Impaired Mobility/ROM Flashcards
To coordinate, communicate and document every aspect of care takes place through the process of:
patient management
Providing direct supervision of assistive personnel involved in the provision of PT services happens through what process?
patient management
History, systems review and test & measures are taken during this process
examination
To interpret findings that determine diagnosis, prognosis, and plan of care
evaluation
Classification of conditions that will direct interventions within the scope of PT practice and engage in the process of differential dx
diagnosis
The prediction of optimal level and time frame for improvement
prognosis and plane of care
Comparison of capability vs individual desirability of functional level
prognosis and plan of care
Establish achievable goals an expected outcomes
prognosis and plan of care
Determine frequency and duration of interventions and discharge plans
prognosis and plan of care
Purposeful interaction with the individual and/or others involved in the care
intervention
Hands on provision of services within the scope of PT practice
intervention
Individual and/or caregiver instruction with every episode of care
intervention
What to do if a problem is outside scope of PT practice or if there is a need for complimentary services
referrals/consultations
When to evaluate progress and outcomes
during re-examination
The time to modify prognosis, plan of care or interventions
re-examination
What does ICF stand for?
international classification for function, disability and health framework
The ICF model 3 aspects of functioning with a health condition
body functions and structure
activity
participation
The level of activity, from the ICF model breaks down to which two factors
environmental and personal
The 6 determinants of function
- muscle performance
- cardiopulmonary/endurace
- mobility/flexibility
- neuromuscular control/coordination
- stability
- balance/postural equilibrium
How to treat mobility physiologic impairments during rehabilitation?
PROM Flexibility - static - dynamic - PNF (contract/relax)
How to treat stability physiologic impairments during rehabilitation
muscle strength
muscle endurance
muscle power
neuromuscular control
When a patient is able to use muscle to move a segment without assistance
AROM
When a patient is able to contact muscle, but can’t move segment through full/desired ROM
Active assisted ROM
What are limitations of AROM/AAROM?
for muscle that are WNL for strength, AROM/AAROM does NOT maintain or increase strength
What are two of the relative contraindications of ROM?
- life threatening condition
- when motion will disrupt the healing process
What are 4 indications for doing PROM when assessing ROM?
- acute inflamed tissue
- after injury or surgery
- pt is not allowed to actively move, or physically cannot move a segment
- pt is comatose, paralyzed, or on bed rest
What are 6 goals of PROM?
- maintain jt
- connective tissue and muscle mobility/elasticity
- decrease contracture risk
- decrease pain
- assist with circulation
- increase synovial fluid movement
What are 3 limitations of PROM?
- does not prevent atrophy
- cant increase strength or endurance
- aides with circulation but isn’t as effective as voluntary muscle contraction
What are 3 passive stretching techniques used by PTs?
manual
mechanical
positional
Reflex inhibition and subsequent elongation of muscles using neurologic principles to reduce tension and lengthen a muscle, such as contract relax or hold relax
active inhibition
Passive or active exercises used to elongate muscles and are performed by the patient
flexibility exercises
What does T.E.R.T stand for?
total end range time
What are the parameters for PROM stretching?
- hold 15-30 sec
- repeat 3-5 times
- instruct pt on the need to feel some “pulling and slight discomfort”
Static flexibility purpose is to:
lengthen the muscle tissue or structure
Indicated with a joint contracture and muscle extensibility loss
static flexibility
Prolonged stretch at end range earlier through patient positioning or mechanical device
static flexibility
More functional, total body approach which involves repetitive contractions of the agonist muscle to produce quick stretches of the antagonist muscle
dynamic stretching/flexibility
Unique approach which uses diagonal movements of the extremities and a combination of isometric and isotonic contractions to encourage muscle relaxation and increased overall ROM/mobility
PNF stretching/flexibility
What does CPM stand for?
continuous passive motion
Name the 4 indications of CPM (continuous passive motion)
- OA
- contractures
- joint fracture
- post-op early recovery especially TKR
Adaptive shortening of the muscle-tendon unit and other soft tissues that cross or surround the joint, resistance to stretch and limited ROM
contracture
How are contractures named?
by the side of the joint that is tight
Stretching a joint well beyond the normal length of muscle, its surrounding soft tissues and ROM
overstretching
This type of fiber has a function of providing strength/stiffness and resists tensile forces
collagen fibers
This fiber provides extensibility and can eloongate
elastin fibers
This type of fibers main function is to bulk
reticulin fibers
This protein hydrates, stabilizes collagen and resists compressive forces
proteoglycans
This type of proteins links cells together for nutrient transport, metabolism, and maintain space between fibers to prevent excessive cross-linking
glycoproteins
This structure has parallel fibers to withstand HIGH tensile forces, to transmit mm force to bone
tendons
Ligaments, joint capsule, and fascia have varied alignment of collagen to resist what type of forces
multidirectional
What type of pattern of fibers does skin have to withstand only LOW tensile forces
random pattern of fibers
Ability to return to its pre-stretch resting length directly after a short-duration stretch force is removed
elasticity
Ability to resist deformation in length when a stretch force is applied, slowly lengthens if the force is sustained, but gradually returns to its original resting length when force is removed
viscoelastic properties
Ability to assume a new and greater length after a stretch force is removed
plasticity
Elongation happens in which range of stretching, due to the amount of collagen failure that happens
plastic range
The faster you apply the load, the stiffer the tissue describes which soft tissue response to stretching
rate dependence
Constant load applied over time increases the length of tissue is what soft tissue response to stretching
creep
Load applied with the tissue kept at a constant length decreases tension in tissue for which soft tissue response to stretching
stress-relaxation
When stretching, which phase is the muscles response to increase in tensile stress in the non-contractile tissue
initial phase
Decreased crossbridging of the myofilaments causes abrupt lengthening of the sarcomeres (sarcomere give) during this phase of muscle response to stretching
stretch phase
When stretching, which phase is the muscles response for the sarcomeres to return to their length (inherent elastic property of muscle)
release phase
While stretching, targeting this tissue of the muscle will break up collage tissue adhesions?
non-contractile
This means to increase the number of sarcomeres in a series and happens when targeting the contractile tissue of a muscle
myofibrillogenesis
What part of the muscle is the stretch receptor
muscle spindle
Sensory organ in muscle that reacts to quick and sustained stretching, to tell the muscle about changes in length, and the speed of those changes
muscle spindle
The tension monitor during stretching
golgi tendon organ
Where is the golgi tendon organ located?
in the musculotendinous junction
During increased tension, the golgi tendon organ will then cause what kind of inhibition of the muscle to decrease the tension
autogenic inhibition
Contraction of the agonist of the movement will inhibit the antagonist describes which inhibition
reciprocal inhibition
Contraction of the antagonist of the movement will inhibit the antagonist describes which inhibition
autogenic inhibition
Able to provide a low intensity stretch over a prolonged period of time using the creep or stress-relaxation properties of soft tissue is the effectiveness of which type of stretch
mechanical stretch
