Exam 2 Flashcards
Goniometry, Joint Replacement, Teaching and Learning Techniques, ROM Interventions, Pelvic Floor and Incontinence Management
AROM
active range of motion
- movement produced by one’s own muscles
AAROM
active assisted range of motion
- movement produced by one’s own muscles and assisted by an external force
PROM
passive range of motion
- movement produced by an external force
functional ROM
ROM needed to perform functional movements
- ex. reach top of head or small of back
WNL ROM
within normal limits range of motion
- indicates that the arc of AROM is within normal acceptable limits
limitations, contraindications, and precautions to ROM
- bone metastasis
- unhealed fracture or recent dislocation
- infection
- post surgery
- myositis ossificans
- subluxed or unstable joints
- skin grafts
- other as identified by the physician
hard end-feel normal/abnormal
normal: bony block - olecranon process in olecranon fossa
abnormal: client has an external fixator bone in grown
firm end-feel normal/abnormal
normal: soft tissue, tight but a bit resilient
abnormal: client has frozen shoulder
soft end-feel normal/abnormal
normal: flexing elbow with excess adipose tissue
abnormal: flexing elbow with edema
always round to the nearest ___ when using a goni
5 degree
rotator cuff muscles (4)
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
shoulder condition: shoulder instability
- causes: joint laxity, trauma, rotator cuff disease
- unidirectional - multidirectional
- subluxation - dislocation
- surgery - arthroscopy to tighten GH capsule
shoulder condition: impingement and tears
shoulder impingement: tendonitis, bursitis, tendinopathy
- causes: tendons/ bursa trapped/ compressed by shoulder movements
rotator cuff tears: acute vs. chronic
- causes: acute - trauma/ chronic extension of shoulder impingement
shoulder condition: adhesive capsulitis
adhesions
- synovitis
- fibrosis
- primary vs. secondary
4 stages of adhesive capsulitis & treatment
- mimic other rotator cuff diseases
- freezing
- primarily pain management - frozen
- thawing
- ROM
shoulder condition: fractures
cause: FOOSH
- rehab depends on stability
- complex immobilized 4-6 weeks
- minimally displaced 1-3 weeks
* must consider different questions
- non-operative management
- stable, non-displaced
- surgical management
shoulder condition: brachial plexus
- C1-T1
- dysfunction, intervention, and prognosis relate to mechanism and severity of injury
- neuropraxia - avulsion
- traumatic vs. non-traumatic causes
shoulder condition: cervical radiculopathy
- arm pain radiating from cervical nerve root condition
- other complaints may require referral to other discipline
- limited ROM (shoulder, arm, head/neck)
- postural difficulties
medical and surgical management: factors in decision making
- status of injury
- key neurovascular structures involvement
- potential for anatomical/ functional recovery
- client’s factors
medical and surgical management: conservative treatment
when is it the best option
- education
- HEP
- strategies for balancing rest & modified activities
when for a poor surgical candidate
- prevention of further injury
- caregiver education
immobilization, pain/edema control/modalities
medical and surgical management: different types of surgery/ surgical management
- arthroscopy
- arthroplasty
- open repair
- thermal capsulorrhaphy
OT evaluation of the shoulder
- history and intake
- clinical observation
- physical examination
- outcome measures
- occupational profile
OT assessment - shoulder
- symptoms
- activities - pain
- routine before/after symptoms
- interventions tried?
- clinical observations/ physical exam
- posture
- ortho screening tests
outcome measures - shoulder
- disabilities of the arm, shoulder & hand (DASH)
- shoulder pain & disability index (SPADI)
- analysis of occupational profile
immobilization phase: ___ weeks
- 4-6
- education & training
- don/doff sling/shoulder immobilizer
- cryotherapy
- pendulum/modified pendulum exercises
- modify ADLs
mobilization phase: ___ weeks
- 4-10
- exercises
- modalities
- superficial heat
- aerobic exercise
- occupation
- rest
- activity
reintegration phase: ___ weeks; goals
- 8-10
- increase strength
- increase power
- increase endurance
- progress to advanced functional activities
- progress to optimal weight bearing
reintegration phase: ___ weeks; exercises
- 8-10
- rotator cuff strengthening
- scapular stabilization
- core strengthening/ postural education
OTAs role - shoulder
- psychological impact of shoulder issues
- compensatory strategies or AE
- collaboration with PT
what is arthritis?
- inflammatory, infectious, metabolic, or autoimmune
- progressive, static, or have periods of remission and exacerbation
arthritis and goals of OT intervention
- improve/ prevent decline in function
- reduce/ manage pain management
- preserve joint integrity
- improve QoL
OA/DJD vs. RA
OA: articular cartilage wears away
RA: systemic, autoimmune; affects eyes & internal organs; exacerbations/ remission
OA signs & symptoms
- joint pain
- joint stiffness
- decrease ROM
- inflammation
- difficulty performing daily activities
- visible joint changes
- muscle weakness
RA signs & symptoms
- tender, warm, swollen joints
- morning stiffness
- rheumatoid nodules
- fatigue, fever, and weight loss
diagnosing OA
- detailed health history
- history of symptoms
- physical examination
- x-ray/ MRI
- ruling out other arthritic conditions (blood tests, joint aspiration)
diagnosing RA
- extensive history
- physical examination
- blood tests
- imaging studies
OA treatment/ OT intervention
- pain management
- improve function
- reduced potential for long-term (LT) disability
- variable medical treatment
OT
- body mechanics
- lifestyle changes
-AE
- environmental modifications
RA treatment/ OT intervention
- non-steroidal anti inflammatory drugs (NSAIDs)
- disease-modifying antirheumatic drugs (DMARDs)
- pain medication
OT
(exacerbation)
- jp
- orthoses
- pain/ inflammation management
- AE
(remission)
- gentle progressive exercise
fibromyalgia signs & symptoms
- pain
- fatigue
- cognitive impairment
- other