Lecture 5 (9-23) Flashcards
What is pain is experienced after injury has taken place and tissue damage is occurring
Acute
What pain is defined as pain lasting longer than 6 months
Chronic
Does chronic pain respond to intervention
No
If pain goes away and comes back does that constitute as chronic pain
No
What type of pain is perceived to be in an area that has little relation to the pathology
Referred
What type of pain is caused by irritation of nerves and nerve roots
Radicular/radiating
What causes referred pain to be long lasting (4)
- Altered reflex pattern
- Continued mechanical stress on muscles
- Learned habits of guarding
- Development of trigger points (hypersensitive areas)
Deep somatic pain is what type of pain
Referred
What is pain that emanates from a sclerotome
Deep somatic
True or False:
Deep somatic pain is often has a discrepancy between the site of pain and the location of pathology
True
What do we gain from rating pain (4)
- Improves communication
- Directs clinician testing
- Standard measure for monitoring progress
- Provides documentation of progress for physicians and third party payers
What does the patient gain from rating pain (2)
- Reassure the patient
2. Reinforce the commitment to the plan of treatment when gains are made
What are the 5 pain scales
- Visual analog scale
- Pain chart
- McGill pain questionnaire
- Activity pattern indicators pain profile
- Numeric pain rating scale (NPRS)
What type of pain scale assess location of pain and allows patient to color/draw on areas of pain
Pain charts
What pain scale is 78 words that describe pain grouped into sets, used for LBP, and show change ever 2-4 weeks
McGill pain questionnaire
What pain scale is 64 questions that examines functional impairment and frequency of certain behaviors
Activity pattern indicators pain profile
What pain scale is rated from 0-10
Numeric pain scales
What is the measure of how far a patient can go until it hurts
ROM to pain onset (TPO)
What is the measure of pain during isometric break testing
Force to pain onset (FTPO)
How do you manage pain (2)
- Identify source of pain
2. Select appropriate interventions based on best evidence
What are the 4 pain management strategies
- Encourage activities that influence perception of pain
- Extensive patient education
- Validate your patient’s pain
- Incorporate pain modulating modalities where appropriate
What are the activities that influence perception of pain (4)
- Motivation techniques
- Relaxation techniques
- Meditiation
- Diaphragmatic breathing
What are ways to educate patients (3)
- Explain what patient should expect during recovery
- Discuss signs of inflammation
- Encourage gentle progression of activity
True or False:
All pain is very real to patients
True
When do we use goniometers (2)
- Patient says they have pain
2. Quantify deficits
What are the 6 rationales for goniometry and MMT
- Ability to conduct test, record, and interpret findings
- Develop outcomes and goals
- Modify interventions
- Motivate patient
- Research effectiveness of intervention
- Fabricate orthotic/prosthetic/adaptive equipment
What does goniometry measure
Osteokinematics not arthokinematics
Degrees of error with plastic
5-7 degrees
Degrees of error with metal
2-3 degrees
What are the 3 parts of a goniometer
- Body
- Stationary arm (SA)
- Moveable arm (MA)
What are the 4 tools used for goniometry
- Universal goniometer
- Inclinometer
- Electrogoniometer
- Visual exam
What are the 3 plane of osteokinematics
- Sagittal plane
- Frontal/Coronal plane
- Transverse plane
What axis goes with sagittal
Medial-lateral
What axis goes with frontal
Anterior-posterior
What axis goes with transverse
Vertical/Longitudinal
What are the 3 notation systems
- 0-180
- 180-0
- 360
What are the variations with goniometry (4)
- Age
- Sex
- Pathology
- Type: AROM PROM and joint play
What are the 3 types of normal end feels
- Soft
- Firm
- Hard
What is an empty end feel
No real end feel since end of ROM not reached due to pain or apprehension
What are the 9 examiner influences of MMT
- Location of force
- Force maagnitude
- Speed of resistive force
- Duration of contraction
- Interaction between PT and patient
- Word choice and tone
- Wearing gloves
- ICU
- Avoid tricks of trade
What are the 6 patient influences of MMT
- True effort expended
- Willingness to endure discomfort
- Fatigue
- Motor skills beyond ability
- Depression/malaise
- Cultural, social, gender issues
What is a 5
Full ROM against max resistance and pass break
What is a 5-
More than 1/2 range against max resist or fail break
What is a 4+
Less than 1/2 range against max resistance
What is a 4
Full ROM against moderate resistance and pass break
What is a 4-
More than 1/2 range against moderate resistance or fail break
What is a 3+
Less than 1/2 range against moderate resistance
What is a 3
Full ROM against gravity
What is a 3-
More than 1/2 range against gravity
What is a 2+
Less than 1/2 range against gravity
What is a 2
Full ROM gravity eliminated
What is a 2-
More than 1/2 range gravity eliminated
What is a 1+
Less than 1/2 range gravity eliminated
What is a 1
Visual or palpatory without movement
