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MSK 1 > Interventions in MSK > Flashcards

Interventions in MSK Flashcards

1
Q

patient centered care is focused around

A

individual context
effective communication
shared decision-making

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2
Q

what two things correlate to outcomes

A

patient expectations and rapport

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3
Q

increased therapeutic alliance leads to

A

increased patient confidence in PT
better outcomes

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4
Q

what is an aspect of therapeutic alliance that is often overlooked

A

documentation can lead to better inter-therapist treatment

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5
Q

5 overarching themes from patient perspective regarding therapeutic alliance

A

meeting a competent and warm therapist

being understood as a whole person

feeling appreciated, tolerated, and supported

gaining new strength/hope for the future

overcoming initial fears and apprehension

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6
Q

6 overarching themes from therapist point of view regarding therapeutic alliance

A

balancing technical with interpersonal

showing genuine desire to understand

openly supporting client agency

adjusting to create a sense of safety

paying attention to body language

providing helpful experiences during the first session

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7
Q

findings of history/examination that indicate high severity

A

high pain (>7/10)
consistent pain through night/rest
pain before end ROM
high disability

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8
Q

interventions focused on high severity

A

minimization of physical stress
activity modification
monitor impairments

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9
Q

findings of history/examination that indicate moderate severity

A

moderate pain (4-6/10)
intermittent night/rest pain
pain at ROM
AROM similar to PROM
moderate disability

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10
Q

interventions for moderate severity

A

mild-moderate physical stress
addressing impairments
basic level functional activity restoration

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11
Q

findings of history/examination that indicate low severity

A

low pain (<3/10)
absent night or rest pain
minimal pain with overpressure
AROM = PROM
low disability

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12
Q

interventions for low severity

A

moderate-high physical stress
address impairments
high-demand functional activity restoration

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13
Q

what is one of the most forgotten interventions

A

education

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14
Q

explain patient education on pain

A

reflection that pain is not always a true representation of the state of tissue

instead, it is the nervous system’s interpretation of the threat of injury

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15
Q

what can pain be modulated by? why are these important?

A

psychological factors
- fear avoidance, catastrophizing, expectations, cognition, beliefs

–> NEED TO BE SCREENED

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16
Q

x amount of CPGs encourage education
- what specifically do they encourage regarding education?

A

10
self management and active treatments
informing/reassuring patients about condition/management

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17
Q

types of patient education

A

biomedical/biomechanical
general advice
pain neuroscience
cognitive behavioral principles

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18
Q

biomedical education definition

A

providing in-depth, pathoanatomical explanations for specific cause of patient’s pain

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19
Q

biomechanical education definition

A

role of positions, postures, movements that are related to patient’s pain

20
Q

what form of education is nonadvisable for patients?

A

biomedical/biomechanical

21
Q

what is general advice

A

reassurance of favorable prognosis
promotion of activity / mvmt
graded activity
paired education and activity

22
Q

what is a principle associated with general advice

A

acting as usual, slight backing off initially

23
Q

definition of PNE

A

pain neuroscience education

providing patients with concept of pain symptoms that are comprehensible and reassuring

24
Q

what is a very important aspect of PNE

A

explaining that pain isn’t always an accurate representation of tissue

pain is the body’s response to possible threat

the more you are in pain, the better the brain gets at producing the pain signal

25
Q

what is cognitive behavioral therapy

A

form of talk therapy that can identify and develop skills to change negative thoughts/behaviors

26
Q

goal of CBT

A

changing thoughts, emotions, and behaviors related to pain

improving coping strategies
putting discomfort in a better context

27
Q

how to facilitate effective self-management

A

1 - help patient identify their barriers / goals

2 - assist in identification of optimal strategies to reduce or avoid irritation of symptoms through problem solving

3 - support patient to identify ways to measure the effectiveness of self-management

28
Q

what effect do passive self-management approaches have

A

can increase likelihood of pain behavior and disabilities

29
Q

how to approach patient education

A

make an educated diagnosis

establish tailored pt education with learning focused on perceptual inconsistencies

plan and provide individual/group education

assess acquired skills/knowledge and adjust as needed

30
Q

when recommending physical activity, it is important to remember

A

general exercise is good
- regular performance has more benefits

no need to recommend highly specific exercise, general does just fine

encourage management of pain in different modes in conjunction with exercise

31
Q

what is important to educate the pt on when recommending exercise?

A

that there will be some form of pain and that is normal, but do what is tolerable

32
Q

what is important to remember about inflammation stage vs proliferative stage of healing

A

inflammation - loading can cause disruption in this phase

proliferation = load promotes optimal regeneration and tissue will respond to the load placed on them

33
Q

what is mechanotherapy

A

tissue will respond to the load placed on them

34
Q

remodeling and protein synthesis relationship

A

> protein synthesis = more contractile proteins and more dense myofiber

35
Q

PEACE & LOVE

A

Protection
Elevation
Avoidance of anti-inflammatories
Compression
Education

Load
Optimism
Vascularization
Exercise

36
Q

using the ICF, what categories are related to ____________ interventions
- foundational
- performative
- functional

A

foundational = body structure/function

performance = activity limitations

functional = participation restrictions

37
Q

exercise progression

A

1 - normalize dysfunctional structure

2 - correct muscle/movement balance

3 - increase proprioception and facilitate subcortical reorganization

4 - improve endurance in coordinated movement

38
Q

activity guidelines

A

moderate intensity for at least 150 min a week (or 75 min vigorous)
and
muscle strengthening at least 2 days a week

39
Q

components of physical fitness

A

cardiorespiratory
musculoskeletal
flexibility
balance
speed

40
Q

how does load and recovery affect capacity?

A

appropriate dosage of load and recovery leads to increased capacity/threshold for exercise

41
Q

when is manual therapy typically done

A

early on in therapy in adjunct with other treatments

42
Q

what are the typical applications of manual therapy

A

reduction of pain / disability initially to get patients moving in following interventions

43
Q

what is the timeline associated with most MSK guidelines and surgery

A

conservative care for 3-6 months prior to surgical indication

44
Q

when surgery is indicated, what is the therapist’s role

A

education on expectations of procedure, outcomes and role of rehabilitation after
- maybe rehab prior to

45
Q

risk factors that determine continuation/resumption of work

A

socioeconomic status
work environment

46
Q

what examination factors affect continuation/resumption of work

A

self-reported measures
psychological factors
job demands
performance measures

47
Q

interventions that can facilitate continuation/resumption of work

A

graded, modified or transitional work

ergonomic consultation

psychologically informed practice

education / communication/ coordination

progressive graded exercise

MSK 1 (12 decks)

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