Contraindications For Tx (UE/LE)

Question 1

thoracic outlet syndrome

Answer 1

Avoid arms overhead, heavy lifting, weight bearing on affected shoulder

Question 2

Ape hand deformity

Answer 2

Avoid strengthening too early! Wait about 2 months after surgery or according to MD orders

Question 3

Carpal tunnel syndrome

Answer 3

Avoid repetitive motion& vibration to volar wrist

Question 4

Flexor tendon/extensor tendon injuries

Answer 4

DO NOT DO ROM IN OPPOSITE DIRECTION OF THE INJURY! CAN CAUSE RUPTURE (EX: for flexor tendon injury, only do ROM in flexion! No extension or neutral!!)

Question 5

Radial tunnel syndrome

Answer 5

Avoid forceful wrist extension & supination

Question 6

Pronator teres syndrome

Answer 6

Avoid FA pronation & supination, strengthen at 2 weeks post op

Question 7

Median nerve injury

Answer 7

Strengthening at 6 weeks post op

Question 8

Median nerve laceration

Answer 8

Hypertrophic scarring can lead to more damage

Question 9

Proximal humerus fx with ORIF

Answer 9

Phase 1 (@1-3 weeks): sling at all times, no AROM, lifting, pushing, pulling x 6 weeks, no supporting of body weight

Phase 2 (@3-6 weeks): sling/ROM limitations, no IR/ER, driving, pushing/pulling/lifting, no cuff strengthening

Phase 3 (@6-12 weeks): sling use per MD, can start to drive, 20 lb weight limit, no pushing/pulling or overhead activity

Phase 4 (@12 weeks +): no overhead lifting until 4-6 months post op

Question 10

early stage dementia

Answer 10

FOCUS: IADL difficulties
DO NOT: provide client with educational materials abt dx, retrain client in ADL/IADLs, ask client about their routines during evaluation

DO: provide visual cues, environmental supports, train caregivers on disease progression, interview caregivers on safety concerns during evaluation

Question 11

middle stage dementia

Answer 11

focus: safety, wandering
DO NOT: administer COPM to client, administer Mini Mental Status Assessment if they are agitated or aggressive, ask client about their ADL performance

DO: assess home environment, ask family about the client’s ADLs & interventions that they may have already tried, observe the client during ADLs, provide structured activity to the client during the daytime (exercise & time outside)

Question 12

Multiple Sclerosis

Answer 12

DO NOT: use heat modalities, aggressive strengthening

DO: use compensatory strategies, energy conservation, gradual/low load strengthening, rest breaks, break down tasks, maintain hips at 90 degrees flexion to reduce LE extensor tone, use ice, use hand over hand techniques, use weighted utensils

Question 13

Guillain Barre

Answer 13

DO NOT: continue activity if client is overexerted

DO: HEP (low resistance, short set of reps) during recovery phase

Question 14

ALS

Answer 14

DO NOT: do progressive resistive exercises which causes cramping, fatigue