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Flashcards in Rehabilitation in Neurology Deck (15)
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1
Q

definition of rehabilitation

A

Conceptual Definition:
A process of active change by which a person who has become disabled acquires the knowledge and skills needed for optimal physical, psychological and social function.

Service Definition:
The use of all means to minimise the impact of disabling conditions and to assist people with activity limitation to achieve their desired level of autonomy and participation in society.

2
Q

what is rehabilitation medicine?

A

The specialty of medicine involved with the prevention and reduction of activity limitation and participation arising from impairments, and the management of disability from a physical, psychosocial and vocational point of view.

3
Q

aims of rehabilitation?

A
Enabling and supporting you
Adjusting to your new situation
Achieving your best possible potential
Living life as fully and actively as possible
Becoming as independent as possible
4
Q

who might need rehabilitation?

A

Long Term Neurological
Conditions-Disease of, injury or damage to the nervous system which will affect the individual and their family in one way or another for the rest of their life

Sudden Onset Conditions
Acquired brain injury
Spinal cord injury
Stroke
Intermittent / Unpredictable
Epilepsy
Early multiple sclerosis (relapses and remissions)
Care needs change according to the nature of the illness
Static Conditions
Care needs changing according to person’s development and ageing
Post-polio syndrome
Cerebral palsy in adults
Spina bifida in adolescence/adults
Progressive Conditions
Motor Neurone Disease
Parkinson’s disease 
Progressive Multiple Sclerosis (primary or secondary)
5
Q

what are the classifications of acquired brain injury?

A
Head injury (traumatic brain injury)
Haemorrhagic (e.g. SAH)
Hypoxic / Anoxic (e.g. out of hospital cardiac arrest)
Metabolic (e.g. hypoglycaemic)
Infective (meningitis, encephalitis)
6
Q

what are the physical impairments form neurologival conditions?

A
Weakness (hemiparesis/paraparesis)
Loss of / abnormal sensation
Increased or decreased tone / spasticity
Autonomic dysfunction
Bladder instability
Bowel disturbance
Difficulty in bowel and bladder sensation and recognition
Swallowing and communication difficulties
Pain Syndrome
Somatic
Neuropathic
Seizures
Neuroendocrine disturbance
Physical fatigue
7
Q

cognitive impairments after brain injury

A
Post-traumatic amnesia
Confusion / disorientation
Time, Place, Person
Severe memory problems 
Recall of recent events
Working Memory
Poor concentration/ attention
Slowed thinking and mental fatigue
Poor executive function, planning, reaction to changing events
Impaired reasoning and problem solving
8
Q

cerebral functional impairments

A
Dyspraxia and Perceptual Difficulties
Dysphasia
Expressive
Receptive
Impaired language skills
Visual cortical difficulties
Hemianopia / Quadrantanopia
Loss of hearing
Loss of smell and taste
9
Q

psychiatric/behavioural impairments after brain injury

A
Depression
Anxiety
Personality change
Irritability
“Childishness, selfishness, laziness”
Behavioural problems
Aggression
Disinhibition
Apathy
Anhedonia
10
Q

secondary complications of LTNC?

A
Pressure sores
Infections
Urine, Chest
Falls and other secondary injury
Deep venous thrombosis
Malnutrition
Constipation
Pain and Spasticity
Contractures
Low morale and depression
11
Q

activities potentially limited by LTNC

A
Mobility
Outdoor mobility
Manual abilities
Fine motor skills
Thinking and Planning
Reading and Comprehension
Speaking
Nonverbal communication
Feeding self
Continence and hygiene
Personal care
Activities of Daily living
Food preparation
Driving
Housework
Self medicating
12
Q

social impact of neurological illness and injury?

A
Family role complications
Relationship breakdowns
Childcare and dependents issues
Employment and Financial implications
Retirement
Legal implications, guardianship
Social isolation
Recreational restrictions
13
Q

benefits of rehabilitation

A

Greater independence
Greater chance of getting home or remaining at home
Increased comfort and dignity
Increased chance of remaining in / returning to work
Improved quality of life
Reduced need for care / assistance

14
Q

where does rehabilitation take place?

A
Acute hospital
Rehabilitation ward
Outpatient centre
Community facilities, e.g. local sports hall
Vocational rehabilitation service
In the patient’s home
15
Q

management of spasticity

A
Prevention, Prevention and Prevention!
Multidisciplinary team approach
Physiotherapy
Exclude exacerbating factors
Full medical examination, relevant investigations

Oral antispasticity agents
Focal treatment
Botulinum toxin
Intrathecal therapy

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