Henry: Videos with Related Questions

Henry
036

Diagnosis: Stroke
Setting: SNF

All faculty resources for Henry

 

Videos & Related Questions

Questions taken from the faculty resource: Observation Skill Development using Sit to Stand

  • What are your observations on patient/therapist relationship/therapeutic alliance?

  • Comment on verbal cues, body language, and confirmation of patient understanding of the task.

  • What could the therapist have done differently to promote better alignment and symmetry before the patient moved from sit to stand?

  • What could the therapist have done to promote muscle activation during the sit to stand transition?

  • Comment on verbal, tactile or other strategies to promote motor learning and recovery of function.

  • What challenges exist when guarding a patient who is moving from sit to stand? Do you think the therapist over-guarded this patient? What is the impact of allowing the patient to pull themselves up on the parallel bar?

  • Comment on the use of a gait belt for patients with neurologic impairments. From a brief review of the literature, are gait belts proven to prevent falls? Are there draw backs to the use of gait belts?

  • Comment on any safety concerns you see in the video. As the therapist, what could you do differently?

  • What is the level of assist for the sit to stand transition? How are you determining this?

  • What participation activities incorporate sit to stand as a major component?

  • Where on the mobility>stability>controlled (dynamic) stability>skill continuum does sit to stand fall? How does that influence your critical thinking regarding treatment planning?

  • List all possible impairments that you think may be contributing to the functional limitation of decreased ability to move from supine to sit. Use professional terms and be specific.

Questions taken from the faculty resource: Critical Thinking Skills using Sit to Stand

  • What is the level of assist for the sit to stand transition? How are you determining this?

  • How much verbal cueing does the patient need for the task? Do you feel the verbal cueing was appropriate? Why or why not? What could you do differently?

  • Is sit to stand an impairment or a functional activity?

  • What participation activities incorporate sit to stand as a major component?

  • Where on the mobility>stability>controlled (dynamic) stability>skill continuum does sit to stand fall? Defend your answer. Discuss how this influences your critical thinking regarding treatment planning.

  • What challenges exist when assisting a patient from sit to stand? Remember to think big picture.

  • List all possible impairments that you think may be contributing to this patient’s functional limitation of decreased ability to move from sit to stand. Use professional terms and be specific.

  • What examination strategies would you use to determine if the impairments are present or not?

Questions taken from the faculty resource: Observation Skill Development using Ambulation

  • View the video Early Gait Training: Patient Observations Inside the Parallel Bars. Starting with static standing, what do you observe regarding:

    • Trunk midline orientation

    • Head and neck orientation and posture

    • Posture and symmetry of the upper extremities

    • Posture and symmetry of the lower extremities

  • Does the individual require assistance or upper extremity support to stand statically?

  • What supportive devices is the therapist using during this intervention? Comment on pros and cons of using this type of upper extremity support for ambulation.

  • Begin observation of gait with the swing phase, comment on the following:

    • Swing starts with push off of the affected leg. Does there appear to be adequate push off with the left lower extremity?

    • Does the individual have more or less hip flexion and knee flexion on the left side than your peers during the swing phase?

    • What does the therapist do to promote swing phase with this individual?

  • Observe the stance phase of gait, comment on the following:

    • Comment on the position and alignment of the left hip during midstance. How does that differ from the peers you observed?

    • Comment on the position and alignment of the left knee during midstance. How does that differ from your peers?

    • What other alignment issues do you see in this patient during the stance phase?

  • What verbal cueing is provided to the patient during the activity? Do you think the patient has a good understanding of the task and is benefitting from the verbal cues?

  • What manual facilitation did the therapist provide to the patient during the task?

  • How does Henry’s alignment change when the other therapist places his left hand on the parallel bar?

Questions taken from the faculty resource: Critical Thinking Skills using Ambulation

  • What level of assist did the patient in the video require for static standing? How much verbal cueing did the patient require for the task? Practice your documentation skills below, using professional and skilled terminology:

  • What level of assist did the patient require for ambulation? Did you notice differences in assist needed for swing versus stance phase of gait? Practice your documentation skills below, using professional and skilled terminology:

  • What assistive and supportive devices are used with the patient for ambulation?

  • As the patient transitions away from use of the parallel bars in the near future, what assistive device would you anticipate would be most beneficial for him at the present stage of recovery? Defend your answer.

  • What are the indications for use of an ankle foot orthosis (AFO) for a patient like Henry? Comment on your observations of the AFO and how it is assisting him with ambulation.

  • Describe the ways in which the L AFO is not working to assist in Henry’s recovery.

  • What are the considerations for using an AFO in a patient like Henry who has diabetes mellitus and other medical co-morbidities?

  • What does the therapist in the video do to develop a therapeutic alliance with Henry? What could she do to improve communication with him?

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