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1、作业疗法学重点（Occupational therapy emphasis）Occupational therapy?Is an important part of rehabilitation medicine, is a relatively independent professional rehabilitation treatment, its purpose is to assist the disabled and patients choose to participate in the application, purposeful and meaningful activi
2、ties, to prevent or reduce the recovery and life related dysfunction and promote maximum function, to maximize the recovery of the body, adaptation, psychological and social aspects of health, prevention of disability and disability, which can be developed in the living environment, and encourage th
3、em to participate in and contribute to societyScope of activity?Human beings are all basic activities, including daily activities, work, production activities and recreational activitiesBehavior composition?Each action of the basic elements of activities, including the basic steps of action, movemen
4、t type and the basic dysfunction, required clinically, can each activity is decomposed into a series of actions constitutesCOPM?It was implemented by the Canadian Association of occupational therapy, a patient centred, patient oriented approach to primary treatment goalsTherapeutic activity?Refers t
5、o carefully chosen, targeted activity that aims at maintaining and improving patient functioning, Op Amp, disability or disability, and improving patient quality of lifeMechanical grasp?Refers to the thumb movement and the ring finger and the small finger flexion resistance action, is the thumb and
6、the foot finger movement result mutuallyAccurate grip?Is the thumb and index finger and middle finger flexion, lifting force caused by movements, is the thumb and radial fingers moving with each otherRight palm?The movement of the tip of the thumb to the direction of other fingers is a necessary con
7、dition for the normal function of the handCognition?It includes perception, recognition, memory, concept formation, thinking, reasoning, and expressionUlnar nerve injury?Claw hand deformity, median nerve injury - Ape hand, round nerve injury - vertical wrist model, mixed nerve shovel handWhat are th
8、e major dysfunctions after hand injury?Motor dysfunction, sensory dysfunction, autonomic nerve dysfunction, movement disordersTreatment principles for hand function rehabilitation include?Early intervention reduces swelling, maintains proper joint position, protects nonunion, increases and maintains
9、 ROM, increases and restores muscle strength, restores crown strength, improves coordination, and improves endurance. The main stages include rehabilitation, reconstruction and compensation adaptationResting position of hand?In the relaxed state, without any force, hand muscles in a relatively balan
10、ced state. At this time, wrist posture, body 10 to 15 degrees, mild ulnar deviation, MP and PIP were semi joint flexion, from the index to the little finger, the more the more to the ulnar flexion, finger tip finger to the navicular tuberosity, mild thumb abduction, mild finger abduction, finger fin
11、ger close to the radial side of the distal interphalangeal joint, such as holding a pen postureHand protection bit?A hand in the injury and surgery, need a fixed period of time, in order to hand thumb function can maximize the recovery, can be fixed on the palm of a hand, which is the maximum thumb
12、abduction, flexion position, such as holding a board positionHand functional position?The wrist body 20 to 30 degrees in the palm of the thumb, the thumb joint MP and IP slightly bent, other fingers slightly apart, MP joint, PIP and DIP joint micro buckling, such as hand ball posture, hand function
13、is to maintain the lateral collateral ligament stretching as far as possible, to maintain to avoid shortening after the limitation of joint activitiesFunctional evaluation of peripheral nerve injuries in the upper extremities1 - 2 of axillary nerve and musculocutaneous nerve - shoulder abduction and
14、 elbow flexion 3 radial nerve injury - wrist extension thumb extensor 4 median nerve - flexion, the thumb of 5 metacarpal ulnar flexor, shape, feelingThe timing of hand function rehabilitation?1 early rehabilitation - attention to the protection of joint braking is required in phase 2 - functional r
15、ecovery 3 post compensationHand function recovery?1 muscle strength and endurance training, maintenance and improvement of 2 joint movement, 3 coordination and exercise mode trainingAllergies?Mild stimulation of nerve injuries that can cause a strong sensation,Because of the increase of pain sensiti
16、vity or the decrease of threshold, the technique of desensitization is mainly used in sensory remodeling trainingFeel excessive?Refers to the stimulation, after a certain incubation period, feel the strong positioning is not clear, and the proliferation of the surrounding, not suitable for pain feel
17、ingThe process of feeling re education involves?Object perception, discrimination, memory and recall in four stagesSpecific application of occupational therapy for nerve injuries1 median nerve injury: flexion of wrist joint was fixed for 3-4 weeks, and gradually extended after 4-6 weeks. Wrist joint
18、 was normal. Orthosis made the thumb to the palm, and the fingers and metacarpophalangeal joints were flexed. Early activities should include activities involving the entire upper limb, gradually with multi-point grasping and two-point grasping. 2 foot nerve injury: MP joint and flexion position for
19、 3-4 weeks, operation activity, improve grasping ability and grasping and pushing ability, improve finger coordination, improve finger dexterity, work activity training. 3 around the nerve injury: maintain wrist extension, metacarpophalangeal joint extension, thumb abduction fixation of 3-4 weeks, a
20、ctivities of wrist stability can be maintained in grasping the wrist and finger extension at the same time, improve the coordination of hand and enhance muscle strength, work activity training. 4 combined nerve injuries: ape handFlexion tendon injury?Fixed DIP, DIP joint 20-30 degree flexion, MP joi
21、nt 45-50 degree flexion exercises, active extensor, passive extensor flexor, no activeThe treatment principle of edema?High, extending, good for refluxCognitive impairment?There are various manifestations, such as memory, attention, reasoning, judgment, abstract thinking, and small order disorderPer
22、ceptual impairment?Refers to the perception and integration of sensory stimuli in specific areas of the cerebral cortex when the sensory conduction system is intactPay attention to its level, divided into five typesAttention was paid to continuous attention, selective attention, alternate attention,
23、 respectively, respectivelyAgnosia?That is not feeling dysfunction or mental retardation, unconsciousness, inattention, and difficult speech of the matter is not familiar with the other reasons, but due to brain damage, not through the senses and the familiar things, eggs can still be carried out a
24、series of symptoms of its recognition of the use of other ways of feelingMemory impairment assessment scale?The Rivermead behavioral memory test examined the patients ability to remember specific behaviorsStress therapy?It is one of the most effective methods for the prevention and treatment of hype
25、rplastic scar by means of applying proper pressure to the human body surface to prevent or control the hyperplasia of the skin and prevent the swelling of the limbs. Commonly used motion treatments include bandage compression and pressure compression.What is the role of stress therapy?1 to control s
26、car hyperplasia, 2 to control edema, 3 to promote limb plasticity, 4 to prevent joint contracture and deformity, 5 to prevent deep vein thrombosis, and 6 to lower extremity varicose veinsClinical features of hypertrophic scar?3R, red, convex, hard,Characteristics of mature scar?3P, pale, flat, softI
27、ndications for stress therapy?1 hypertrophic scars, 2 edema, 3 amputations, 4 prophylactic treatments, burns, long-term bedridden patients, sedentary or long standing workers. Contraindications: treatment sites include infectious wounds, acute episodes of vasculitis, and deep venous thrombosis of th
28、e lower extremities. Application principles: early application, proper pressure, long-term useWhat are the principles of assistive technology?Compensation and adaptation, methods of saving energy, learning theory, just because of people. The application, function assessment - AIDS prescription - opt
29、ional training before making use of or purchase - Training - after use evaluation (assessed by follow-up, such as can be used independently, functional limitations on aid modification, environmental restrictions can be used to improve the environment, others care)Commonly used assistive devices?Orth
30、oses, wheelchairs, walking aids, self-help devices, Spoons: bold handles, spoons for gripping, poor functioningWalking aids?According to the structure and function, the utility model can be divided into a rod type walking aid and a walking aid frame. Indication: 1 single foot walking sticks are suit
31、able for patients with good grip and strong upper limb support, such as hemiplegic patients and old people. 2 three feet cane,It is suitable for patients whose balance ability is a little poor and unsafe for using a foot walking stick. 3 legged cane: applied to balance the ability of poor, weak arm
32、or upper limb with parkinsonism, with three foot walking stick is not safe enough for patientsAccording to the training, the foot size is divided into two partsPosterior type, paratactic type, anterior typeMeasurement of a crutch?A simple method is to use the length minus 4CM, or will gently close t
33、o the axillary crutch, toe and foot in the anterolateral 15CM flush is the most appropriate crutch length, elbow flexion 25-30 degrees, wrist dorsiflexion when the palm to handle position. Note: the distance from the top and axillary axillary pad should be 5CM or three horizontal, high risk of brach
34、ial plexus compression, too low against the side of the chest wall, not only lost the function of shoulder stability, but also lead to bad walking posture. Methods: the normal side of the crutch and trunk should be 150 degreesEquilibrium?Push the wheelchair by foot pedal rod and dumping down hands u
35、nder the pressure hands push wheelchair back in the process after dipping in hands to withstand the weight gradually decreased, when the wheelchair backward about 30 degrees when the hands load minimum, this location is called the balance pointHow is the COPM assessed?In the COPM assessment, the sco
36、pe of activities in accordance with the basic projects, such as ADL including modification, personal hygiene, bathing, dressing, personal appliances, medicine, health maintenance, social exchange, selected 5 target for therapy in patients with the most urgent, and the solution of the limited activit
37、y of patient satisfaction as for homework, the goal of treatment. Patients range from 1-10 in the group activity limitation scores, 1 of which is completely limited, 10 points is not limited, at the same time, patients need to determine the time for each activity in patients with self satisfaction,
38、score is from 1 points to 10 points, and then treated according to the scoring results, treatment some time after the re evaluation, before and after the activity score and satisfaction scores, adjust the treatment or termination of the treatmentWhat are the common prognostic factors for occupationa
39、l therapy?1 non human environment 2 conscious use of self 3 teaching and learning process 4 purposeful activity 5 activity group 6 activity analysis and compositionDoes the definition of occupational therapy include?1 occupational therapy is a professional, must be in the professional training of oc
40、cupational therapists know 2 activities as a treatment medium 3 is for daily operation functions including self care, work and leisure, can be used as OT 4OTs ultimate goal: to actively participate in the activities of 5 patients treated by physical injury or disease: Social psychology, dysfunction,
41、 developmental or learning disabilities, the aging process, limiting factors and cultural differences of poverty 6 final purpose, including the prevention of injuries caused by disability and handicap, and maintain health, promote the living level of independence, improving the quality of life, so that people can participate in and make the public line to the society, improve the social integration of ADL