L13 Mechanical Therapy Flashcards
Types of mechanical motion
continuous passive motion
static progressive stretching
traction
intermittent pneumatic compression
Continuous passive motion
device provides uninterrupted motion through controlled ROM
typically applied 1-4 hours/session for 1-3x day
best applied 2-21 days post injury
most helpful in acute phase when nothing else helps
Proposed effects of CPM
accelerate interarticular cartilage healing
decrease edema/effusion
minimize contractures
increases ROM
decease post op pain
increase lubrication
improve circulation
prevent adhesions
Precautions of CPM
significant bleeding
sensory impairments
skin irritation
increasing pain
Contraindications of CPM
unstable fracture
uncontrolled infection
spastic paralysis
DVT
poor pt compliance
All of the following parameters of Continuous Passive Motion are modifiable before it is applied to the patient
speed of motion
length of proximal and distal supportive arms
ROM the limb will be taken through
pulse duration of biphasic waveform can be modified during
Most common conditions for CPM
TKA
back surgery
shoulder surgery
frozen shouldeer
CPM alternatives
drop and dangle
sling
supine gymball roles
wall slides
Static progressive stretch devices
shoulder, knee, elbow, jaw, wrist, fingers, toe, ankle
helps with excessive tone, alignment of joints/bones, maintaining vascular integrity, diabetes, neuropathy, edema, osteoporosis
Dosage of static progressive devices
5 min on, 1 min off for 30 min, 3x a day
Ultimate conclusion of static progressive devices
first line of treatment should not be this
evidence is conflicting
patient compliance is an issue
not very comfortable, causes skin breakdown
Goals of traction
distracting joints, stretching soft tissue, reducing disc herniation, reducing pain, muscle relaxation
Cervical traction
Supine, 15-20 degrees. Increase up to 30 degrees if it is lower down the neck. Joint = 20 to 30 lbs, Disc = 10-15 lbs. Acute = 5-10 min, chronic = 15-30 min. Can do static (disc/motion aggravated pain) or intermittent (disc/joint distraction)
Lumbar traction
acute = 30 to 40 lbs
disc, spasm, soft tissue = 25% BW
joint = 50 lbs
duration is 5-10 min for disc, 10-30 min for other
not a stand alone treatment, mostly helpful for pain. can use auto traction, inversion, gymballs
Constant compression
increase hydrostatic pressure on the interstitial space
changes in lymph/venous, trauma, or amputation can cause this.
ace wraps, compression socks, TED hose help
Intermittent compression
typicall 7-8 minutes of treatment
forces fluids into lymph and venous systems to reduce edema
still should use compression socks afterwards
does appear to be helpful reducing risk of DVT and exercise recovery
IPC precautions
impaired sensation
malignancy
uncontrolled hypertension
numbness, tingling, pulse, pain during treatment
IPC contraindications
acute trauma
acute DVT
obstructed fluid return
arterial disease
very old or very young pts
After setting up a patient with acute lumbar radiculopathy on supine intermittent mechanical lumbar traction, you check in on them and they report feeling less pain in the involved lower extremity when the traction force is applied and worse when the traction is off. Which of the following parameters would be BEST to modify to improve their response?
Changing from intermittent to static traction duty cycle
When setting up traction for a 125 lb patient with acute C6/7 radiculopathy, which of the following parameters would be BEST to start with?
5-10 minutes of traction 3x/day
cervical traction documentation
(Position) cervical traction applied at (weight) for (length & cycle). Applied at (beginning, end, middle) of session for (purpose). Patient response.
