Deck 16 Flashcards
supine SLR preferentially strengthens which muscles?
hip flexors
quadriceps
A 69-year-old male with left lateral hip pain that sometimes radiates to the groin (rated 2/10) is referred to physical therapy. He is having some difficulty with basic ADLs like putting on his socks and shoes because of hip pain. The physical examination shows restrictions and pain with active hip flexion to 75 degrees, active hip extension to 8 degrees, active hip internal rotation to 12 degrees, and active hip external rotation to 30 degrees. He has strength of 4-/5 in bilateral hip abductors and extensors. A FABER test is positive on the left but negative on the right. Joint play is limited with inferior, anterior, and posterior glides of the femoroacetabular joint on the right.
The physical therapist has seen the patient for six visits, and the patient is improving, but the physical therapist would like to change the manual therapy and utilize thrust manipulation on the patient’s hip. What is the best course of action for the physical therapist?
A. It is not appropriate to use thrust manipulation with this patient because of her age and objective findings
B. Use long-axis distraction hip manipulation, starting in open-pack position and progressing to closed-pack position in the patient’s most restricted range
C. Use long-axis distraction hip manipulation only in open-pack position
D. Use thrust manipulation, but only at the lumbar spine, to address the hip
B. Use long-axis distraction hip manipulation, starting in open-pack position and progressing to closed-pack position in the patient’s most restricted range
A 69-year-old male with left lateral hip pain that sometimes radiates to the groin (rated 2/10) is referred to physical therapy. He is having some difficulty with basic ADLs like putting on his socks and shoes because of hip pain. The physical examination shows restrictions and pain with active hip flexion to 75 degrees, active hip extension to 8 degrees, active hip internal rotation to 12 degrees, and active hip external rotation to 30 degrees. He has strength of 4-/5 in bilateral hip abductors and extensors. A FABER test is positive on the left but negative on the right. Joint play is limited with inferior, anterior, and posterior glides of the femoroacetabular joint on the right.
After four weeks in physical therapy, the patient indicates he will be going to Florida for the winter, where he lives in a retirement community with a pool. Based on current evidence, what should the physical therapist’s recommendation be regarding aquatic therapy?
A. Aquatic exercise is only appropriate for those who are obese, so because the patient has a normal body mass index, aquatic therapy will be of no benefit
B. Aquatic exercise will provide good long-term benefit, so it is best to discontinue land physical therapy and only utilize aquatic therapy in the future
C. Aquatic therapy will provide short-term benefit, so the patient should continue to perform some of his home exercises and go to a physical therapist in Florida if symptoms persist
D. There is no evidence available for hip osteoarthritis and aquatic therapy, only knee osteoarthritis, so the physical therapist cannot make a recommendation to the patient
C. Aquatic therapy will provide short-term benefit, so the patient should continue to perform some of his home exercises and go to a physical therapist in Florida if symptoms persist
Per Hoeksma studies in 2004/2005, LAD thrust manipulation of the hip used starting in open packed and progressing to closed packed position where the pt was most restricted for a maximum of __ manipulation attempts
5
Per Hoeksma et al. studies, LAD thrust technique for the hip should progress to ___ position for the best pt outcomes
close packed
Aquatic therapy has only been shown to provide (short/long) term benefit
short
An 82-year-old male is referred to physical therapy with right calf pain that radiates to the right ankle sporadically throughout the day and began six months ago. There is no injury or incident the patient can connect the symptoms to, and he is unable to provoke symptoms by changing position or activity. In the past year, the patient began taking blood pressure and cholesterol medications for the first time, but other than that, the patient’s health is remarkable for his age. Given the provided information, which diagnosis is most likely?
A. Achilles tendinosis
B. Femoral artery obstruction
C. GSC strain
D. Popliteal artery obstruction
D. Popliteal artery obstruction
With popliteal artery obstruction, the pt will report pain or discomfort where?
calf and/or ankle
With a femoral artery obstruction, the pt would be more likely to see pain where along with calf pain?
thigh
A 54-year-old male reports substernal pain that will radiate to the posterior thoracic spine and also to his left shoulder. He attributes the pain to a recent tennis game, where he exerted himself more than normal. He plays tennis twice a week, but this recent match became much more competitive than his typical matches. He noticed that his pain gets worse when he lies down and that it also seems to increase when he coughs, takes a deep breath, or laughs hard. If he leans forward or holds his breath, the symptoms decrease. The patient has a history of high blood pressure, but he is currently not taking medication because his recent readings were within the normal range. What should the physical therapist’s next step be?
A. Initiate a trial of manual therapy and therapeutic exercise to address the thoracic and shoulder pain per current evidence and address a rib dysfunction that is likely causing the substernal pain
B. Refer the patient for immediate medical attention due to what the physical therapist believes to be pericarditis
C. Refer the patient to a cardiologist for symptoms of angina
D. Treat the patient with modalities for pain and educate on activity modification until symptoms subside
B. Refer the patient for immediate medical attention due to what the physical therapist believes to be pericarditis
Pericarditis aggs
- lying down
- coughing
- deep breath
- laughing hard
Pericarditis eases
- forward flexion
- holding the breath
A physical therapist asks a patient about pharmacological management for her recent diagnosis of ankylosing spondylitis. The patient states that she has not been taking any medication although she was advised to take a particular medication by her physician. She cannot remember the name of the medication. What recommendation is most appropriate for those with ankylosing spondylitis?
A. Acetaminophen
B. Naproxen
C. Paracetamol
D. Tylenol
B. Naproxen
A physical therapist is treating a patient with rheumatoid arthritis, and the patient has developed a swan-neck deformity. The patient noticed an onset of this deformity six months prior to referral from her physician to physical therapy. It has become rather painful and has started to limit hand mobility in the past six weeks. Which of the following interventions will be most effective for this patient’s condition, based on the progression of the deformity?
A. Joint mobilization
B. Strengthening
C. Stretching
D. Surgical intervention
D. Surgical intervention
Typically pts with a boutonniere deformity from RA will respond to what if treated early?
splinting and therapeutic exercise