Treatments


Objective notes

Keep your patient records up to date

 

Pace of rehab treatment will be affected by the following factors

& MORE...

 

 

Inclusion and participation

Encourage independence and include patient in all aspects of life

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Multiple injuries

Related respiratory injuries

Related SCI injuries

8 related eight modules

Prioritise your treatments and adapt positions as necessary

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Day 1 post-operation

 

Early mobility

As soon as possible encourage bed mobility, sitting out of bed and using the wheelchair

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Early rehab

Encourage mobility and independence in wheelchair, and gradually increase the number of exercises as the patient becomes more able.

Exercises

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Wheelchair transfers

Floor to chair & chair to bed

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Day 3, post operation

Teach exercise and progress them under supervision

(not yet sure if below what is needed... or is it something more of a repeat of previous?)

Progress exercises, strengthening and mobility as able

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Wheelchair mobility

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Balance

 

Crutches

Only use crutches if essential, altered centre of gravity, loss of proprioception & stump swelling make their use unsafe

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Stump pain

 

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Phantom pain

(in missing limb)

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Pain elsewhere

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Use other modules for specific treatment

 

Lower limb range of movement (ROM)

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Reduced leg strength

Increase the weights used or the number of each exercise as the patient gets stronger

Exercises to strengthen remaining leg

Exercises to strengthen below knee stump

Exercises to strengthen above knee stump

Increase the weights used or the number of each exercise as the patient gets stronger

above knee stump exercises

reduced leg strength exercises

 

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Upper limb exercises

Maintain and improve range of movement and strength in upper limbs

Increase the weights used or the number of repetitions of each exercise as the patient gets stronger

See also

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Health of remaining foot

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Oedematous stump

stump bandaging, elevation, exercise and massage will reduce post-op swelling

Above knee bandaging (print)
Below knee bandaging (print)

 

Infected wound

An infected would will be painful, delay healing and slow rehab

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Delayed healing

 

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Tethered scar

 

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Dexterity

Inform prosthetist if dexterity is poor.

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Anxiety & depression

Hospital Anxiety and Depression

HAD see also
Find culturally acceptable anxiety and depression diagnosis tool

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Unable to retain new information

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Post operation day 1 (print-out version)

prevent hip flexion contractures by prone lying with hip in neutral

Bones: pelvis, femur, patella, tibia, fibula

keep hip and knee in neutral and do not place pillow under stump

encourage active movement of remaining leg and avoid foot drop

 

Early rehab (print-out version)

go to early mobility section

go to transfers in early mobility section

encourage patient to look at and feel stump

prevent hip flexion contractures by prone lying with hip in neutral

keep hip and knee in neutral and do not place pillow under stump

encourage active movement of remaining leg and avoid foot drop

encourage inclusion

lift bottom as high as possible, hold for 5 seconds, lower slowly

squeeze towel or football between thighs

with towel under end of stump press leg down into the floor

lift stump up

lift stump up

lift stump up, keeping hip in neutral

with towel under end of stump and knee straight, press leg down

keep knee straight and lift leg

keep knee straight and lift leg

keep knee straight and lift leg, keeping hip in neutral

keep knee straight and lift leg

keep knee straight and lift leg

keep knee straight, lift leg in line with body

move ankle up and down

push down on blocks and lift bottom and legs off the chair

tie an elastic band firmly to the arm of the wheelchair and pull against it

bend knee, do not allow hip to lift

use weights in hands with elbows straight and lift arms out sideways

hold weight in hand and bend and straighten elbow slowly