intervention strategies Flashcards
what are the intervention recommendations for hip pain and mobility deficits?
patient education- Grade B
functional, gait, and balance training- Grade C
manual therapy- Grade A
flexibility, strengthening, and endurance exercises- Grade A
modalities- Grade B
bracing- grade F
weight loss- Grade C
which are included in classification of hip osteoarthritis?
pain reported in the hip
<115 degrees hip flexion ROM
<15 degrees hip IR ROM
pain with hip IR ROM
<60 minutes of morning stiffness
> 50 years of age
what are some manual therapy things we can do for the hip?
iliopsoas stretch
piriformis stretch
hip flexion with caudal glide
internal rotation with distraction
long axis distraction
distraction
posterior-anterior mobilzation
what is the rationale for the iliopsoas stretch?
improve hip extension ROM by addressing soft-tissue restrictions
what is the rationale for the piriformis stretch?
the piriformis along with the other hip external rotators has intimate connections with the hip joint capsule. stretching this muscle group may therefore reduce across the joint capsule, thus improving pain and ROM
what is the rationale for the long-axis distraction?
increase capsule elasticity and thus improve pain and hip ROM
what is the rationale for hip flexion with caudal glide?
improve hip flexion ROM
what is the rationale for internal rotation with lateral glide?
improve hip internal rotation ROM
what is the rationale for posterior-anterior mobilization?
improve hip extension ROM
what are some therapeutic exercises for the hip?
clam exercise
knee to chest stretch
hip flexor strength
piriformis stretch
hip abduction
bridging
what are interventions we should perform in the acute inflammatory phase?
modalities to promote healing and decrease pain and inflammation (ice, US, ionto, phone, e-stim, and tens)
use of assistive device prn to normalize gait
grade 1 and 2 joint mobs
submaximal isometric exercises (mid range painfree contractions)
passive ROM exercises
what are interventions we should perform in the subacute proliferative phase?
assistive device prn
AAROM and AROM within available pain free ROM (progress to concentric exercises, including functional closed chain and weight bearing exercises)
multiangle sub-maximal isometrics
muscle endurance training (low load, high repetition)
manual therapy (grade 3 and 4)
gentle flexibility exercises
progressive balance and stability exercises
cardiovascular endurance exercises
what are interventions we should perform in the chronic maturation phase?
eccentric exercises (strengthening and power exercises)
sport-specific training
manual therapy and flexibility training as needed
correct lower-extremity biomechanics, flexibility deficits and muscle imbalances as needed
cardiovascular exercise
what is the biomechanical load intolerance intervention for strength?
3-5 sets of 6-12 reps
what is the biomechanical load intolerance intervention for endurance?
3-5 sets of 20-30 reps
