Lecture 6/7 (9-28/30) Flashcards
What does F stand for in MMT
Functional
What does WF stand for in MMT
Weak Functional
What does NF stand for in MMT
Non Functional
What does 0 stand for in MMT
No Function
What are the 2 types of reliability
- Intratester
2. Intertester
What is intratester
Within one rater, how reproducible are your results
What is intertester
Between multiple testers, can they get the same results
The grades and there letters for MMT
5: N-normal
4: G-good
3: F-fair
2: P-poor
1: T-trace
0: O-zero
What are the 5 steps of the rehab cycle
- Identify problems and needs
- Relate problems to modifiable and limiting factors
- Define target problems and target mediators, select appropriate measures
- Plan, implement, and coordinate interventions
- Asses effects
True or False:
The rehab cycle is not continuous
False
What does the Nagi disablement model consider
Medical model and starts at cellular level to disability
What does the WHO-ICF enablement model consider
Medical model and social model
What are the levels of the disablement model (5)
- MOI/etiology
- Pathophysiology
- Impairment
- Functional limitation
- Disability
What is MOI/etiology
Causative or risk factors
What is pathophysiology
Altered cellular anatomy, mechanics, or physiology
What is impairment
Loss of abnormality or physiologic or anatomic structure or function
What is functional limitation
Restriction/inability to perform basic tasks or components of ADLs
What is disability
Restriction/inability to perform B/IADL (basic/instrumental) and socially defined roles
What leave do PTs and DRs work at in the disablement model
PT: Impairment
DR: Pathophysiology
What are the levels of the enablement model (5)
- Disorder/disease
- Body structure/function
- Activities
- Participation
- Contextual factors
What are the contextual factors of the enablement model (2)
- Personal
2. Environmental
What are environmental factors (5)
- Social attitudes
- Support and relationships
- Architectural characteristics
- Climate
- Terrain
What are personal factors (5)
- Gender
- Age
- Habits
- sexual orientation
- Character
What are body functions
Physiological function of body systems including psychological functions
What are body structures
Anatomical parts of the body such as organs, limbs, and their components
What do body structures correlate with in the disablement model
Impairments
What are activities
Execution of a task or action by an individual
What are activity limitations
Difficulties an individual has in executing a task or action
What do activity limitations correlate with on the disablement model
Functional limitations
What is participation
Involvement in a life situation
What are participation restrictions
Problems an individual may experience in involvement in life situations
What does participation restrictions correlate with on the disablement model
Disability component
What are the things you must think about before selecting an intervention (4)
- Rationale
- Criteria for progression
- Criteria for D/C of intervention
- Criteria for D/C from PT
What is the rationale component of intervention
Why you are giving the patient the exercise
What is the criteria for progression component of intervention
Think about what benchmark you want to achieve to advance or get rid of exercise
What is the criteria for D/C of an intervention component of intervention
Benchmark to advance patient to the next exercise or get rid of the current exercise
What is an intervention
Purposeful and skilled interaction of the Pt with the patient using various PT procedures and techniques to produce changes in the condition consistent with the diagnosis and prognosis
What are the 3 elements of intervention
- Coordination, communication, and documentation
- Patient related instructions
- Direct intervention
What falls under coordination, communication, and documentation (7)
- Documentation of all elements of the patient management
- Referral to other health care services
- Coordination of care
- Communication with significant others or health care practioners
- Case management
- Record reviews
- Discharge planning
What falls under patient related instruction
PATIENT EDUCATION
What are some things you educate patients on (5)
- Nature, significance, and prognosis of clinical findings
- Rationale for PT intervention
- ADL modification recommendations, including assistive devices and adaptive equipment
- Secondary prevention
- Home/self intervention program instruction for current condition
What falls under direct intervention (4)
- Select apply and modify based on exam, eval, Dx, and Px
- Work from patient problem list
- Goal and outcomes should guide direct intervention
- If you arrive at a diagnosis of an APTA Guide Practice Pattern follow the interventions offered
What is the injury cycle (6)
- Injury
- Swelling
- Pain
- Spasm, guarding, tightness
- Decreased blood flow which leads to fluid congestion
- Regional acidity
True or False:
If you don’t stop the injury cycle before the regional acidity the patient will stay there
True
What are the 5 considerations that are made while picking intervention
- Stage of healing
- Objective data
- Research evidence
- Patient experience/Preference
- Clinician expertise
What are the 4 things of objective data
- ROM/ROM TPO
- FTPO/MMT
- Special tests
- Accessory motion testing
- Palpation
What are other factors to consider in selecting direct interventions (4)
- SAFETY
- Psychological and/or emotional status and/or needs
- Economic factors: insurance finances
- Social support, needs, and responsibilities
During the proliferation stage where is pain felt
Towards the end of range not at rest
True or False:
Loss of function during the maturation phase is not due to inflammation
True
What is PROM
Movement within the unrestricted ROM by an external force
What is AAROM
Movement within the unrestricted ROM with assistance by other internal or external force
What is AROM
Movement within the unrestricted ROM produced by active, volitional contraction of the prime movers
When is PROM used
Acute/inflammed tissue and when the patient is UNABLE to or NOT SUPPOSED to move themselves
What is the primary goal with PROM
Decrease complications of immobilization
What are some other goals of PROM (7)
- Maintain joint and CT mobility
- Minimize contractures
- Maintain mechanical elasticity of muscle
- Assist circulation and vascular dynamics
- Enhance synovial movement for cartilage nutrition
- Stimulate mechanoreceptors/inhibit nociceptors
- Help patient maintain awareness of movement
What will PROM not do (3)
- Get you stronger
- Increased function
- Increase AROM
What are indications the patient is ready/need to progress to AROM (4)
- Whenever they can actively contract the muscle
- Weak musculature
- Aerobic conditioning
- To regions above/below the immobilized
What are the goals of AROM (6)
- Same as PROM as long as no inflammation
- Maintain physiologic elasticity and contractility of muscle
- Provide sensory feedback from contracting muscles
- Provide a stimulus for bone and joint tissue integrity
- Increase circulation and prevent thrombus formation
- Develop coordination and motor skills for functional activities
What will AROM no do for strong muscles
Strengthen the muscle
What will AROM not do in general (3)
- Not improve AROM
- Not increase PROM
- Lead to quality functions of motor movements
What are the indications to do AAROM
Patient is able to generate some force without pain and no contraindication to active movement
What are the goals of AAROM (2)
- Progress from PROM to AROM
2. Tendon training
What is the goal of the inflammatory phase of healing (5)
- Protect injured area
- Decrease pain
- Decrease edema
- Decrease inflammation
- Decrease injurious ADLs
What is the general intervention principle for the inflammatory phase
PRICE
What does PRICE stand for
P: Protection R: Relative rest I: Ice C: Compression E: Elevation
