Module 1 - Pre-test

When demonstrating/instructing transfers to a patient, it is important to emphasize all of the key points mentioned. The different ways a patient can set themselves up for a transfer to minimize forces placed on the upper extremity is crucial for preventing injuries and promoting proper body mechanics. Additionally, keeping weight at a minimum is important to reduce strain on the body during transfers. Alternating which arm is leading/training helps to distribute the workload evenly and prevent overuse injuries. Therefore, all of these points should be emphasized for safe and effective transfers.

Upper extremity pain in spinal cord injury patients can have various negative impacts on their lives. It can lead to lower quality of life scores as the pain can affect their physical and emotional well-being. The pain can also result in limitations of independence, as it may restrict their ability to perform daily activities and tasks. Additionally, the pain can contribute to an increased rate of unemployment, as it may hinder their ability to work or engage in employment-related activities. Therefore, all of the given options are valid results of upper extremity pain in spinal cord injury patients.

If a patient is at risk for shoulder subluxation, having an arm rest on their wheelchair would be a mandatory characteristic. Arm rests provide support and stability to the patient's arms, reducing the risk of shoulder subluxation. They help to prevent excessive movement and strain on the shoulder joint, promoting proper alignment and reducing the likelihood of injury or dislocation.

Approximately 30% of patients with upper limb pain report a limitation of independence. This suggests that a significant portion of individuals experiencing upper limb pain are unable to fully perform daily activities without assistance or restrictions. This finding highlights the impact and burden of upper limb pain on a person's overall independence and functionality.

Power wheelchairs require regular maintenance to ensure they are functioning properly. This includes tasks such as checking the battery, cleaning and lubricating the moving parts, and repairing any damages. Increased maintenance can be seen as a negative aspect because it requires additional time, effort, and potentially costs to keep the wheelchair in good condition. This can be inconvenient for individuals who rely on power wheelchairs for mobility.

Performing floor to/from wheelchair transfers daily is not a method to prevent the development of upper extremity pain. This activity actually puts strain on the upper extremities and can contribute to the development of pain. The other options, such as daily stretching and strengthening exercises, decreasing the number of overhead activities, and decreasing the number of non-level transfers, are all methods that can help prevent the development of upper extremity pain.

A power wheelchair has two positive aspects: conservation of energy and eliminating propulsion-related repetitive strain. Conservation of energy refers to the fact that using a power wheelchair requires less physical effort compared to manually propelling a wheelchair, allowing individuals to conserve their energy for other activities. Eliminating propulsion-related repetitive strain means that using a power wheelchair reduces the risk of developing repetitive strain injuries that can occur from continuously propelling a manual wheelchair. Therefore, the correct answer is I & III.

Patients with weak bicep and tricep function are considered high risk patients regarding the use of a manual wheelchair. Weak bicep and tricep function can affect a person's ability to propel and control the wheelchair, increasing the risk of accidents and injuries.

If a patient is unable to perform a pressure relief on their own, it is important for the caregiver to tilt the patient's chair for a minimum of 2 minutes. This allows for the redistribution of pressure on the patient's body, helping to prevent the development of pressure ulcers or bedsores. Tilted positioning helps to relieve pressure on specific areas of the body, reducing the risk of tissue damage and promoting better blood circulation. Therefore, 2 minutes is the minimum amount of time required for an effective pressure relief maneuver.

The correct answer is "All of the above". This means that both leaning forward in the chair and putting one's chest to their knees, as well as leaning from side to side, are alternatives to wheelchair pushups when performing pressure relief exercises. These alternative exercises can help relieve pressure and prevent discomfort or injury for individuals who are unable to perform wheelchair pushups.

SNF patients should stress to their caregivers not to pull on their arms when performing transfers in and out of bed. Pulling on their arms can cause discomfort and potential injury to the patient. It is important for caregivers to use gentle and proper techniques to ensure safe and comfortable transfers.