1. Topic-
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2. Content-
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Exercise instruction, patient learning responsibility, incorporating
caregiver into plan |
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3. Goals: Aims/Outcomes-
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1.After being instructed by demonstration and in writing, patient
will complete cane exercises in flexion, abduction and internal rotation
without any cueing, for three consecutive visits.
2.Once caregiver and patient have been educated by OT on exercises
(including frequency and duration), patient will complete a home exercise
program progress chart, demonstrating compliance with home exercise
program at least two times per day, five days per week.
3. After speaking with patient's caregiver on the phone, caregiver
to attend at least one therapy visit per week and meet with therapist
to be updated on patient's progress and get new home exercises. |
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4. Objectives-
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1.Psychomotor Domain
2.Cognitive Domain
3.Affective Domain |
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5. Materials and Aids-
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Exercise computer program, paper, mat table, cane, paper & pencil |
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6. Procedures/Methods-
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A. Introduction-
1.Explain to patient the purpose of the cane exercises is to increase
motion at the shoulder and avoid tendons getting shorter from not
moving.
2. Explain to patient the importance of regular HEP completion for
increasing use of her arm.
3. Explain to caregiver that the success of therapy is dependent on
the HEP compliance. |
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B. Development-
1. Instruct patient to lay supine, give her the cane and verbal
instructions for each exercise.
2. Educate the patient that her exercises are to be completed 30 times,
2-3 times per day & show her where the frequency of her exercises
is written on the exercise sheet.
3. Explain the HEP to caregiver and ask if she has any questions about
therapy. |
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C. Practice-
1.While the patient is completing the exercises, use hand over hand
to correct her technique as needed.
2. Demonstrate filling out the exercise log that the therapist will
be providing to the patient.
3. Request caregiver attempt to monitor patient's compliance with
HEP. |
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D. Independent Practice-
1. Once patient demonstrates understanding of the exercise with
hand over hand, the therapist will step back and allow her to complete
20 reps without additional instruction.
2. Request patient fill in a column to demonstrate understanding.
3. Request caregiver attend at least one therapy session per week
to ask questions & get updated HEP instruction |
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E. Accommodations (Differentiated Instruction)-
1 & 2. Use verbal cueing as needed throughout the process.
3. Set up a phone conference if caregiver is unable to attend therapy. |
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F. Checking for understanding-
1. At the end of the session, review each exercise along with the
handout to ensure patient understands it.
2. Ask patient to repeat the entire HEP back
3. Ask caregiver what day she can come next week and set up an "appointment" |
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G. Closure-
1. Show patient the phone number of the clinic on the handout should
she have urgent questions. Encourage her to write down all other questions
to be answered at the next treatment session.
2. Remind patient to fill in her exercise log as she is leaving.
3. Thank her for her time |
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7. Evaluation-
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1.There are three cane exercises so I could give the patient a percentage
of 33.3%, 66.6% or 100% depending on how many she could do without
cueing, with the goal being 100% 3 times in a row.
2.I would issue this chart to patient with the days of the week along
the vertical axis (separated into 2 rows each, see below) & the exercises
along the horizontal axis. The patient would then just need to mark
an "X"� in the column if she does complete the exercise. I would
probably also have the caregiver initial each to ensure the patient
is not just marking the chart without completing the program.
3. I would document this meeting including any questions the caregiver
raised and how they were answered. I would include in the chart any
handouts issued along with a description of the type of education
provided along with it (verbal, demonstration, hand over hand assist,
etc.). |
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