Final Exam Flashcards
productivity…
helps defines to some degree our self image and sense of purpose and helps give meaning to life
define sedentary
exerting 10 lbs of force occasionally, involves frequent sitting, occasional walking and standing
define light
exerting 10 lbs frequently and 20 lbs occasionally
define medium
exerting 10 to 25 lbs frequently and 20 to 50 lbs occasionally
define heavy
exerting 10 – 20 lb constantly, 25 – 50 lb frequently and 50 – 100 lb occasionally
define very heavy
exerting more than 20 lb constantly, 50 lb frequently and 100 or more lb occassionally
physical demand frequency
- never
- occassionally
- frequently
- constantly
Never – Activity or condition does not exist
Occasionally – Up to 1/3 of the day
Frequently – ½ to 2/3 of the day
Constantly – 2/3 to full day
who often gets musculoskeletal injuries?
common among workers in physical jobs, although office workers can also sustain injuries
define Work-relatedness
of the claim needs to be established before a claim is accepted
define no time loss claim
worker continues to work but receives treatment if necessary
define time loss claim
worker off work, wage loss benefits, treatment costs
define functional exercise
related to the job the person is returning to is more relevant and generally more preferred
Occupational Rehab I (OR 1)
single discipline
structured, active rehabilitation program focused on return to work through physical and functional conditioning, education, and supported return-to-the workplace
attend the program four days per day, five days a week for a maximum of 30 consecutive business days.
Occupational Rehab II (OR 2)
multidisciplinary
multidisciplinary treatment program offered by occupational therapists, physical therapists, psychologists, and physicians.
Workers typically attend the program six hours per day, five days a week to a maximum of 50 consecutive business days.
who may have the presence of a vocational, psychosocial and/or medical barriers
Pain Management Programs
complex multidisciplinary
Suitable for persons with persistent chronic pain affecting several aspects of their life including physical and psychological well being, vocation, family
Common Work-Related MSK Conditions
Muscular strains Contusions or lacerations Lower back pain Shoulder injuries Knee or ankle sprains Fractures Repetitive strain injuries
exercise program terms
- Specific
- General
- Functionally
Specific exercises related to injury
General fitness activities (Work Conditioning)
Functionally related activities (Work Hardening, Work Simulation)
prevention programs consist of
Education
Back School
On site Therapy Programs
Fitness and Wellness Programs
define self efficacy
belief in one's own abilities - affects everything we do and every goal we work towards Self-efficacy is different than self-confidence or self-esteem. It is an expectation of how likely you are to succeed at some specified goal.
define kinesophobia
an irrational fear of activity, often related to concern of reinjury
define track improvment
positive reinforcement and recognition of change
define graded exposure to exercise
provide general activities that work the area indirectly first, then more specific exercises
waddell’s sign- Superficial tenderness
skin discomfort on light palpation.
waddell’s sign-Nonanatomic tenderness
tenderness crossing multiple anatomic boundaries
waddell’s sign-Axial loading – eliciting pain when pressing down on the top of the patient’s head.
eliciting pain when pressing down on the top of the patient’s head.
waddell’s sign-Pain on simulated rotation
rotating the shoulders and pelvis together should not be painful as it does not stretch the structures of the back
waddell’s sign-Distracted straight leg raise
if a patient complains of pain on straight leg raise, but not if the examiner extends the knee with the patient seated
waddell’s sign-Regional sensory change
Stocking sensory loss, or sensory loss in an entire extremity or side of the body
waddell’s sign-Regional weakness
Cogwheel weakness: non-organic weakness will be jerky, with intermittent resistance
waddell’s sign-Overreaction
Exaggerated painful response to a stimulus, that is not reproduced when the same stimulus is given later
what are waddell’s signs?
Waddell’s signs are a group of physical signs, first described by Waddell et al in 1984, in patients with LBP
risk factors for RSI’s
Awkward postures or positions Cold or vibration Repetition Force Activities involving pinch grip Productivity demands Poor overall fitness level Work stress
define FCE
functional capacity evaluation
FCE components
Repetitive lifting capacity at various levels
Repetitive push, pull, and carrying capacities
Hand grip strength
Tolerance for elevated work
Prolonged trunk flexion in sitting and standing
Prolonged trunk rotation in sitting and standing
RTW barriers-WORKER
Pain • Fear of re-injury or relapse • Prolonged inactivity • Job performance anxiety • Failure to communicate with employer/co-workers • Pre-injury job dissatisfaction
RTW barriers- employer
- Lack of coworker support
- No reliable method for tracking injured workers
- Failure to communicate with injured worker
- Negative workplace climate and low staff morale
- Stressors in workplace
developmental disorder-Congenital Muscular Torticollis…what is it?
The child’s head is tilted towards the tight sternoceidomastoid muscle and rotated away
what is plagiocephaly
Refers to asymmetrical head shapes, also known as positional plagiocephaly
what is Talipes Equinovarus
The most common form of club foot in which the foot is plantar flexed and inverted
what is Osgood-Schlatter’s Disease
Pathology involves inflammation of the epiphysis where the infrapatellar tendon attaches to the tibial tuberosity
what is retropatellar pain syndrom
Retropatellar Pain Syndrome commonly occurs in active adolescents and young adults and is thought to be related to overuse, trauma, and/or abnormal alignment of the lower extremities
what is the cobbs method?
method of measuring the degree of scoliosis.
when the child is in the womb they are…
When in the womb and just born they are c shaped, feet dorsiflexed, hips in a flexion contracture
what is the Landau Reaction
able to maintain trunk extension when held horizontally
ex:Pushing in prone to extend elbows increases spinal extension and proximal stability
3-5 months
functional head control and landeau reaction, reach patterns (hand to mouth), weight shifting from leg to leg, increased body awareness (obect move from hand to hand), log rolling(all in one motion tho)
six months
- Increased antigravity and trunk control
- Voluntary asymmetric and reciprocal movements are possible
- Segmental rolling and belly crawling
- Infant develops equilibrium reactions and protective responses
- Can sit independently with arm support, and can reach with one arm while supporting with the other arm
7-9 months
Can sit unsupported on floor
Increased time spent in sitting or quadriped
Increased postural stability
Increased interaction with environment and motor control
Uses upper extremity for manipulation and to pull self to more upright positions
Rocking back and forth on all fours, and bear standing
10-12 months
Development of lumbar lordosis and postural alignment in standing
Climbing is a common activity
Sitting control is very dynamic, transitions positions with ease
Begins to practice stepping movements in standing, wide stance
Some children begin walking at this stage
12-18 months
Walking can begin at 9 –16 months
Child enjoys walking to objects, squatting and picking them up
Central motor pattern develops for automatic stepping (us now)
Refined postural control and balance
Hand preference begins to emerge, hands can assume asymmetrical roles i.e. taking lid off jar, release of large objects smooth and graded
pt goals in infancy
promote symmetry, limit abnormal postures and movements, and facilitates normal motor development
pt goals in preschool
achieve independent mobility
pt goals in School-Age and Adolescence
limiting secondary effects of impairment and on the promotion of age-appropriate activities
cerebral palsy fact and how its diagnosed
CP is the most frequently encountered neurological condition in paediatrics
CP is diagnosed when a child does not reach motor milestones and exhibits abnormal muscle tone or qualitative differences in movement patterns such as asymmetry
CP- Motor cortex - Spastic:
resistance to passive movement, typically gives way as more pressure is applied
CP- Brain Stem– Rigid:
‘stiffness’ is present throughout the ROM
CP- Cerebellum - Ataxic (Ataxia):
poor balance/coordination (wide gait), tremor with voluntary movement
CP- Basal Ganglia - Athetoid (Athetosis):
repetitive, slow, involuntary movements
CP- Generalized - Hypotonia:
low muscle tone, poor strength, decreased ability to hold postures
CP- Multiple areas - Mixed:
usually results in spasticity with athetoid movements
types of CP
- Spastic– most common, “stiff” or permanently contracted muscles in synergy pattern
- Athetoid (or Dyskinetic) – alternating tone with slow, uncontrolled writhing movements
- Ataxic- rare form, poor coordination and difficulty with quick or precise movements
- Mixed – a child with two or more forms, the most common mixed form is a blend of the spastic and athetoi
what is Spastic diplegia
affects the legs more than the arms.
what is Hemiplegia
affects one side of the body
what is Spastic quadriplegia
all four limbs and the trunk are affected
how does botox help with cp
by blocking the release of a substance (Ach) the nerve uses to signal the muscle to contract
what is SDR-Selective Dorsal Rhizotomy
is a procedure in which the sensory rootlets from the lower extremity are selectively cut
what is spina bifida
a congenital defect of the spine in which part of the spinal cord and its meninges are exposed through a gap in the backbone. It often causes paralysis of the lower limbs, and sometimes mental handicap.
A child will with Spina Bifida will have varying degrees of neurological impairment, depending on severity and neurological level involved
pt goals for spina bifida
Maintain alignment of the extremities and joints Maximize ROM Stabilize the spine and extremities Maximize function Provide comfort Skin protection
common limitation with kids who have spina bifida
tightness in hip flexors, hip adductors and dorsiflexors or evertors of the ankle
The characteristics of levels of spina bifida are important to be aware of as the degree and type of support required can be determined.
Thoracic level – usually need support /seating system to support sitting
- spine is rounded
L1 L2 : sits slightly better; may need support to sit
L3: usually able to sit independently
L4 L5: usually able to walk with a walker; require orthotics – A. F. O’s
S1 S2 S3: usually walk independently but requires orthotics.
muscular dystrophy- duchennes
Duchenne’s muscular dystrophy is an inherited disorder characterized by rapidly progressive muscle weakness which starts in the legs and pelvis and later affects the whole body.
the most common type of muscular dystrophy
gower’s sign
evidenced through observation of children’s use of their arms to push themselves erect by moving their hands up their thighs due to weakness in proximal muscle groups
what is trendelenburg
toe walking, retracting of shoulders and decreased reciprocal arm swing.
etiology for kids and tbi’s
Infants more than 2/3 of TBI are sustained due to falls.
Preschool children TBI are related to falls 55% and MVA 22%.
School-age children: MVA 31%, falls 31%,
and sports and recreation activities 32%.
In adolescents 43% are related to sports and recreation activities.
down syndrome
Trisomy 21 (extra chromosome)
Low tone, late achieving motor milestones
Ligamentous laxity
dcd
Developmental Coordination Disorder
General clumsiness, lack of coordination, poor strength
examples of yin
night dark cold negative passive female
examples of yang
day light warm positive active male
the 5 element theory
Water, Wood, Fire, Earth, and Metal
The Five Elements are symbolic representations of fundamental forces. The most important aspect of these forces is their interactions. Each force has a generative and destructive effect on one another.
the generative cycle
Wood burns to make Fire
Fire makes ashes, which makes Earth
Earth makes Metal, which is from under the ground
Metal becomes molten when heated, like Water
Water leads to the growth of plants, making Wood
the destructice cycle
Wood grows from the soil and depletes its nutrients
Earth contains Water in one place and soils its clarity
Water extinguishes Fire
Fire melts Metal
Metal cuts Wood
