Deck 10 Flashcards
17F athlete 2 days s/p inversion ankle injury during a soccer game. Moderate ecchymosis and swelling about lateral ankle. Able to limp off field immediately after the injury and ambulates into clinic using arm support of her father with significant antalgic gait with early heel off, reduced WB, and shortened stance time of the involved side. Objectively, has pain with ROM in all planes, most notably into PF and inversion. DF of approximately 2˚ on involved side, 12˚ on uninvolved.
Pt has ttp of ATFL and CFL, no ttp at base of 5th met, malleoli, or navicular bone. Anterior drawer, talar tilt reveals pain and laxity.
Based on the above and best current evidence, what tx is recommended at this time?
A. Dispense axillary crutches and recommend ambulation as tolerated
B. AP mobs and ankle pumps
C. Cryocuff and pulsed US
D. Lymphatic drainage to reduce swelling and OTC NSAIDs for inflammatory reduction
A. Dispense axillary crutches and recommend ambulation as tolerated
Ankle sprains: level of recommendation for early progressive WB with use of external support as needed
A
Ankle sprains: level of recommendation for joint mobilizations
B
Ankle sprains: level of recommendation for lymphatic drainage
B
Ankle sprains: level of recommendation for pulsed US
not recommended
22F distance runner presents to PT with c/o retropatellar and peripatellar knee pain when training for ½ marathon. Reports inc pain with jumping, running, stair descent > ascent, and sitting with knee flexed > 30 minutes.
What is the most appropriate self-reported outcome measure for this pt?
A. Lysholm knee scale
B. International Knee Documentation Committee (IKDC)
C. Anterior Knee Pain Scale (AKPS)
D. Tegner activity scale
C. Anterior Knee Pain Scale (AKPS)
The Lysholm knee scale is ideal for
meniscus/cartilage lesions
knee ligamentous injury
The IKDC is ideal for this type of injury
knee ligament
The Tegner activity scale is ideal for this type of injury
knee ligament
22F distance runner presents to PT with c/o retropatellar and peripatellar knee pain when training for ½ marathon. Reports inc pain with jumping, running, stair descent > ascent, and sitting with knee flexed > 30 minutes.
What is the best intervention day 1 for the pt in order to resolve her knee pain and return to volleyball?
A. Standing hip abd and resisted knee ext training
B. BFR training with high rep knee ext strengthening
C. Tibiofemoral and patellofemoral knee mobilization with medial glide taping
D. DN quadriceps femoris and prefabricated foot orthosis prescription
A. Standing hip abd and resisted knee ext training
Level of evidence for BFR for patellofemoral pain
F - expert opinion
DN for PFPS recommendation
NOT recommended
22F distance runner presents to PT with c/o retropatellar and peripatellar knee pain when training for ½ marathon. Reports inc pain with jumping, running, stair descent > ascent, and sitting with knee flexed > 30 minutes.
What gait retraining modification would NOT be recommended for this pt to reduce her anterior knee pain?
A. Adopt a forefoot strike pattern rather than a rearfoot strike pattern
B. Inc cadence
C. Reduce peak hip add during gait
D. Barefoot mimicking footwear for 10% of training volume
D. Barefoot mimicking footwear for 10% of training volume
Barefoot mimicking footwear worn (%) of the time has been shown to be helpful in combination with increasing _____ as compared to foot orthoses in treatment of anterior knee pain
20%
cadence
Anterior knee pain: Level of recommendation for use of forefoot strike pattern rather than rear strike
C