Bimechanical FOR 2 Flashcards
What does edema do
Leads to swelling within tissues in your body
What are early stages of edema
Visible puffiness
skin hot to touch
mushy end feel
What do you see in advanced edema
Massive swelling
skin cold to touch
impaired range of motion
severe pain
What happens if edema is not treated
You can have permanent loss of range of motion, active movement, sensation and decreased nutrition to distal body parts leading to amputation
What is intrinsic tightness
When MCP joints placed in extension, would see less PIP flexion
What is extrinsic tightness
When MCP joints are placed in flexion you would see less PIP flexion
What is a specialty test for intrinsic tightness
Hold MP joint in maximum extension and passively flex the PIP joints. then hold the MP joints in flextion and passively flex the PIP joints.
Specialty test for extrinsic tightness
The same as the test for intrinsic tightness but results are opposite.
What do intrinsic muscles act on
Only on the digits
What do extrinsic muscles act on
The wrist and digits
What does total active motion measure
Tendon excursion during MCP/PIP/DIP flexion
Tendon tightness
What Is tendon excursion
Distance A tendon travels when a joint moves
How to do total active motion
Patient actively flexes all three finger joints at the same time
What is normal TAM
260°
How to calculate abnormal TAM
Add the degrees of MCP/PIP/DIP flexion and then subtract the degrees of MCP/PIP/DIP extension that is lacking
What are the steps in the assessment decision tree for joint mobility and muscle strength
- Screen; eyeball PROM
- PROM goniometry only for restricted joints
- specialty tests for hand ROM or edema
- screen for weakness; eyeball AROM (quick AROM)
- MMT (generally quick MMT)
- goniometry when active range of significantly limited or when manual resistance is contraindicated
- individual MMT
- muscle palpation
Interventions for structural stability
Orthoses, braces, splints, positioning devices
- be aware of skin breakdown
- have to come out of that position so they don’t become contracted
Interventions for edema
Elevation-above heart
pressure- co an wrap, jobst stocking, retrograde massage, AROM (allows for natural pump going on in the hand)
contrast baths
What do contrast baths do
Cause alternate dilation and contraction providing increased blood flow, white blood cell activity and oxygen to speed up the healing
Interventions to maintain ROM
PROM AAROM AROM Tenodesis ROM Scar remodeling
Who do you use tenodesis ROM with
What does it do
Those with C6 spinal cord injury
used to promote tightness of the finger flexors for functional mechanical grip
What is scar modeling
Breaks of collagen and bundles
How to do Scar remodeling
Deep friction massage
tendon gliding exercising
What is the point of deep friction massage
Tries to increase pliableness of tissue to be able to complete stretches following deep friction.
Use ball of thumb in circular motion
