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OCE-Case 2-Treatment > 1.2 Common Problem & corresponding Rx > Flashcards

1.2 Common Problem & corresponding Rx Flashcards

1
Q

Abnormal gait pattern

A
  • Gait practice (break gait down into manageable parts
  • Graded exercises depending on deficit
  • Stretching depending on deficit
  • Gait aid to unload (if painful limb)
  • Gait aid to support (if balance/strength-related issues)
  • Hydrotherapy to pracitce gait pattern in unloaded environment
  • Bracing/taping
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2
Q

Acute dyspnea

A
  • SOS for SOB
  • Pursed lip breathing
  • Remove triggers
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3
Q

Chronic dyspnea

A
  • Pursed lip breathing
  • Secretion removal tachniques (if secretions are contributing to dyspnea)
  • Cardiovascular conditioning
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4
Q

Decreased functional mobility

A
  • Practice the functional task or components of the task
    –> Bed mobility (e.g. supine to sit, rolling)
    –> Increase sitting tolerance (at edge of bed or in chair/wheelchair)
    –> Transfer practice (e.g. slide board, stand step around)
    –> Sit to stand practice
    –> Ambulate practice (short distance with or without gait aid)-assess for appropriate gait aid
    –> Stair practice
  • Strength exercise (bed, sitting or standing)
  • Pacing & planning
  • Time treatment with medications if necessary (e.g. pain meds)
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5
Q

Decreased muscle length

A
  • Stretching (e.g. static, dynamic, PNF techniques)
  • ROM exercises
  • Soft tissue techniques
  • Heat
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6
Q

Decrease muscle strength

A
  • Use condition-specific exercise
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7
Q

DVT risk (Post-op Pt and has not mobilized)

A
  • Monitor for DVT:
    –> Inspect bil calf for redness, swelling, warmth, tenderness
    –> Homan’s test (passive DF with knee extended)
    –> if suspected, DO NOT mobilize and immediately report to the team (nursing staff, physician)
  • AROM/PROM for lower extremities
  • Mobilize as tolerated
  • Ankle pumps
  • Compression socks
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8
Q

Fatigue

A
  • Pacing and planning
  • Energy conservation
  • Activity modification
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9
Q

Comorbidities:
- HT
- Hypercholesterolemia
- Obesity
- Atherosclerosis
- Type 2 DM

A
  • Cardiovascualr exercise within safe intensity (modified BORG 3-5)
    E.g. Acute: mobilizing from bed to chair, chronic: walking for 20 minutes
  • Educate the Pt on modifiable risk factors associated with their co-morbidities
  • Consult with team or phyiscian to ensure appropriate medical management of their co-morbidities
  • Refer to a community health program to provide
  • HT specific: Monitor BP & ensure the Pt is at a safe level to mobilize (under 200/110 to mobilize)
  • DM specific: Educate Pt about and monitor for S&S of hypoglycemia associated with DM & exercise
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10
Q

Increased tone/spasticity

A
  • Bracing/splinting
  • Stretching
  • ROM exercises
  • Strengthening
  • Positioning
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11
Q

Incorrect gait aid or patient requires a gait aid (and gait aid is not specified)

A

Refer to Gait Aid Selection Flowchart

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12
Q

Inflammation (from acute soft tissue injury)

A
  • Modalities (E.g. pulsed US, laser)
  • PEACE & LOVE
    –>Protection: avoid aggravating activities for a few days
    –>Elevation
    –>Avoid anti-inflammatories: Avoid icing
    –>Compress: reduce swelling
    –>Education: Avoid unnecessary passive Rx & medical investigation

–>Load: pain guided gradual return to activity
–>Optimism: Condition your brain for optimal recovery by being confident and positive
–>Vascularization: pain free cardiovascular activity to inc. blood flow to repairing tissues
–>Exercise: Restore mobility, strength and proprioception by adopting an active approach to recovery

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13
Q

Joint stiffness

A
  • ROM exercise working in the range of stiffness (AROM, AAROM, PROM)
  • Manual therapy (joint mobilization, traction)
    –>Direction to improving which range
    –>grading
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14
Q

Poor posture

A
  • Stretch muscle that tend to become tight in forward flexed posture (e.g. DNE, UFT, Pects, hip flexors)
  • Strengthen muscles that tend to become weak in forward flexed posture (e.g. DNF, MFT/LFT, rhomboids, spinal extensors, glutes)
  • Education (e.g. ergonomics)
  • Soft tissue techniques
  • Heat for muscle relaxation
  • Manual therapy
  • Bracing/orthotics
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14
Q

Pain

A
  • Modalities (e.g. TENS)
  • Education (e.g. activity modification)
  • PEACE & LOVE
  • Manual therapy
  • Positioning
  • Relaxation technique
  • Time PT Rx with pain medications
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15
Q

Poor sitting balance

A
  • Seated balance exercises (e.g. static, big/small BOS, eyes open/closed, internal/external perturbations)
  • Seated core strengthening exercise (e.g. partial sit up, weight shift, seated marching)
16
Q

Poor standing balance

A
  • Standing balance exercise (e.g. static, big/small BOS, eyes open/closed, internal/external pertubations)
  • Proprioception exercises
  • Strengthening exercises depending on deficit
  • Use of gait aids
17
Q

Prevent complications of bed rest

A
  • PROM/AAROM/AROM
  • Bed exercise (heel slides, ankle pumps, glute squeeze, bridge)
  • Graded mobilizations
    –> Sitting in bed
    –> Sitting at edge of bed
    –> Standing
    –> Pre-ambulatory exercises (marching, heel raise, toe raise)
    –> Ambulation
  • Deep breathing exercise
18
Q

Pulmonary secretions

A

Secretion removal technique
- Active:
–> Huffing, coughing
–> Active cycle of breath
–> PEP mask/flutter, acapella
- Passive:
–> PD
–> Precussion, vibration

Breathing techniques
- Diaphragmatic breathing with or without inspiratory hold
- Breath stacking

19
Q

Respiratory accessary muscle use

A
  • Diaphragmatic breathing
  • Educate on peroper breathing techniques
20
Q

Smoking

A
  • Education on the effects of smoking on respiratory health
  • Refer to community support if the Pt was ready to change
21
Q

Unable to participate in meaningful activity (work, posr, hobby)

A
  • Start gradually and make a plan for adding more tasks if no exacerbation occurs
  • Liaise with coach/strength and conditioning specialist
  • Progressive agility and sport specific exercises when able
    –> Sidestepping, grapevine
    –> Explosive movements
    –> Star drill
    –> Change of direction drills
    –> Running forward/backward, hopping
  • Gradual return to sports
    –> Non-contract practice (e.g. drills)
    –> Contact practice (e.g. scrimmage)
    –> Partial gameplay (e.g. 1st half only)
    –> Full gameplay
  • Gradual return to work
    –>number of hours
    –>demand of tasks
  • Use of bracing/taping

OCE-Case 2-Treatment (8 decks)

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