Interventions Lecture 2

Question 1

Stages of inflammation and repair

Answer 1

1. Acute
2. Early subacute
3. Late subacute and chronic

Question 2

Signs of excessive stress

Answer 2

1. inflammation - redness, swelling, warmth
2. pain - exercise soreness that does not decrease after 4 hours & is not resolved
   - exercise/activitty pain that comes on earlier or is increased compared to previous sessions
3. progivesively increased feelings of stiffness and decreased ROM over sessions
4. progressive weakness over several sessions
5. decreased functional use of the body

Question 3

general soft tissue intervention goals

Answer 3

-decrease inflammation
-decrease stress/mechanical factors
-increase flexibility & strength
- increase stability if necessary
*agressiveness based on tissue healing times/individual
sings of excessive stress with exercise or activity

Question 4

Acute Stage: inflammation tissue responses & characteristics

Answer 4

• vascular changes
• exudation of cells and chemicals
• clot formation
• phagoyctosis, neutralization of irritants
• ealry fibroblastic activity

Question 5

Acute stage clinical signs

Answer 5

• inflammation
• pain before tissue resistance
• pain, edema, mm spasm
• impaired movement
• joint effusion (if the joint is injured or arthriits is present)
• restricted use of associated areas

Question 6

Acute stage physical therapy goals

Answer 6

Phase 1: maximum protection

• control the effects of inflammation; selective rest, ice, compression, elevation
• prevent deterious effects of rest: non-destructive movement, passive ROM, massage and muscle setting with caution

Question 7

Subacute stage tissue: proliferation, repair, and healing

tissue responses and characterisitcs

Answer 7

• removal of noxious sitmuli
• growth of capillary beds into area
• collagen formation
• granulation tissu e
• very fragile, easily injured

Question 8

subacute stage: proliferation, repair and healing

clinical signs

Answer 8

• decreasing inflammation
• pain synchronous with tissue resistance
• pain when end of available ROM is reached
• Edema (decreasing but may still be present if joints involved)
• soft tissue, muscle/joint contractures (developing in immobilized region)
• muscle weaakness from reduced usage or pain
• restricted in ADLs realted to involved tissues

Question 9

subacute stage: proliferation, repair and healing

physical therapy goals

Answer 9

Phase II: moderate protection/controlled motion

• develop a mobile scar; selective stretching, mobilization/manipulation of restrictions
• promote healing; non-destructive active, resistive, open and closed chain stabilization, muscular endurance, and cardiopulm endurance exercises; carefully progressed in intensity and range

Question 10

chronic stage: maturation & remodeling

tissue responses & charactersitcs

Answer 10

maturation of connective tissue
contracture of scar tissue
remodeling of scar
collagen aligns to stress

Question 11

chronic stage: maturation & remodeling

clinical signs

Answer 11

• absence of inflammation
• pain after resistance
• soft tissue and/or joint contractures and adhesions that limit normal ROM or joint plau
• decr muscle performance; weakness, poor endurance, poor neuromuscular control
• decr. unsage of involced part
• inability to participate normally in an expected acitvity

Question 12

chronic stage: maturation & remodeling

physical therapy goals & interventions

Answer 12

minimum to no protection/return to function
-increase tensile quality of scar: progressive strengthening and endurnace exercises
develop funcitonal independence; functional exercises and specificity drills
~return to function