Final: Special Populations Flashcards
What is the goal of treatment in patients with treatment considerations?
Allow people to function better in their daily lives
-Improve function or maintain function
Basically improve Quality of Life
Pt comes in with diplopia and blurred vision. He has also been having more frequent numbness and tingling in his hands and toes. In addition, he admits to having more incidences of impotence than in the past. Dx?
Multiple Sclerosis
- due to demyelination of his nerves
- -progressive weakness, tremor, fatigue, bladder function
What are some common MSK issues that people with MS have?
Joint, tendon, ligament strains
-due to overuse from shifting patterns
Reduced Diaphragm movement and tension
-reduced flow of lymph!
What is the goal of treatment in MS?
Modify positional compensation patterns
Improve lymph flow
Reduce pain
Sudden onset of slurred speech and facial paralysis or full sided hemi-paralysis would be indicative of?
Stroke
-hemorrhagic or ischemic
How does a CVA lead to MSK issues?
Unilateral Paralysis creates:
- Spastic paralysis
- Decreased balance issues (sensory and motor)
- Edema (loss of tissue tension)
- Contralateral Compensation (overuse injury)
Should you treat a stroke with OMT within the first 24 hours?
No, re-perfusion of blood flow can lead to worse prognosis
Can acute treatment (during hospitalization) improve stroke outcomes?
Maybe? (no real OMM studies)
- improved movement and sensorimotor
- increased cerebral profusion
- reduce head associated strain patterns
- reduced Sym tone
What does subacute (rehab after 1 week-months) treatment of stroke help with?
Maintain ROM and reduce contracture
If you want to reduce tissue reorganization after stroke, when should you start treatment?
First 7 days after!
What is the goal of post-subacute (at home) Tx of stroke?
Improve sensorimotor function
Improve ROM, balance, strength, gait
Reduce strain patterns
Reduce Sym tone
What phase of recovery (hyperacute, acute, subacute) had most benefit from treatment?
Acute phase
-overlap with OT, PT, neurology tx
What OMM modality has been shown to improve outcome in stroke pts?
MFR
-mild tension applied over a longer period of time helped
What is the goal of OMM tx for those in wheelchairs specifically?
Most seek treatment for pain
- UE and Core: reduce strains and stress
- LE: increase tissue mobility from prolonged lack of motion
- -reduce pain, ulcers, edema
What should you, as a physician, be mindful of when scheduling for a patient in a wheelchair?
Schedule more time for the pt
-could have trouble gaining access to or getting to the building
What is the biggest factor in determining treatment after trauma?
Timing after injury
How does tissue heal after injury? (7 days, 21 days, 4 weeks)
7 days of swelling–>
21 days of collagen deposition–>
4 weeks of major remodeling
What is important when treating after trauma?
- Reduce Tension
- Maintain proper alignment
- ROM exercises
- Neuromuscular re-education exercises
Best treatments for after trauma?
joint release (for alignment/ROM) -articulatory, BLT
MFR
-CS
Lymphatic
What should be considered (anatomically) when treating Ehler-Danlos?
Skin
-bruise easily and have poor healing
Joint
-laxity and dislocation
Blood vessels
What are the treatment goals for treating Ehler-Danlos?
Soft tissue
Correct muscle imbalances
Educate strengthening muscles
Educate on Injury avoidance
Can tylenol, pregabalin, and gabapentin help with Ehler-danlos symptoms?
Nope, they may worsen
What should you focus on when treating oncology pts?
Decrease Pain
Increase ROM
Improve ability to achieve activities of daily living
If a patient has a possibility of metastatic bone cancer, what should you be aware of when treating with OMT?
Concern for pathologic fracture and spinous processes may be more tender
Should HVLA be done on oncology pts?
No, generally avoid
Did OMM help with breast cancer pts with Nausea/Vomiting after chemo?
No, but it did help with diarrhea/constipation
How did OMM help geriatric pateints pain?
Decreased pain, but did not improve QOL
Goal of treating Cerebral Palsy Pts?
Decrease Pain, limit progression of contractures
Improve functionality and QOL
-reduce constipation and URI
What techniques can you use for CP patients?
MFR (both direct and indirect) and stills
-maybe MET/BLT
NOT HVLA
What autoimmune condition is associated with ascending paralysis that has numbness, tingling, or deep muscle pain. Can be caused by microbes, ie campylobacter (thanks sketchy).
Guillian-Barre
-microbes appear similar to myelin, so the body attacks myelin
What is the goal of treating Guillian Barre?
Prevent infections
Promote healing
Help with Pain
What techniques can be used for Guillian Barre?
MET, ST, MFR
Autonomics: rib raising, paraspinal inhibition, suboccipital release, sacral rocking
