Interventions - Shoulder

Question 1

Acute phase - irritability

Answer 1

High

Question 2

Subacute phase - irritability

Answer 2

Moderate

Question 3

Return to function phase - irritability

Answer 3

Low

Question 4

Phase 1 =

Answer 4

acute
post op
Stability/ROM

Question 5

Phase 2 =

Answer 5

subacute
ROM/early strengthening
Biggest area for PT

Question 6

Phase 3 =

Answer 6

Return to function

Strength and function

Question 7

Acute - characteristics

Answer 7

High pain (7/10)
Consistent night or rest pain
Pain before end range 
AROM less than PROM
High disability

Question 8

Subacute - characteristics

Answer 8

Moderate pain (4-6/10)
Intermittent night or rest pain
Pain at end range
AROM about equal to PROM
Moderate disability

Question 9

Return to Function - Characteristics

Answer 9

Low pain (0-3/10)
Absent night or rest pain
Minimal pain with overpressure
AROM = PROM 
Low disability

Question 10

Acute phase/Phase 1 = PT

Answer 10

Minimize physical stress
Activity modification
Physical agents
Medication
Pain relief manual therapy
Low physical stress
Pt education 
Monitor impairments

Question 11

Subacute phase/Phase 2 = PT

Answer 11

Mild to mod physical stress
Address impairments
Controlled physical stress via progressive manual therapy, mild stretching, motor control exercises
Basic level functional activity restoration

Question 12

Return to function phase/Phase 3 = PT

Answer 12

Mod to high physical stress
Address impairments
Stretch
Resisted exercise
More aggressive manual therapy
High demand functional activity restoration

Question 13

Define controlled physical stress

Answer 13

You are not using it in painful ways

You are minimizing the physical stress

Question 14

Expanded classification system is designed to

Answer 14

match rehab interventions to patient subgroups and stages to facilitate more effective care

Question 15

Pathoanatomic system of diagnosis - rehab

Answer 15

Good for surgical decision making but nor for guiding rehab

Question 16

Classification systems primarily aim to

Answer 16

guide treatment decision making and inform prognosis

Question 17

Article proposes what

Answer 17

A staged approach to classification that includes screening, pathoanatomic dx, and rehab classification - also matches interventions

Question 18

The rehab classification is used to

Answer 18

guide intensity and specific focus of rehab

Question 19

Both pathoanatomic dx and rehab classification are determined from the

Answer 19

history and physical exam

likely to be derived in parallel

Question 20

Level 1 =

Answer 20

Screening

Taking hx and performing basic exam to gain idea of problem - red and yellow flags

Question 21

Potential red flags for shoulder

Answer 21

Tumor 
Infection
Fracture or dislocation
Neurologic lesion
Visceral pathology

Question 22

Level 2 -

Answer 22

Pathoanatomic dx

Made based on identifying presumed tissue pathology that is generating the symptoms

Question 23

First step in level 2

Answer 23

Determine that the symptoms are attributable to shoulder rather than referred from elsewhere

Question 24

Level 2 - one of the primary intervention decisions

Answer 24

surgery or nonsurgery

Question 25

Level 3 -

Answer 25

Rehab classification/tissue irritability and impairments

Question 26

Level 3 - rehab categories are based on

Answer 26

the stage of tissue irritability to guide the intensity of the tx

Question 27

Pathoanatomical Dx vs. Rehab classification - what do they identify

Answer 27

Patho - identifies primary tissue pathology

Rehab - identifies level of irritability and key impairments

Question 28

Patho Dx vs. Rehab classification - over course of care

Answer 28

Patho - remains stable across episode of care

Rehab - changes over episode of care

Question 29

Patho Dx vs. Rehab classification - Guides what

Answer 29

Patho - guides a general treatment strategy

Rehab - guides specific rehab intervention

Question 30

Patho Dx vs. Rehab class - prognosis

Answer 30

Patho - informs prognosis

Rehab - may inform prognosis