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Musculo > Bae's Last Lecture 8/9 (10-1/6) > Flashcards

Bae's Last Lecture 8/9 (10-1/6) Flashcards

1
Q

What does a grade 1 mean for non thrust

A

barely touching the skin and small amplitude

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2
Q

What does a grade 1 non thrust do

A

stimulates mechanoreceptors and inhibit nocioceptors

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3
Q

What does a grade 2 mean for non thrust

A

Starting to feel something is happening and large amplitude

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4
Q

What does a grade 2 non thrust do

A

Takes patient to point of first resistance

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5
Q

What does a grade 3 mean for non thrust

A

Some tissue resistance and large amplitude

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6
Q

What does a grade 3 non thrust do

A

Takes patient past point of first resistance making some sort of impact on mobility

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7
Q

What does a grade 4 mean for non thrust

A

End range pushing into barrier and small amplitude

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8
Q

What does a grad 4 non thrust do

A

Brings patient to second resistance (end range)

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9
Q

How long do you do grade 1 and 2 non thrusts for

A

60 seconds

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10
Q

How long do you do grade 3 and 4 non thrusts for

A

3-5 minutes

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11
Q

What are something you can do with a patient in the inflammatory stage (3)

A
  1. Gentle sub maximal isometrics
  2. Retrograde massage
  3. Maintain function where/if appropriate
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12
Q

What is the purpose of gentle sub maximal isometrics (2)

A
  1. Increase blood flow

2. Maintenance of strength

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13
Q

True or False:

Gentle sub maximal isometrics are usually not pain free or comfortable

A

True

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14
Q

What is the purpose of retrograde massage

A

Trying to work fluid back towards the heart

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15
Q

What are the goals of the proliferation phase (4)

A
  1. Promote tissue growth
  2. Continue protection as needed
  3. Encourage safe controlled mobility
  4. Progress to more active rehab
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16
Q

What is the general intervention principle of the proliferation phase

A

Do interventions that are safe and progress tissue loading

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17
Q

What should you educate the patient about during the proliferation phase (3)

A
  1. Signs of inflammation
  2. Tell them exactly what they can’t do
  3. Sometimes you have to inform other people of what to do
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18
Q

What does often mean during the proliferation phase

A

Too much too soon

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19
Q

What does maybe mean during the proliferation phase

A

Not enough too late

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20
Q

What are things that should be done during the proliferation phase (4)

A
  1. AROM
  2. Multiangle sub maximal isometrics
  3. Muscle endurance
  4. Initiation and progression of stretching
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21
Q

Where should AROM be done during the proliferation phase

A

Within available pain free ROM

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22
Q

What do multiangle sub maximal isometrics do

A

Initiate muscular control and strengthening

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23
Q

What muscle fibers are first to atrophy

A

Slow twitch

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24
Q

What are 2 ways to initiate and progress stretching

A
  1. PNF inhibition techniques

2. Joint mobilization

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25
Q

What does PNF stand for

A

Proprioceptive neuromuscular facilitation

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26
Q

How do you improve endurance during the proliferation phase

A

Low load and cyclic loading for extended periods of time

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27
Q

What are the goals of the maturation phase (2)

A
  1. Progress functional activities

2. Continue tissue reorganization

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28
Q

How long does it take collagen to rearrange completely

A

12-18 months

29
Q

What are the general intervention principles of the maturation phase (3)

A
  1. Prepare to return to full ADLs
  2. Secondary prevention
  3. Complete D/C plan
30
Q

What are 2 types of secondary prevention

A
  1. Maintenance exercise plan

2. Lifestyle alteration

31
Q

Activities/therapeutic exercise should not have persistent discomfort beyond how long

A

4-24 hours

32
Q

What is a key thing to look for during the maturation phase

A

Signs of inflammation returning

33
Q

What is chronic inflammation

A

A chemical process

34
Q

What causes repetitive microtrauma and/or strain overload

A

Not giving the tissue a break

35
Q

What are 3 types of inflammation that can perpetuate

A
  1. Chronic inflammation
  2. Repeated microtrauma
  3. Repeated strain overload
36
Q

What should you do with the 3 perpetuated types of inflammation

A

Treat them as if they were in the inflammatory stage of healing

37
Q

Why would the inflammatory process perpetuate (10)

A
  1. Muscle length and strength imbalances
  2. Rapid or excessive repeated eccentric demand
  3. Muscle weakness
  4. Bone misalignment or weak structural support
  5. Change in usual intensities or demands
  6. Return to activity too soon
  7. Sustained poor posture or motion
  8. Environmental factors
  9. Age related
  10. Training errors
38
Q

What are 4 typical musculoskeletal impairments of body structure

A
  1. Impaired joint mobility
  2. Impaired muscle performance
  3. Tissue reactivity
  4. Impaired motor performance
39
Q

What are 3 causes of impaired joint mobility

A
  1. Inextensible capsule/ligament
  2. Inflexible muscle
  3. Excessive laxity of capsule or ligament
40
Q

What are 3 types of impaired muscle performance

A
  1. Strength (decreased force magnitude
  2. Endurace (decreased force duration)
  3. Hypertonicity (elevated resting tone)
41
Q

What are 2 types of tissue reactivity

A
  1. Compression load intolerance

2. Tension load intolerance

42
Q

What are the 2 types of direct interventions PT can do with patients with musculoskeletal dysfunction

A
  1. Add cyclic biomechanical load

2. Remove biomechanical laod

43
Q

What are the 2 reactive tissue load intolerance questions

A
  1. Was the premorbid tissue “normal”

2. Were the premorbid biomechanical loads “normal”

44
Q

What do you look at to determine if the premorbid tissue was “normal” (3)

A
  1. Length abnormality
  2. Contractile abnormality
  3. Infrastructure abnormality
45
Q

What are examples of length abnormalities (2)

A
  1. Inelastic

2. Inflexible

46
Q

What are examples of contractile abnormalities (2)

A
  1. Strength

2. Endurance

47
Q

What are examples of infrastructure abnormalities (3)

A
  1. Degeneration
  2. Osteoporosis
  3. Post immobilization
48
Q

What do you look at to determine if the premorbid loads were “normal” (3)

A
  1. Excessive intensity
  2. Excessive frequency
  3. Excessive duration
49
Q

What type of tissue load intolerance is more severe in nature

A

Premorbid tissue: abnormal

Premorbid biomechanical loads: abnormal

50
Q

What type of tissue load intolerance is some degenerative changes, older patient, integrity of tissue is abnormal making normal load more difficult

A

Premorbid tissue: abnormal

Premorbid biomechanical loads: normal

51
Q

What type of tissue load intolerance is some one who helped you move in or weekend warriors

A

Premorbid tissue: normal

Premorbid biomechanical loads: abnormal

52
Q

What type of tissue load intolerance is healthy people, not patient, potential clients

A

Premorbid tissue: normal

Premorbid biomechanical loads: normal

53
Q

True or False:

there is a window of appropriate cyclic loading

A

True

54
Q

What is the stress shield

A

“elastic” activity tissue

55
Q

What happens when you exceed the physiologic limit

A

Tissue disruption

56
Q

True or False:

It is ok to exceed the physiolgic limit as long as it doesn’t can any damage

A

False

57
Q

What are the parameters for working on strength

A

6-12 reps

3-5 sets

58
Q

What are the parameters for working on endurance

A

20-30 reps

3-5 sets

59
Q

What are the parameters for working on tendons

A

30-40 reps

3-5 sets

60
Q

What are the parameters for working on ligaments

A

1000s of reps

61
Q

What are the parameters for working on cartilage

A

Hours of reps

62
Q

What is the window of where you are confident you won’t make the patient worse

A

Clinical confidence interval

63
Q

What does the top of the box represent

A

The threshold of making the patient worse

64
Q

What does the bottom of the box represent

A

Not make them worse or better

65
Q

What happens if you don’t get into the box

A

The patient gets better but not as quickly

66
Q

What happens if you do not impart enough stress

A

No change in patients functional levels

67
Q

What happens if you push the patient too hard

A

They may get better for a bit but after a while they will get worse

68
Q

True or False:

You should treat the impairments and treat the activities they are having trouble with

A

True

69
Q

What do you do if gravity is too much for the patient to do the motion (4)

A
  1. Manual assist
  2. Change patient position
  3. Water buoyancy
  4. Counterweight and pulley

Musculo (18 decks)

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