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Ortho 1- second half > Arthritis > Flashcards

Arthritis Flashcards

1
Q

goals of exercise intervention

A

slow or reverse body’s response to joint pathology by increasing strength, flexibility, endurance and by decreasing pain

improve impairments, functional limitations, and disabilities resulting from arthritis

lead to overall improved health status as an effect of cardiovascular, strengthening, ROM and stretching exercises

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2
Q

ligs, muscles, tendons, capsule, cartilage, bone

A

stabilize
absorb
transmit forces

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3
Q

OA

A

nonsystemic
mostly noninflammatory
localized pathology

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4
Q

RA

A

systemic
inflammatory disease
usually involves multiple joints
often affects organ systems

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5
Q

articular cartilage function

A

shock absorption

joint congruence

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6
Q

effects of OA on articular cartilage

A

thickening to softening

thinning to loss

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7
Q

effects of RA on articular cartilage

A

erosion

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8
Q

synovium function

A

secretes synovial fluid for nutrition of cartilage, lubrication and stability

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9
Q

effects of OA on synovium

A

abnormal joint alignment stresses

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10
Q

effects of RA on synovium

A 
microvascular lining cells activated by inflammatory process
pannus formation (granulation tissue)
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11
Q

ligament function

A

stability
reinforce capsule
limit movement
guide movement

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12
Q

effects of OA on ligaments

A

abnormal joint alignment stresses

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13
Q

effects of RA on ligaments

A

erosion

weakens

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14
Q

muscle function

A

reinforce joint capsule
reflex joint protection
move joints

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15
Q

effects of OA on muscle

A

immobility shortens pain, causes guarding and reflex inhibition leading to weakness

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16
Q

effects of RA on muscle

A 
joint deformity interferes w/ peak torque
immobility shortens
myositis weakens
pain & effusion cause guarding
reflex inhibition leads to weakness
17
Q

bone function

A

structural support

18
Q

effects of OA on bone

A

subchondral bone remodeling changes shock absorption properties

joint margin spurring leads to bony blockage and pain

19
Q

effects of RA on bone

A

erosion leads to joint deformity
bony blockage
pain

20
Q

OA effects on extra-articular system function

A

increased energy expenditure from abnormal movement patterns

21
Q

RA effects on extra-articular system function

A 
myositis
anemia
sleep disruption
fatigue
increased energy expenditure from abnormal movement patterns
22
Q

RA Class I

A

EARLY
completely able to perform usual ADLs

no destructive changes on roentgenographic exam

roentgenologic evidence of osteoporosis may be present

23
Q

RA Class II

A

MODERATE
able to perform usual self-care and vocational activities, but limited in avocational activities

roentgenologic evidence of osteoporosis, with or without slight subchondral bone destruction; slight cartilage destruction may be present

no joint deformities, although limitation of joint mobility may be present

adjacent muscle atrophy

extra articular soft tissue lesions, such as nodules and tenosynovitis

24
Q

RA Class III

A

SEVERE
able to perform usual self care activities, but limited in vocational and avocational activities

roentgenologic evidence of cartilage and bone destruction in addition to osteoporosis

joint deformity, such as sublux, ulnar deviation, or hyperextension, w/out fibrosis or bony ankylosis

extensive muscle atrophy

extra-articular soft tissue lesions, such as nodules and tenosynovitis, may be present

25
Q

RA Class IV

A

TERMINAL
limited in ability to perform usual self-care, vocational and avocational activities

fibrous or bony ankylosis

criteria of stage III

26
Q

exercise recommendations and wellness

A

appropriate exercise regiment should emphasize:

  • maintaining appropriate BW
  • sustaining good postural alignment
  • developing good muscular strength and length
  • correct movements during functional activities
27
Q

therapeutic exercises for OA

A
  • decrease pain and inflammation
  • re-establish muscle length and strength around the joint
  • address adaptive changes in proximal and distal joints
  • performance of basic functional tasks
28
Q

therapeutic exercises for RA

A

*considerations are similar to OA
PLUS
-pts must be taught how to recognize symptoms, to modify activity according to symptoms development and stage of illness

29
Q

results of pain

A 
pain, swelling and splinting
disuse atrophy
reduce protective reflexes
further cartilage breakdown
disruption of soft tissue balance
inefficient movement/muscle patterns
decrease in cardiovascular activity
activity reduced further
30
Q

pain

A

exercise is used to restore muscle balance, joint ROM, CV conditioning

thermal modalities and estim for management

31
Q

impaired mobility and ROM can be diminished by:

A
  • stiffening and shortening of muscles or tendons from spasm, guarding, or habitual postures
  • capsular stiffness or contracture
  • loss of joint congruity because of bony deformity
32
Q

RA prescription

A

1-2 daily application of PROM (large joints) and AROM (small joints)

single submax isometric contractions (2/3 of MVC) 6 sec work/20 sec rest (acute and subacute phases)

caution should be used during MVC efforts

reps at various angles

33
Q

OA prescription

A

isometric contractions in acute phase

as pain and swelling decreases, graduating into a routine containing dynamic contractions

34
Q

impaired aerobic capacity

A

CV training should be a major part of therapy programs with OA or class I and II of RA

*aquatic therapy

35
Q

aquatic benefits

A

allos performance of movement patterns that may not be possible on land bc of balance or strength deficits

provides ms relaxation

modifying pain perception through sensory stimulation

36
Q

special considerations

A

protect joints during strengthening when lig or capsular laxity exists

restore muscle balance when splinting, postural habit, pain inhibition has weakened muscle groups around 1 or more joints

normalize specific joint movement patterns

restore functional activities

treat pain during and after exercise

Ortho 1- second half (5 decks)

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