Other Disciplines and Discharge Recs

• The two cognitive tests used by speech therapists are the MOCA and MMSE.
• Dysphagia is difficulty or discomfort in swallowing.
• The Prep 2 algorithm is used by OT to predict likely upper extremity motor outcomes 3 months post-stroke.
• Prep 2

  A) safe > 5

  B) under 80

  C) MEP+

  D) safe > 8

  E) safe < 8

  F) NIHSS < 7

  G) NIHSS > 7

  
• Patients in the excellent category have potential to make a complete or near-complete recovery within 3 months.
• Rehab for excellent patients should focusing on promote normal use of the hand and minimizing compensation.
• Rehab for the good patient should focus on the promotion of normal function while minimizing compensation with the unaffected hand.
• Rehab for limited patients should promote movement and adaptation to daily activities. The affected limb should be incorporated as much as possible.
• Rehab for poor patients will focus on preventing secondary complications and reducing disability by learning how to complete tasks with the unaffected hand.
• The trail making test measures attention, memory, sequencing, decision-making, and automatic thinking.
• The trail making test is a useful tool for predicting the risk of unsafe driving in stroke patients.
• The Orpington prognostic scale is an assessment of stroke severity.
• Orpington Prognostic Scale

  A) < 3.2

  B) 3.2 - 5.2

  C) > 5.2

  D) home

  E) rehab

  F) high risk for permanent institution

  
• Inpatient rehab is 3 hours of intense therapy for 5 out of 7 days of the week.
• When planning discharge from inpatient rehab, caregiver involvement is crucial with an emphasis on safety.
• Interventions in inpatient rehabilitation aim to enhance neurorecovery and promote functional independence.
• Skilled nursing facilities are for patients who cannot tolerate 3 hours of therapy per day, but still need 24/7 assistance.
• Patients can be discharged from inpatient rehab to a SNF if they are still unable to go home.
• LTACH's are for patients who are too medically complex or critically ill for both inpatient rehab or SNF.
• Outpatient neuro rehab will establish a HEP. The interventions will stress independence in the community and a return to the prior level of function.