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DPT 730/1: MSK > E1-Healing Phases and MET > Flashcards

E1-Healing Phases and MET Flashcards

1
Q

what are the characteristics of direct trauma

A

obvious trauma
rapid onset of symptoms including surgery

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2
Q

what are the characteristics for overuse syndrome

A

no trauma
sudden changes in parameters of activity
subsequent onset of symptoms- tendinitis

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3
Q

what are the characteristics of repetitive strain syndrome

A

no trauma
gradual onset of symptoms without change in parameters of activity
biomechanical limitation or degenerative disease

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4
Q

what are the characteristics of regional interdependence

A

increased nociceptive response and decreased pain inhibition, peripherally and centrally
gradual onset of symptoms- victim vs real culprit
doesn’t fit traditional biomechanical model
often unsuccessful treatments

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5
Q

what are the general phases of tissue healing

A

hemostasis
inflammation
proliferation/repair
remodeling

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6
Q

can healing occur without inflammation and vice versa

A

no, healing will always include inflammation

yes, inflammation can occur without the presence of healing

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7
Q

how long does the acute inflammation last

A

24 hours to 2 weeks

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8
Q

what are the the acute inflammation cardinal S&S

A

red
swollen
hot
P!

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9
Q

what is the purpose of the acute inflammation phase

A

protect and preparation

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10
Q

what happens systemically during vascular reaction

A

vasoconstriction from pain and SNS stimulation to- shunt blood from injury site, start clotting, slow bleeding

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11
Q

what happens at the site of injury during vascular reaction

A

local vasodilation and vascular permeability brings cells to kill and clean

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12
Q

what happens at the cellular level during hemostasis and inflammatory stages

A

serotonin released
platelets aggregate- release growth factors
histamines, etc released for local dilation
WBCs

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13
Q

Because of vasodilation in the local area of injury, what happens

A

local stasis= edema
increased viscosity
increase of chemicals and acidity leads to chemical muscle guarding

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14
Q

what is the “glue” of cellular reactions in the hemostasis/inflammatory stages

A

RBCs, cellular debris, fibronectin

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15
Q

what is the general Rx during the hemostasis/inflammatory stage

A

max protection
POLICED

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16
Q

what is POLICED

A

protection
optimal
loading
Ice
Compression
Elevation
Drugs

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17
Q

what does the P stand for in POLICED

A

protection with possible….
activity modification
immobilization- bracing/taping
assistive device

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18
Q

what does “OL” mean for POLICED

A

optimal loading thru activity and MET..
P! and inflammation
early motion
promote tissue repair
muscle activation to combat inhibition

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19
Q

Why can drugs be limited for POLICED

A

NSAIDs may impair healing by impairing histamines from causing vasodilation and local permeability
drugs should only be used if ADLs are impaired because of pain

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20
Q

how long can the repair phase last

A

24 hours to ~10 weeks

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21
Q

what is the purpose of the repair phase

A

collagen production by respective tissue cell
formation of new blood vessels
restoration of skin

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22
Q

what is the general Rx for the repair phase

A

continue inflammatory phase Rx
greater ROM restrictions and tissue with manual therapy/MET
progress MET for optimal loading with dose response to direct and protect new collagen but achieve neuromuscular benefits

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23
Q

what general Rx would benefit the following tissues in the repair phase: articular cartilage, annulus, disc (fibrocartilage)

A

compression, distraction, gliding

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24
Q

what general Rx would benefit the following tissues in the repair phase: bone

A

compression and distraction

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25
Q

what general Rx would benefit the following tissues in the repair phase: muscle, tendon, ligament, capsule, outer annulus, menisci (fibrocartilage)

A

tension

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26
Q

what is the time period for the remodeling phase

A

2 weeks to a year, but may continue up to 3 years

27
Q

what is the purpose of the remodeling phase

A

collagen conversion and organization- immature collagen to mature collagen
wound contraction by myofibroblasts

28
Q

what is the general Rx for the remodeling phase

A

return to function
address symptoms- move away from passive treatment
restore full ROM with MT/MET
progress to higher MET

29
Q

what could possibly go wrong and create a set back?

A

subacute inflammation
chronic/persistent inflammation
abnormal scar tissue

30
Q

what are the differences between acute, subacute, and chronic inflammation

A

acute= healing
subacute= mild prolonging of inflammatory response
chronic= pitting edma, release of inflammatory products

31
Q

how could you treat chronic inflammation

A

heat- lowers the viscosity of the edma

32
Q

what is remodeled tissue

A

combination of original and secondary types of collagen

33
Q

What level of tissue dosage is MET considered

A

High dosage exercise
More reps, exercises, aerobic activity

34
Q

What is the primary purpose people come to PT

A

Pain, inflammation, and muscle guarding

35
Q

What are benefits of treating pain, inflammation and muscle guarding with PT

A

Reduce symptoms
Improve circulation and venous return
Facilitate lymphatic drainage
Limit atrophy

36
Q

When is it OK to have mild pain with exercise

A

Non acute or persistent conditions:
Muscular strain
Tendinopathies
Nociplastic conditions

37
Q

What are some rationales that Pts need to know about their treatment

A

Demonstrate hurt does not equal harm
Alleviates mental fear of movement
Reduces sensitivity of CNS
Same or better gains

38
Q

What is it not OK to treat when the pt has pain

A

Acute conditions
Remaining tissues/conditions: age related change, hypermobility/instability, stenosis

39
Q

What purpose needs to be achieved earliest for muscle function using MET

A

Muscle activation

40
Q

How is endurance related to MSK in PT

A

We are stressing the integrity of tissues. The act of tissues withstanding stress over a period of time

41
Q

How can you change the integrity of tissue with endurance

A

Tissue dose response: motor activation, skill, coordination development

42
Q

What are characteristics of motor skill/coordination

A

Controlling increased motion and speed
Occurs very early
More and better fiber recruitment

43
Q

What purpose has to be obtained first for better outcomes with motor skill/coordination

A

Activation

44
Q

How do we prescribe to reach motor skill/coordination

A

Can occur at <50% 1 RM
Work or quick concentric, brief isometric hold, then slower eccentric action

45
Q

What is muscle strength

A

Force generation

46
Q

What is the best intervention for sports injuries

A

Muscular strength
Decrease sports injuries by 1/3
Decrease overuse injuries by nearly 1/4

47
Q

When can you see hypertrophy or increase in fiber size

A

6-8 weeks

48
Q

If hypertrophy is not seen until 6-8 weeks, what is changing

A

Neurological adaptations are taking place

49
Q

What is the 2nd best injury preventer

A

Agility

50
Q

What is plyometrics

A

Eccentric load or lengthening followed by concentric action through the stretch reflex

51
Q

What are the plyometric parameters

A

Explosive and up to 5 reps with heavier load

52
Q

What are the benefits of plyometrics

A

Achieve greater cross bridging
Length and speed feedback from muscle spindle that links synergistic muscles to act

53
Q

What do aerobic components help with

A

Endogenous influence
Even more optimal stresses for a better dose response
More movement to combat fear avoidance behaviors
Oxygenation of tissue

54
Q

What is the frequency needed for exercises

A

At least 2-3x/wk

55
Q

What weight and reps would you do to achieve pure strength and power

A

Heavy load with max 8 reps

56
Q

What weight and reps would you do to achieve ROM, activation, integrity, coordination, and agility

A

Moderate load with max 30 reps

57
Q

What are the indications to do isometrics

A

Unable to perform motion with even the lightest resistance
Pain modulating benefits
To use heavier loads when more motion is painful

58
Q

What are isometric exercise parameters

A

Varied 3-5 reps of 10-45 sec holds

59
Q

Based on Oddvar Holden diagram, what sets and reps would be appropriate for acuity

A

1-2 sets with light resistance

60
Q

Based on Oddvar Holden diaphragm, what is appropriate for tendonosis

A

3 sets of 10-15 reps with heavy resistance

61
Q

What would you do for sets and reps with this case:
Disc herniation
Avascular/hypovascular tissue
Needs better tissue endurance/integrity or healing

A

3x30 with moderate load

62
Q

What would you do for sets and reps with this case:
Shoulder impingement due to joint hypermobility and insufficient rotator cuff
Better motor activation and coordination

A

3x30 with moderate load

63
Q

What would you do for sets and reps:
Patellofemoral Pain Syndrome
Impaired trunk and hip strength

A

3x15-20 reps with moderate load

64
Q

What would you do for sets and reps with this case:
Ankle joint hypo mobility and adaptive muscle shortening following prolonged immobilization
Improve ROM

A

3x30 reps with moderate load

DPT 730/1: MSK (11 decks)

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