. Normal Phases of Motor Development
    Infantile Phase (Cognitive)
    Birth to 3 months
    • -Flexed position w/ head up in prone 45 (1 month)
    • -Beginning head control in prone w/ forarm support (3 months)
    • -Visual and auditory tracking all directions (2-3 months)
    • -Pelvis flat on floor (2-3 months)
    • -Pulls to sit w/ beginning head control (2-3 months)
  5. Normal Phases of Motor Development
    Preparation Phase (Associative)
    4-6 Months
    • -Mobility, rolling (B) w/ weight shift through arms and legs (6 months)
    • -Sustained head control w/ hands to midline (4 months)
    • -Sits w/ support of arms or support at trunk (6 months)
    • -Feet to mouth when supine (5 months)
    • -Head control in prone w/ exteneded arm support (5 months)
    • -Pulls to sit w/ head control (5 months)
  6. Normal Phases of Motor Development
    Modification Phase (Associative)
    7 to 9 Months
    • -Transitional movements in ann dout of positions (9 months)
    • -Sits independently w/o arm support (7-8 months)
    • -Pulls to stand and cruises w/ aid (8-9 months)
    • -Quadruped crawl forward independently (9 months)
    • -Most primitive reflexes integrated (9 months)
  7. Normal Phases of Motor Development
    Refinement Phase (Refinement)
    10 to 12 Months
    • -Refinement and coordination of all skills (12 months)
    • -Increased speed and accuracy of all skills (12 months)
    • -Independent cruise and ambulation (12-15 months)
    • -Reciprocal four point crawl (12 months)
  8. Normal Phases of Motor Development
    Continued Refinement
    • -13 to 15 months = independent walking
    • -18 months = running and jumping
    • -24 months = independent use of stairs, walks w/ narrow base of support
  9. PT Eval process shold include info in the following 11 areas:
    • 1. History/observation
    • 2. Tone/strength
    • 3. AROM and PROM
    • 4. Alignment
    • 5. Reflexes
    • 6. Quality of movement
    • 7. Automic Reactions
    • 8. Functional skills
    • 9. Adaptive Equipment
    • 10. Communication skills
    • 11. Cognitive Abilities
  10. History/Observation
    • -Look for soft signs or red flags regarding the diagnosed problem or other problems
    • -Question the pt/family on activity level, pain level, etc.
  11. Tone/Strength
    • -What is the overall strength level scale 0-5
    • -What is the strength level of the involved body part on the same scale
    • -What is the overall tone like (hypertonic, hypotonic, fluctuating)
    • -Does the strength or tone problem affect function
  12. AROM and PROM
    • -What is the passive/active ROM
    • -Is it w/i functional limits or WNL
    • -Does it affect function
    • -If restricted, what restricts the motion (pain, tissue, bone, etc.?)
  13. Alignment
    • -Is the body aligned or held to one side, or rotated to one side
    • -Are the extremities symmetrical
    • -Is the head positioned in midline
  14. Reflexes
    • -Is there any evidence of primitive, patological or obligatory reflex patterns
    • -Do they interfere w/ function
    • -Are they age appropriate or not
  15. Quality of Movement
    • -How well can the pt. move in and out of different positions
    • -How are their motor planning skills can they transition smoothly
  16. Automic Reactions
    • -How well can the pt. catch themselves when their balance is challenged in all directions and positions
    • -Are the reactions present on both sides
    • -Are any reactions delayed
  17. Functional Skills
    • -What is the chronological age vs. the adjusted age vs. the developmental age
    • -What ADL's can the pt. perform or cannot perform
    • -What are the pt's overall functional skills
    • -How does this affect their abilities to function
  18. Adaptive Equipment
    • -What type of equipment does the pt. need to improve function
    • -Will the equipment help w/ mobility, stability, alignment, communication
    • -Assess the use of equpment and the need for revisions
    • -Ensure the equipment fits and is appropriate for the pt.
  19. Coummunication skills
    • -Can th ept. comprehend what you are telling them
    • -Can the pt express themselves and be understood
  20. Cognitive Abilities
    • -Can the pt. comprehend what you are asking and respons in a normal, socially acceptable manner
    • -This is the most important function for a pt. to have to enable a positive rehab outcome

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