STUDY GUIDE: Adult Physical Conditions – Intervention Strategies for OTAs (Latest Edition) | High-Yield for NBCOT® & OTA Exams

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STUDY GUIDE: ADULT PHYSICAL
CONDITIONS – INTERVENTION
STRATEGIES FOR OTAS (LATEST
EDITION)



## Section 1: Neurological Conditions


### 1.1 Stroke (CVA) – Quick Reference


| **Hemisphere** | **Deficits** | **Behavior** | **OTA Focus** |
|----------------|--------------|--------------|----------------|
| Left | Right hemiplegia, aphasia, apraxia | Cautious, slow, organized |
Verbal cues, step-by-step, aphasia boards |
| Right | Left neglect, impulsivity, poor safety | Impulsive, unaware of
left | Visual scanning, anchor lines, safety cues |


**Stages of Motor Recovery (Brunnstrom):**
- **I (Flaccid):** PROM, positioning, edema control → NO resistive
exercise
- **II (Spasticity appears):** Gentle ROM, weight bearing
- **III (Spasticity peaks):** Synergistic movements, tone reduction

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- **IV-VI (Recovery):** Isolated movements, strengthening, CIMT


**Key Interventions by Phase:**


| **Phase** | **Interventions** |
|-----------|--------------------|
| Acute/Flaccid | Positioning (shoulder abduction, elbow extension),
PROM, family education |
| Subacute | Bed mobility, transfers, grooming with adaptive equipment |
| Chronic | CIMT, mirror therapy, community re-integration |


**Neglect Interventions (Mnemonic: "SCAN"):**
- **S** – Stimulate affected side (place items there)
- **C** – Cue scanning (verbal, tactile anchor line)
- **A** – Anchor line on wheelchair (red tape on affected side)
- **N** – Neglect education for family


**Aphasia Types:**
- **Broca’s (non-fluent):** Yes/no questions, gestures, picture boards
- **Wernicke’s (fluent):** Simplify language, confirm comprehension,
visual aids


**Red Flags Post-Stroke:**

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- Shoulder subluxation → arm trough, lap tray, avoid aggressive pulling
- Pusher syndrome → visual vertical cues, mirror feedback
- Central post-stroke pain → desensitization (fabrics, rice, vibration)


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### 1.2 Traumatic Brain Injury (TBI) – Rancho Los Amigos Levels


| **Level** | **Name** | **OTA Strategy** |
|-----------|----------|--------------------|
| II | Generalized response | Withdrawal to pain, no command following |
| III | Localized response | Localizes to pain, inconsistent |
| IV | Confused-agitated | Low stimulation, redirection, safety first |
| V | Confused-inappropriate | Structured routine, simple tasks, no
complex reasoning |
| VI | Confused-appropriate | External memory aids, supervision |
| VII | Automatic-appropriate | Supervised community outings |
| VIII | Purposeful-appropriate | Compensatory strategies, driving eval |


**Agitation Management (Level IV):**
- Reduce noise, dim lights
- Provide rocking chair, weighted blanket

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- Redirect to calming activity (folding towels, sorting)


**Post-Traumatic Amnesia (PTA):**
- Orientation board, repetition, family training
- Avoid confrontation of false memories
- Errorless learning → spaced retrieval → external aids


**Metacognitive Deficits (Frontal Lobe):**
- Poor insight, impulsivity, social disinhibition
- Interventions: Checklists, structured groups, rule-based activities


**Red Flags: Increased ICP Signs (Mnemonic: "CUSHING"):**
- **C** – Cushing’s triad (bradycardia, hypertension, irregular
breathing)
- **U** – Unequal pupils
- **S** – Slurred speech
- **H** – Headache worsening
- **I** – Inconsolable restlessness
- **N** – Nausea/vomiting
- **G** – Gradual decline in consciousness


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