Chatper 11: Biomechanical Approaches

Question 1

Resting hand splint: functional position

Answer 1

wrist 20-30 degrees extension
MCPs 30-45 degrees flexion
IPs 0-20 degrees flexion
Thumb abduction

Question 2

Safe position splint

intrinsic-plus or anti-deformity splint

Answer 2

Wrist 20-30 degrees extension
MCPs 70-90 degrees flexion
IPs in extension
Thumb abducted and extended

Question 3

Brachial Plexus Injury

Answer 3

Flail arm splint

Question 4

Radial nerve palsy

Answer 4

dynamic wrist, finger, and thumb extension splint

Question 5

median nerve injury

Answer 5

opponens splint, c-bar or thumb post splint

Question 6

ulnar nerve injury

Answer 6

dynamic/static splint to position MPs in flexion

Question 7

combined median ulnar

Answer 7

figure-of-eight or dynamic MCP flexion splint

Question 8

spinal cord (c6-c7)

Answer 8

tenodesis splint

Question 9

Carpal tunnel syndrome

Answer 9

wrist splint positioned in neutral

Question 10

Cubital tunnel syndrome

Answer 10

elbow splint positions in 30 degrees of flexion

Question 11

deQuervain’s

Answer 11

thumb splint, includes wrist, IP joint free

Question 12

Skier’s thumb

Answer 12

hand-based thumb splint

Question 13

CMC arthritis

Answer 13

hand-based thumb splint

Question 14

Ulnar drift

Answer 14

ulnar drift splint

Question 15

Flexor tendon injury

Answer 15

dorsal protection splint

Question 16

swan neck

Answer 16

silver rings or buttonhole splint

Question 17

boutonniere

Answer 17

silver rings or PIP extension splint

Question 18

arthritis

Answer 18

functional splint or safe splint, depending on stage

Question 19

Flaccidity

Answer 19

resting splint

Question 20

spasticity

Answer 20

spasticity splint or cone splint

Question 21

Muscle weakness (ALS, SCI)

Answer 21

balanced forearm orthosis, deltoid sling/suspension sling

Question 22

Hand burns

Answer 22

Wrist 15-30 degrees extension, MCP 50-70 degrees flexion, and IPs in full extension

Question 23

Contraindiciations of heat therapy

Answer 23

Do not use with:

postsurgical repairs, acute injuries, impaired sensation, impaired vascular supply

Question 24

Precautions/Contraindications of cryotherapy

Answer 24

Do not use with:

Sensory deficits, impaired circulation, Raynaud’s disease

Question 25

Ultrasound contraindications

Answer 25

Active malignant tumor, pregnancy, area near pacemaker, some joint replacements, and thrombophlebitis Precautions: fractures, growth plates, and breast implants

Question 26

Electrical Stimulation Contraindications

Answer 26

Cardiac pacemaker, phrenic or urinary bladder stimulators, presence of thrombosis or thrombophlebitis, and over carotid sinus

Question 27

ROM | Cervical Spine

Answer 27

Flexion - 0-45 degrees Extension - 0-45 degrees Lateral Flexion - 0-45 degrees Rotation - 0-60 degrees

Question 28

ROM | Thoracic and Lumbar Spine

Answer 28

Flexion - 0-80 degrees Extension - 0-30 degrees Lateral Flexion - 0-40 degrees Rotation - 0-45 degrees

Question 29

ROM | Shoulder

Answer 29

``` Flexion - 0-170 degrees Extension - 0-60 degrees Abduction - 0-170 degrees Adduction - 0 Horizontal Abduction - 0-40 degrees Horizontal adduction - 0-130 degrees Internal Rotation - 0-60/70 degrees External Rotation - 0-80/90 degrees ```

Question 30

ROM | Elbow

Answer 30

Flexion - 0-135-150 degrees | Extension - 0 degrees

Question 31

ROM forearm

Answer 31

Pronation: 0-80-90 degrees Supination: 0-80-90 degrees

Question 32

ROM | Wrist

Answer 32

Flexion: 0-80 degrees Extension: 0-70 degrees Ulnar Deviation - 0-30 degrees Radial Deviation - 0-20 degrees

Question 33

ROM | Thumb

Answer 33

DIP flexion - 0-80-90 degrees MP flexion - 0-50 degrees Adduction, radial & palmar - 0 Palmar and radial abduction - 0-50 degrees

Question 34

ROM | Finger

Answer 34

MP flexion: 0-90 degrees MP hyperextension: 0-15-45 degrees PIP flexion: 0-110 degrees DIP flexion: 0-25 degrees

Question 35

ROM | Hip

Answer 35

``` Flexion: 0-120 degrees Extension: 0-30 degrees Abduction: 0-40 degrees Adduction: 0-35 degrees Internal Rotation: 0-45 degrees External Rotation: 0-45 degrees ```

Question 36

ROM Knee Ankle and Foot

Answer 36

``` Knee flexion: 0-145 degrees Plantar flexion: 0-50 degrees Dorsiflexion: 0-15 degrees Inversion: 0-35 degrees Eversion: 0-20 degrees ```