Deck 34: Functional Activity Intervention in Horizontal Bed Mobility to Quadruped Skills

Question 1

You are working with a 68 year-old patient who was admitted to the inpatient acute rehabilitation unit this afternoon;3 days post left middle cerebral artery (MCA) cerebrovascular accident (CVA).Which of the following abnormal movement characteristics would you MOST likely expect to see when the patient attempts a bridge?

A)Decreased lifting of the left pelvis and hip
B)Decreased lifting of the right pelvis and hip
C)Extension synergy pattern when picking up the left lower extremity
D)Bradykinesia when initiating movement

Answer 1

B

Question 2

A 91 year-old male recently suffered a hemorrhagic stroke and is admitted into a skilled nursing facility.Which of the following would improve the patient's ability to scoot over in bed?

A)Rhythmic stabilization in quadruped
B)Slow reversal hold in prone-on-elbows
C)Agonistic reversals in lower trunk rotation
D)Alternating isometrics in bridging

Answer 2

D

Question 3

You are working with a 16 year-old girl who recently suffered a traumatic brain injury during a motor vehicle accident.As a result of the brain injury she now presents with a left flaccid upper extremity,trunk,and lower extremity.She is unable to respond to commands and unable to move herself in bed.Which of the following would you consider appropriate supine positioning in bed?

A)Upper extremity draped across tummy
B)Support for extremities in non-abnormal synergistic patterns
C)Foot board placed at the foot of the bed
D)Abduction,external rotation of the hip,and ankle plantar flexion

Answer 3

B

Question 4

You are working with a 36 year-old schoolteacher who is referred to outpatient therapy due to a progressive cerebellar disease resulting in significant ataxia.She displays difficulty maintaining (holding) the quadruped position when transitioning from the floor to chair.Which of the following interventions would you employ FIRST to increase her stability in all fours?

A)Alternating isometrics with approximation
B)Alternating isometrics with traction
C)Rhythmic stabilization with a combination of traction and approximation
D)Simultaneously raising opposite arm and leg

Question 5

You are working with a 78 year-old patient who was admitted to the inpatient acute rehabilitation unit this afternoon;4 days post-right MCA CVA.The patient presents with impaired motor control of functional activities in horizontal.Which of the following would NOT be one of your initial safety considerations?

A)Contractures due to immobility
B)Risk for falling off the bed
C)Protection of boney prominences
D)Careful handling to prevent damage to joint.

Question 6

You are working with a 9 month-old infant with developmental delay.You are working on the transition from prone-on-elbows to prone-on-hands.Which of the following treatment strategies would be MOST helpful?

A)Playing "superman"
B)Increase prone "tummy time"
C)Following interesting toys overhead while prone over a bolster
D)Reaching for a toy in sidelying

Question 7

You are working with a 32 year-old female who was admitted to the inpatient acute rehabilitation unit today.She suffered a stroke while trail running 3 days ago.The patient demonstrates difficulty with rolling,bridging,and scooting in bed.Which of the following standardized tests and measures would you include in your patient exam because it will provide you with a baseline of her horizontal mobility function?

A)Berg Balance Scale
B)Passive range of motion
C)Functional Independence Measure
D)Modified Ashworth Scale

Question 8

To enhance appropriate interactions with family and friends,the family should be brought in early as members of the treatment team.Which of the following would NOT be appropriate family instruction:

A)Proper handling for extremities that cannot move on their own
B)How to appropriately assist with movements to encourage symmetry,control,and muscle activity
C)Proper positioning in supine and sidelying
D)Instruct the family to do everything for the patient to give them rest

Question 9

Agonistic reversals can be used in lower trunk rotation (LTR) to facilitate rolling.Which of the following provides a justification for this treatment intervention?

A)Strengthens LTR in both directions
B)Strengthens isometric,eccentric and concentric muscle contractions in one direction
C)The patient learns to move through progressively increasing increments of range until s/he gains control of the entire LTR range
D)Progresses patient from passive LTR to active assistive to active to resisted LTR

Question 10

When analyzing a functional task in horizontal,which of the following questions would NOT be important to initially take into consideration?

A)What is the patient able to do?
B)How does the patient do it?
C)Why does the patient do it that way?
D)How is the family able to assist?