Interprofessional Musculoskeletal Management Flashcards
What allied health profession/service has the vision statement: Transforming society by optimizing movement to improve the human experience?
Physical therapy
Roles of PT in pt care
Evaluate and manage pts movement system across lifespan to promote optimal development, diagnose impairments, activity limitations, and participation restrictions, and provide interventions targeted at preventing or ameliorating activity limitations/restrictions
Embrace best practice standards in exam, dx/classification, intervention, and outcome measurement
Demonstrate value of collaborations with other providers, consumers, community orgs, and other disciplines
Advocate for pts/clients/consumers
List treatment modalities utilized by PT’s
Ultrasound Phonopheresis Iontopheresis Low level laser therapy Electrical stimulation
Modality utilized by PTs indicated for tendon injuries and for short-term pain relief; uses high frequency sound waves to warm superficial soft tissues
Ultrasound
Modality utilized by PTs indicated for inflammatory conditions such as tendonitis, arthritis, and bursitis; used to deliver medications to tissue under the skin
Phonopheresis
Modality utilized by PTs indicated for inflammatory conditions such as tendonitis, arthritis, and bursitis; uses electrical current delivery of substances through skin to deeper tissues
Iontopheresis
Modality utilized by PTs indicated for minor MSK pain, carpal tunnel syndrome, OA, RA; uses absorption of photon radiation, altering cell oxidative metabolism and decreases PGE2
Low level laser therapy
Modality utilized by PTs indicated for muscle spasm or contusion and/or neuropathic pain; generates an action potential in nerve tissue, causing a muscle contraction or alters sensory input
Electrical stimulation
List common exercise types used by PTs
Closed kinetic chain Open kinetic chain Core stability Eccentric Concentric Isometric Isotonic
Type of exercise utilized in PT in which proximal segment of extremity moves on a fixed distal segment (ex: leg press, squates, elliptical); used for shoulder and knee rehab, dynamic stability
Closed kinetic chain
Type of exercise utilized in PT in which distal segment of extremity moves about the proximal segment; most UE weight lifting exercises; used for functional improvement in ADLs
Open kinetic chain
Type of exercise utilized in PT that targets low back, trunk, and ab muscles (ex: situp, back extension, pilates); used for relief of low back pain or pregnancy related pelvic pain
Core stability
Type of exercise utilized in PT in which muscle contracts as it lengthens (e.g., extension phase of biceps or hamstring curl); used for sport-specific strengthening to prevent injury
Eccentric
Type of exercise utilized in PT in which muscle contracts as it shortens (e.g., flex bicep); used to increase muscle mass and strength
Concentric
Type of exercise utilized in PT in which muscle contracts but its length stays the same (ex: hold weight stationary); used for muscle toning and strengthening when joint mobility is not advised as well as quad exercises to treat patellofemoral pain syndrome
Isometric
Type of exercise utilized in PT in which there is constant resistance through a joint ROM (ex: free weights); used for general muscle toning
Isotonic
Components included in PT Rx
Pt name, DOB, referring physician, and diagnosis
When pt should f/u
Precautions
Frequency/duration
Goals (e.g., ROM, strength, mobility)
Technique developed in China between 2000-4000 years ago in which needles affect various points in the body that are pathways for “Qi” to flow
Acupuncture
[medical acupuncture may be based on traditional principles, or on modern concepts such as recruiting neuroanatomical activities in segmental distributions or a combo of both]
Eastern concepts of acupuncture revolve around the universe and what 5 elements?
Fire Earth Wood Water Metal
Acupuncture of the ______ is based on the idea that there is a homunculus located in that area, based on endodermal (cranial X), mesodermal (cranial V), and ectodermal (C1, C2, C3) locations
Ear
Acupuncture based technique that utilizes deep pressure with a japanese soup spoon or other device; indicated for TTA that results in very taut, thickened quality of skin or muscle
Guasha
Acupuncture based technique that utilizes plastic or glass devices used with suction or vacuum using fire or pump; indicated for TTA that results in hypertonic mm recalcitrant to OMT or massage (“evil wind”)
Cupping
Acupuncture based technique that utilizes deep pressure techniques or circular massage; same indications as acupuncture
Acupressure
Acupuncture based technique that utilizes absorption of photon radiation, altering oxidative metabolism and decreasing PGE2; utilized for minor MSK pain, carpal tunnel, OA, RA
Reflexology
Acupuncture based technique that utilizes muscle testing to identify allergies; uses either acupuncture or acupressure; indicated for allergies; idiopathic illnesses, chronic recalcitrant disease
NAET
Why would a DO refer to an acupuncturist?
Pt needs more frequent treatments
Knows based on PE findings that pt has a physically related problem but lab findings are essentially negative and OMT is not lasting as long as expected
Frequency and insurance considerations with acupuncture
Many acupuncturists see pts 2-3x/week until symptoms abate
Usually not covered by insurance
Different types of acupuncturist training
Medical acupuncturists = MDs or DOs who have done additional 300 hrs of training
Medical ear acupuncturists = MDs or DOs who have done additional 20 hrs of training
Licensed acupuncturists = 3 yr or 4 yr oriental medicine MS
Chiropractic acupuncturists = 100 hr course; ABCA membership requires 300 hrs of courses
Components of Acupuncture Rx
Pt name
Referring doc
Evaluate and treat “X” dx
Evaluate and consider: “XYZ” modalities
[Note: does not typically include frequency recommendation]
__________ practic a hands-on, drug-free approach to healthcare that includes pt examination, dx, and tx. Have broad diagnostic skills and are trained to recommend therapeutic and rehab exercises as well as provide nutritional, dietary, and lifestyle counseling
DCs
T/F: Like their MD colleagues, doctors of chiropractic are subject to the boundaries established in state practice acts and are regulated by state licensing boards. Further, their education in four-year doctoral graduate school programs is nationally accredited through an agency that operates under the auspices of the US Department of Education. After graduation, they must pass national board exams before obtaining a license to practice, and then must maintain their license annually by earning continuing education (CE) credits through state-approved CE programs.
True
Why would a DO refer to a DC?
The DO lost skills or feels unskilled in OMT
Feels that the pt needs more frequent tx
Specializes in another area of practice
Frequency and insurance considerations when referring to a DC
Many DCs see pts 2-3x/week until symptoms abate
Many accept insurance, but there are usually limitations on number of visits per year
What OMT technique is most often utilized in chiropractic care?
HVLA
Components of DC Rx
Pt name
Diagnosis
Imaging results
Precautions
Evaluate and treat — indicate manual therapy, therapeutic exercise, modalities, manipulation, and home program
The vision statement of ___________ is to improve function while controlling costs
OT
General services provided by OTs
ADLs and work assessment and treatment
Site evaluation
Performance
Equipment
Social support
[focus on wellness, management of chronic disease, improving function, and supporting independence]
Components of OT Rx
Pt name and DOB Doc and dx F/u date Precautions Frequency/duration Goals
Eval and treat + additional options
Developed over 1000 years ago; 80 different styles including swedish, deep tissue, sports, chair, shiatsu, and lymphatic
Massage
Type of massage that utilizes varied, rhythmic pressure on certain precise points of the body; indications include anything acupuncture may address for blocked Chi
Shiatsu
Why would a DO refer to a massage therapist?
Feels that pt needs more frequent tx
Feels that muscle hypertonicity is so severe that whole-body massage on more frequent basis is needed
For lymphedema
Components of massage therapy Rx
Pt name, DOB, ID
Provider info + MT info
Diagnosis + frequency and duration or number of visits
______ is often considered a deep-tissue approach, actually works with all layers of the body to ease strain patterns in the entire system; series of 10 sessions that applies systematic approach to aligning your structure; each builds upon the last
Rolfing
[basic certification requires HS diploma and 731 hours of training in 3 phases; advanced certification requires 3 additional years and 18 intermediate courses (168 add’l hrs)]
Group of physical, mental, and spiritual practices or disciplines which originated in ancient india; many consider it a complementary intervention for cancer, schizophrenia, asthma, and heart disease
Yoga
Why would a DO recommend yoga?
Feels that pt needs more frequent approach
Understands that pt is either too tight, weak, or both and that trial of yoga may be beneficial
Considerations regarding the “yoga Rx”
Its a lifestyle change, meaning it will be difficult
Frequency/duration usually starts with daily practice of 5-15 mins
Key is to start conservative and increase as tolerated
Technique that uses gentle movement and directed attention to help people learn new and more effective ways of living with their bodies; based on principles of physics and an empirical understanding of learning and human development; “we move according to our perceived self-image”
Feldenkrais
Why would a DO recommend feldenkrais?
Feels that pt problems are based upon too much focus on their own pain
Observes that pt has significantly ingrained maladaptive patterns of movement and posture
Feldenkrais prescription
Its a lifestyle change, meaning it will be difficult
Frequency/duration — daily practice depending on pt
Pt may attend weekly classes or individual sessions with practitioner
