elbow joint hypomobility

Question 1

usual causes of elbow joint hypomobility

Answer 1

fracture
dislocation

arthritic conditions
burns
myositis ossificans

Question 2

rehab goals in the protection phase of non-op management

Answer 2

pt education

control inflammation

maintain soft tissue and joint mobility

maintain integrity and function of related areas

Question 3

interventions on pt education

Answer 3

anticipated length of symptoms

joint protection and activity mod - no lifting, pushing and fatigue

residual stiffness - loss of 10-15° terminal ext

realistic expectations

Question 4

interventions to control inflammation

Answer 4

reduced disloc: splinted for 5-7 days - hinged elbow brace in full pronation 4-6 wks on a sling at 20-30° flexion to prevent ulnar nueropathy

gr 1-2 joint oscillation for pain d/t arthritis

avoid valgus stress esp for ulnar disclocation

Question 5

interventions to maintain soft tissue and joint mobility

Answer 5

controlled rom ex

gentle isoms or multiple angle

Question 6

interventions to maintain integrity and function of related areas

Answer 6

shoulder, wrist and finger ROM ex

elevation and massage if may swelling - light effleurage

Question 7

rehab goals in the controlled motion phase of non-op management

Answer 7

observe precautions after trauma

inc soft tissue and joint mob

improve joint tracking of elbow

improve muscle performance and function

Question 8

interventions to observe precautions after trauma

Answer 8

heterotopic ossification - ONLY ROM

bony endfeel = malunion

diminished brachial pulse

forced terminal extension

Question 9

interventions to inc soft tissue and joint mob

Answer 9

HR or PJM

reduction of pulled elbow - apply compression and supination to radial head

reduction of pushed elbow - d/t FOOSH; gr 3 distraction

manual and self-stretching

Question 10

interventions to improve joint tracking

Answer 10

MWM

Question 11

interventions to improve muscle performance and function

Answer 11

active light resistance

CKC - OKC

return to play for athletes if 90% na yung bad UE to the strength of good UE

Question 12

rehab goals in return to function phase

Answer 12

further improve muscle performance

restore functional ability

Question 13

interventions to further improve muscle performance

Answer 13

exercises that replicates the pts demands of function

to prepare muscle and joints - simulate specific tasks

Question 14

interventions to restore functional ability

Answer 14

if restrictions still remain - gr 3-4 pjm

Question 15

post-op management of excision of the radial head

Answer 15

immob: 1-3 days

90° flexion c FA in neutral c posterior splint

elevate arm for comfort and minimize edema

if joint is tenuous - delay ROM for 1 wk and after dapat naka hinge splint mag ROM

Question 16

post-op management of total elbow arthroplasty

Answer 16

immob: 8-12 days to wks

compression dressing c post/ant splint

fulle ext to 70-80° flexion c FA in neutral

wear splint at night for 6 wks

Question 17

intervention scenario of total elbow arthroplasty

Answer 17

compensate: use unaffected UE

prevent: prevent disloc or loosening

Question 18

precautions in total elbow arthroplasty

Answer 18

postpone resisted elbow ext for 6-12 wks if triceps -reflecting approach

apply resistance proximal to elbow

avoid push-up activities and carrying objects for 6 wks

consider lifting limits

bawal na mag bowling, badminton, tennis

Question 19

compare triceps-reflecting and triceps-splitting

Answer 19

triceps reflecting - removed then balik triceps tendon hence dapat mag postpone ng resistance

tirceps splitting - tendon split in the middle

Question 20

what are the lifting limits in total elbow arthroplasty

Answer 20

1 lb for 3 mo

2 lbs for 6 mo

no more than 5 lbs afterwards