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2 Therapeutic Exercise > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

Fracture

A

structural separation in continuity of a bone, an epiphyseal plate or a cartilaginous joint surface

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2
Q

When should PTs detect fractures?

A

PT provide initial screening after traumatic event

PT provide initial screening for repetitive traumas

possibility of fracture during PT session

there is possibility of fracture occurring after surgery

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3
Q

Signs and symptoms of fracture

A

localized/specific pain aggravated by movement

muscle guarding with passive movement

pain w/weightbearing

decreased function of body part

swelling, deformity, abnormal movement

sharp, specific, excruciating pain

crepitus

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4
Q

Risk factors for fractures

A

evidence or history of high energy trauma or sudden impact

osteoporosis

history of falls w/increasing age, low body mass index, low levels of PA

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5
Q

Soft tissues & fractures

A

soft tissue may be injured as well
potentially serious if near artery/nerve
fractures in center of body–> internal organs, spinal cord, brain injured

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6
Q

Fracture blister

A

shear forces on skin
possible wound and infection

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7
Q

Adherent scar

A

bone poking through skin

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8
Q

Fracture causes

A

bending
twisting
straight pull
crushing
repetitive microtrauma
normal force on abnormal bone

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9
Q

Bending

A

long bone bends, fracture on convex side
type: transverse, oblique, greenstick

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10
Q

Twisting

A

spiral tension failure
type: spiral

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11
Q

Straight pull

A

tension failure from pull of ligament or muscle
type: avulsion

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12
Q

Crushing

A

compacts or bursts bone
type: compression, burst, buckle

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13
Q

Repetitive microtrauma

A

small crack in bone unaccustomed to stress
type: fatigue, stress

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14
Q

Normal force on abnormal bone

A

osteoporosis, tumor, other disease
type: pathological fracture

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15
Q

How to identify fractures

A

site
extent
configuration
relationship of fragments
relationship to environment
complications

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16
Q

Position of fracture

A

described by how distal fragment displaces in relationship to the proximal fragment

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17
Q

Comminuted

A

more than 2 fragments

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18
Q

Bone healing stages

A

inflammation (swelling)
reparative (osteocytes working)
remodeling (returning to normal)

19
Q

Clinical union

A

fracture site is firm enough that it doesn’t move, motion of limb is permissible but be VERY CAREFUL not to stress the site of the fracture

20
Q

Radiological union

A

fracture callus is replaced by mature bone, meaning bone is healed

4-6 wks = kids
6-8 wks = adults
10-12 wks = elderly, complications

21
Q

cortical vs cancellous bone healing

A

spongy bone typically heals faster than cortical

22
Q

Epiphyseal plate fractures

A

can lead to growth disturbances, bone deformity. bone is not the length it should be

23
Q

Stress sharing device

A

permits some transmission of load across fracture site

cast, rods, pins, wires

24
Q

Stress shielding device

A

protects the fx completely from mechanical stress, transfers stress to the fixation device

surgical plates, external fixators
usually for more fragile bone, longer healing process

25
Q

Tissue response to immobilization

A

connective tissue weakens
articular cartilage degenerates
muscle atrophy
circulation slows
scar, contractures, shortening

26
Q

Post-immobilization impairments

A

decreased ROM, joint play, flexibility
atrophy
pain
scar
motor control
balance

27
Q

Stretching with fx

A

proximal to fracture site ONLY until radiological healing has occurred

28
Q

Muscle performance w/fx

A

begin proximal to fx ONLY
don’t traumatize tissues
provide scar mobilization as possible
correct movements asap

29
Q

Complications with fractures

A

compartment syndromes
infection
fat embolism
refracture
fixation device failure
delayed or malunion

30
Q

Requirements for ex for fx

A

dynamic
high bone strains
apply load rapidly
short bouts separated by periods of rest
mod to high, >2x body weight
4-7 days/wk

31
Q

Low-risk for fx exercises

A

normal BMD
no clinical risk factors (falls, fracture)

32
Q

Mod-risk for fx exercises

A

low bone mass
certain clinical risk factors

33
Q

High-risk for fx exercises

A

very low bone mass
number of risks

34
Q

Some of the clinical risks factors

A

BMD
age
sarcopenia
loss of height
cancer
RA
hx of fractures/falls
excessive alcohol
smoking

35
Q

Frailty

A

geriatric syndrome based on deficit count by population prevalence

weakness, low PA, slow walk speed, exhaustion, unintended weight loss

0 = non frail
1-2 = pre frail
3+ = frail

36
Q

Increasing risk w/exercise

A

you will decrease the intensity from high impact 4x body weight to moderate impact 2-3x body weight

and you also decrease sets

37
Q

High impact exercises

A

> 4 BW
drop landing
star jump
vertical jump
tuck jump

38
Q

Moderate impact activities

A

2-3 BW
jump rope
running
bounding
jump take offs and hops
side hops

39
Q

Exercise modifications Osteoarthritis

A

reduce or eliminate high ground reaction forces
sub power training contraction against mod to high load

goal is rapid onset of high muscle contraction forces but with NO impact landing

40
Q

Exercise Modifications for fragility

A

start with heel drops instead of jumps
supervision
use support system

41
Q

exercise Modifications for cardio/pulm disease

A

keep training intensity below level that causes ischemia or severe dyspnea

deep throbbing pain that is bilateral or symmetrical

42
Q

load modifications OA

A

correct form
limit range
weight machines
alter intensity
consult PCP

43
Q

load mod for frailty

A

decrease intensity
modify impact
supervision for safety

44
Q

load mod for cardio/pulm

A

keep intensity below angina or ischemia
seated exercises
avoid breath holding

2 Therapeutic Exercise (14 decks)

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