ECS Written Exam Questions.docx

What are the essential components of transfers? - correct answer Balanced sitting, standing up, sitting down What are the levels of assistance for transfers? - correct answer Independent Modified independent: use of device, no physical assistance Supervision/stand-by: you wouldn't leave the room Contact guard assist/minimal: patient performs 75%+ Moderate: Patient performs 50% Maximal: Patient performs 25% Total/dependent: Patient performs less than 25% What are the characteristics of normal walking? - correct answer 1. fairly erect posture 2. Characteristic cadence (rate) 3. Length of step 4. Lateral weight shift 5. Swing, stance phase 6. Trunk rotation 7. Reciprocal arm swing Hip Precautions - correct answer Patients who have dislocated their hip posteriorly or have undergone a total hip replacement surgery using a posterior approach No hip flexion greater than 90 degrees No hip adduction No hip medial rotation Gait devices (Least to most coordination) - correct answer Parallel bars walker 1 cane 2 canes axillary crutches forearm crutches Gait Devices Least to most support - correct answer Straight cane quad canes two canes forearm crutches axillary crutches walker parallel bars If a patient is NWB, TTWB or PWB you must use a _______________ device - correct answer Bilateral In the supine position, if the patient can't get to 90 degrees passive hip ROM - correct answer Stop the screen if the patient does not have passive motion to sit and perform a passive transfer If a patient has weakness during the gait and transfer screen... - correct answer Still determine if they have the available ROM for gait/transfers If a patient has pain for the gait and transfer screen - correct answer ASK about pain for each item If a pt experiences pain, assess active and passive ROM to point of pain, do not apply resistance. Can assess other points if not painful Post-surgical /fractures - correct answer -If patient is NWB, do not apply resistance to that lower extremity but it is okay to assess active and passive ROM -If patient is WBAT, TTWB or PWB do not apply resistance to the joint involved. You may be able to apply slight resistance to joints distal and proximal but only to the point of pain (ONLY if no two joint muscles are involved) Always instruct a patient to fall _____ , moving any braces or devices out of the way - correct answer Forward Changes with aging: Muscle mass and strength - correct answer 30-35% decrease in strength Changes with aging: Vision - correct answer decrease in acuity, contract sensitivity, glare sensitivity, dark adaptation, accommodation, depth perception __________/______________ are the strongest visual risk factors for falls - correct answer Depth perception and accommodation Changes with aging: Vestibular sense - correct answer attrition of neural and sensory cells in peripheral labyrinth with aging Prioprioception - correct answer increase in capsular thickness and decrease in the number of intramural fibers that impairs static and dynamic muscle spindle activity. Decreases Pacinian Meissners receptors causing a decrease in vibration and touch sense Most falls occur at __________ (about _______%) - correct answer home, 60% followed by public locations and then health care insitutions Causes of falls: Intrinsic factors - correct answer pertain to individuals body (vision, lack of sleep, strength, vibratory sense, balance, acute illness) Causes of falls: Extrinsic factors - correct answer Stairs, clutter, slippery surfaces, poor lighting, loose footwear, poor adaptive equipment Screening tools for fall risks: Timed up and go (TUG) - correct answer Measures the time to go sit to stand, walk 10' return and sit Gait velocity/speed (cut off score 0.56 m/sec for risk of recurrent falls) Screening tools for fall risks: Fall risk assessment and screening tool (FRAST) - correct answer multifactorial, self-administered questionnaire Screening tools for fall risks: Stopping Elderly Accidents, Deaths, and Injury (STEADI) - correct answer multifactorial, self administered questionnaire Evaluation tools for fall risks: Tinetti Assessment Tool (POMA) - correct answer Score 19/28 high fall risk Evaluation tools for fall risks: BERG - correct answer Single best predictor of fall status 40/56= 100% fall risk Evaluation tools for fall risks: Dynamic Gait Index - correct answer Assess gait in a variety of situations; score 19/24= high fall risk Evaluation tools for fall risks: Activities-Specific Balance Confidence Scale (ABC) - correct answer Self report assessment Evaluation tools for fall risks: Four Square Step Test - correct answer Stepping over obstacles and changing directions 15 sec=high fall risk Geriatric Clinical Practice Guidelines - correct answer -Must include balance training - Strength training and walking programs only have little effect -Ideally multi-factorial home or community based interventions -minimum effective frequency =2x per week -Most effective-3x/week higher frequencies reduce fall risk, but reduce adherence Exercise based interventions - correct answer Otago Exercise Program: 35% reduction in fall rate Matter of balance: 8 week 2 hour sessions including peer discussion, exercise, education and behavior modification