Neuro - Physio

Question 1

role of physio in neuro patients

Answer 1

promote recovery
prevent further complications

Question 2

how would a neuromuscular condition be treated with physio

Answer 2

long term plan

Question 3

how would a spinal cord injury be treated with physio

Answer 3

acute: fracture, fibrocartilaginous embolism
- aggressive therapy 1-2 weeks after trauma

chronic: disc herniation
- low impact and intensity to preserve neuromuscular function

degenerative myelopathy
- physio = longer survival time

Question 4

benefits of physio

Answer 4

pain management
improve range of motion
reduce muscle contraction and tension
stimulate NS
improve blood perfusion
encourage relearning motor patterns
weight management

Question 5

when can physio occur

Answer 5

once the patient is clinically stable
nursing care plan decided

Question 6

what is including in a nursing care plan for neuro patient

Answer 6

actual and potential problems identified
nursing interventions
nursing evaluation
physio

Question 7

what precautions and rules are followed when handling and moving a patient

Answer 7

encourage natural movement
short regular sessions
slow
keep spine in line
positive reinforcement

Question 8

when are appropriate times to encourage natural movement

Answer 8

when grooming/bathing
when turning
feeding
going outside

Question 9

considerations before physio

Answer 9

size, physical abilities, size of indoor and outdoor space
availability of staff
temperament
financial resources
lift equipment
training and experience
location of incision
facility hours
access to specialists
adequate bedding
intravenous or urinary catheterisation
bandages

Question 10

considerations when discussing physio with owner

Answer 10

owners desires and expectations
ability to provide time to exercises
finance

Question 11

moving and handling equipment

Answer 11

harness
hoist
foot covers
peanut ball
floor mats
towel
sling

Question 12

what is the nurses role in physio

Answer 12

massage
assisted exercise
active exercise
passive range of motion
proprioceptive exercises
neuromuscular electrical stimulation

hot/cold therapy
hydrotherapy
laser therapy

Question 13

effleurage

Answer 13

gentle contact with palm of hand
stroke towards heart
can be used all over body

Question 14

petrissage

Answer 14

roll squeeze compress knead skin and muscles to increase circulation

Question 15

percussion

Answer 15

gentle tapping of skin with palm or side of hand
increases blood supply and aids relaxation of muscle

Question 16

vibration

Answer 16

limb gently shaken to stimulate whole limb
end of massage - relaxation

Question 17

importance of respiratory physio in recumbent patients and those suffering from pulmonary disease

Answer 17

loosens secretions and assists in airway clearance by coughing
not on fractures or other thoracic trauma

Question 18

describe passage range of motion

Answer 18

joint mobilisation and stretching
external forces are applied to limbs/axial skeleton to flex/extend
monitor for pain
3-4 times daily for 10 mins

Question 19

describe assisted exercise

Answer 19

assisted standing/walking
assisted sit to stand
three legged standing
weight shifting

Question 20

describe proprioceptive exercise

Answer 20

standing
wobble board
uneven surface
over poles
weaving
different surfaces

Question 21

describe active exercise

Answer 21

lead exercise - slow and increase gradually
add in steps, ramps, stairs
figure of 8
encourage sit and stand
pole walking
weight shifting
move head/neck with treats
hydrotherapy

Question 22

why and how are active exercises performed

Answer 22

improve strength
promote independence with functional activities

how:
actively carry out movement or part of a movement
repetitive
functional

Question 23

what is E-stim

Answer 23

electrical stimulation
2 types
1. neuromuscular electrical nerve stimulation
- applied to skeletal muscle
- stimulates muscle contraction
- delivered percutaneously
- increased tissue perfusion and helps with slow neurogenic muscle atrophy

2. electrical muscle stimulation
   - needle shaped electrodes inserted into muscle
   - not common
   - invasive

Question 24

benefits of E-stim

Answer 24

increased muscle strength
increased ROM
improve muscle tone
pain control
enhancing function
oedema reduction
reducing muscle spasm

Question 25

how are E-stims performed to achieve effective muscle contraction

Answer 25

1 electrode placed near motor point of muscle other electrode placed along muscle body check for muscle contraction contraction:rest = 1:2 or 1:5 adjust pulse intensity 10-20 mins daily

Question 26

prepping a patient for E-stim

Answer 26

clip hair clean with alcohol apply conducting gel place electrodes on muscle select intensity and timer