Rehabilitation System: Principles, Goals, and Stages
Classified in Medicine & Health
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*** Constituent Parts of Rehabilitation System: Principle Goals....
- Rehab is the treatment designed to facilitate recovery from injury/disease
- Can be: physical/psychological/social/educational
- Legal part
- Medical rehabilitation
- Vocational rehabilitation
- Education
- Compensatory technical, orthopedic means
- Environmental adaptation
- Culture, sports, recreation, religion
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^^ Stages of Rehab:
- I----. Hospital Setting, Hospital Staff
- II----> In Sanatorium/Outpatient
- III----> Home Setting, Practitioner or Family Member
^^ Principles, Goals & Task of Rehab:
- Treatment of Pathology
- Decrease Impairment
- Prevent and Treat Complications
- Increase Activity
- Physiological Support
**** Rehab Principle:
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**** Composition of Rehab Team for CVS Disease in Rehab Phases?
Step 1:
| Step 2:
| Step 3:
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**** Stages of Rehab of CVS, Contraindication:
(composition of rehab team)
^^ Step I:
- Hospital setting & after patient is out of life-threatening situation
- Team: Physician, Nurse, Therapist, Family Members, Psychologist
- Goals: Treatment for Patient, Prophylaxis of Complications, Increase Strength
^^ Stage II:
- 2-3 after Stage I
- For Diagnosis, Code of Pathology, General Status & Risk
- If there are risk factors, rehab can be conducted at home
- Team: (SAME) + Ergo Therapist, Dietitian, Social Worker
- Goals: Increase Coronary Function, Education, Training Plan, Family Involved
- Can be In Sanatorium/Outpatient Sanatorium
^^ Stage III::
- Home setting
- Major lifestyle changes
- Family member involved
- Goals: Maintain Healthy Lifestyle, Continue Step II
**** CI for Rehab:
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*** How are the physical training programs formed for cardiovascular patients after
considering the degree of risk?
considering the degree of risk?
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Mild Risk:
| Moderate Risk:
| High Risk:
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**** Exercise Tolerance Test for Rehab of CVSD Patient:
- Function: allow evaluation of Physical work Capacity
- Continue test till Symptoms of Exhaustion appear
- ^^ 6 min Step test:
- + : cheap No electricity
- - : Not all patient, Difficult BP measurement
- ^^ Bicycle Test:
- - Wide spectrum of evaluation
- + : facilities BP & ECG recording performed upright or supine
- - : Requires frequent calibration
- ^^ Treadmill Test:
- Evaluation of physical capacity
- + : Adjusted Intensity
- - : expensive, Patient Fall
- ^^ Types of loads:
- - Single Level Load
- - Increasing Loads:
- 1-continuous
- 2-Continuous with steady stage
- 3-Continuous with Intermittent Rest Period
***(Disturbance Biological, Psychological, Social).
^^ Biological Factor: | ^^ Psychological Factors: | ^^ Social Function: |
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| Impairment in
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**** Intensity of Everyday Life .....
- MET
- Daily life Recreational activity Determined by MET (metabolic equivalent)
- Indicate how much O2 is consumed during physical activity
- MET M > Female
- 1 MET = 3.5 ml
- MET 1--> Poor: walking, dressing
- MET (5-7)---Moderate: mild house work
- MET >10: Excellent: intensive sport
NYHA class+ Activity: | MET |
I :
| 7 |
II:
| 5-6 |
III:
| 3-4 |
IV:
| 1-2 |
**** Determination of Disability, The Residual Working Capacity ....
- Disability to WHO:
- Impairment: problem with body function or structure
- Activity limitation: difficult executing a task
- Participation Limitation: problem in live situation
- Can be: physical/cognitive/emotional/sensory/developmental
- The ICF produced a WHO 9 domains:
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^^ Qualification of Disability :
- 0-----> No problem 0-4%
- 1-----> Mild problem 5-35%
- 2-----> Moderate Problems 25-49%
- 3-----> Severe Problem 50-95%
- 4------> Complete problem 96-100%
- ^^ Determining Working Capacity :
- 1- Medical criteria: DM, Renal hepatic insufficiency
- 2- Functional criteria: hours the individual can work
- 3- Professional: Profession prior to disability
- 0-25% = Incapable to work
- 30-55% = Partly capable of work
- 60-100% = Capable to Work
Stage
I =100%II=80-50%III=50-20%IV=20-0%
^^ Special Devices:
Wheelchair