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THER EX 2: LQ > lecture 7: therapeutic exercise for the ankle and foot > Flashcards

lecture 7: therapeutic exercise for the ankle and foot Flashcards

1
Q

what are the primary motions of the talocrural joint

A

DF and PF

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2
Q

during OKC supination and pronation what is the motions of the foot

A

sup: calcaneus PF , add and inversion

pro: calcaneus DF , ADB and eversion

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3
Q

during CKC supination and pronation what is the motions of the foot

A

SUP: calcaneal inversion , talus abd and DF

pro: calcaneal eversion , talus add and PF

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4
Q

what is included int he bifurcate ligament and when is it injured

A

calcaneonavicular ligament
calcaneocubdoid ligament

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5
Q

what 4 ligaments are included in the deltoid ligament

A

posterior tibiotalar
tibiocalcaneal
tibionavicular
anterior tibiotalar

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6
Q

what are the primary plantar flexors

A

 Gastrocnemius
 Soleus
 Plantaris

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7
Q

what are the secondary plantar flexors

A

 Posterior Tibialis, FDL, FHL
 Peroneal longus and brevis

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8
Q

what is the primary and secondary DF

A

 Anterior Tibialis (primary)
 EHL
 EDL
 Peroneal tertius

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9
Q

what does the tibial nerve break off into

A

medial calcaneal nerves
inferior calcaneal nerves
lateral plantar nerve
medial plantar never

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10
Q

what mms are responsible for eversion of the foot

A

 Peroneal longus
 Peroneal brevis
 Peroneal tertius

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11
Q

what mms are responsible for inversion of the foot

A

tib ant and post

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12
Q

what are included int he foot intrinsic dorsaly

A

EDB
EHB

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13
Q

what is the function fo the foot intriniscis

A

toe motion and arch stability

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14
Q

what are the 4 layers of the foot intrinsics plantarlly

A

Layer 1 (superficial): Abductor Hallucis, FDB,
Abductor DM

Layer 2: Quadratus Plantae, Lumbricals

ayer 3: FHB, Adductor Hallucis, FDMB

Layer 4: Plantar Interossei, Dorsal Interossei

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15
Q

in CKC tibial IR and ER is associated w what at the foot

A

IR= pro
ER= sup

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16
Q

as the heel strikes the ground there is slight ___ and as at the foot lowers to the ground there is __- to absorb some of the impact of the ground)

A

sup
pro

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17
Q

as the foot is fixed on the ground and the tibia comes up over the foot what happens at the ankle

A

DF

tibia IR , reinforces pronation of the foot

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18
Q

what happens at the tibia and hind foot during instance thru terminal stance

A

tibia ER
initiating supination of hind foot , locking transverse tarsal joint (foot is in closed packed position)

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19
Q

what is claw toe

A

MTP hyperextension and IR flexed

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20
Q

what is hammer toe

A

MTP hyperextension
PIP flex
DIP hyperextension

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21
Q

what is the MOI for a lateral ankle sprain

A

inversion and PF

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22
Q

if you are examining an ankle after an inversion and PF MOIn and there is a slight stretching and microscopic tearing of the ligament fibers , they have some mild tenderness and swelling around the ankle what grade would u suspect and what lig is prob injured

A

grade 1 sprain (mild)

anterior talofibular ligament

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23
Q

what is a grade 2 sprain (moderate) of a lateral ankle

A

partial tearing of anterior talofibular lig and some tearing of the calcaneofibualr lig

mod tenderness and swelling

recover in 2-3 weeks

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24
Q

what is a grade 3 lateral ankle sprain (severe)

A

complete tear for the ATFL , CF and PTFL

sig tenderness and swelling around the ankle

takes 3-12 weeks to recover

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25
Q

if a pateint comes in and their MOI is forced eversion and DF of the ankle wha kind of sprain are u thinking

A

syndesmotic ankle sprain (high ankle sprain)

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26
Q

what is the most common ligament that is invovled in the syndesmotic ankle sprain

A

anterior interior tibiofibular ligament

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27
Q

what are teh S/S for a syndesmotic ankle sprain

A

less swelling , inability to bear weight , inability to fully PF and ecchymosis

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28
Q

what is the MOI of a medial ankle sprain

A

eversion

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29
Q

what are the validated outcome measures used for a ankle sprain

A

PROMIS
FAAM
LEFS

30
Q

what do u assess and document for a ankle sprain

A

ankle swelling
ROM (DF using weight bearing lunge test(
talar translation
talar inversion
single leg balance

31
Q

is it recommended to use a prophylactic bracing for a ankle sprain ?

A

yes level A evidence

32
Q

what is recommended as level A evidence for patients w acute LAS

A

use external supports (bracing or taping )
progressively bear weight on affected limb

33
Q

what kind of therapeutic exercises should be used for a ankle sprain

A
  • focus on proprioception and balance drills
  • focus ther ex on impairments
  • protected AROM , stretching , NM training
34
Q

is it good to do manual therapt and joint mobilization for ankle sprains

A

yes level A evidence

35
Q

for ankle sprains use .. therapeutic exercises to reduce ____ , improve pain free ankle and foot ___ and normazlize ___ parameters

A

swelling , mobility , gait

36
Q

can u use ultrasound for LAS

A

noooooonnonononnononno

37
Q

what do u prescribe for chronic ankle instability

A

proprioceptive and NM therapeutic exercises to improve dynamic postural stability and patient perceived stability during function

38
Q

what special test can u use for ankle sprain

A

reverse anterolateral drawer test
anterolaterla talar palpation
anterior drawer test

39
Q

should u use a external support as a stand alone intervention to improve balance and postural stability in people w CAI

A

NOOOO

40
Q

what outcome measures can u used for achilles tendinopathy

A

VISA-A
FAAM
LEFS

41
Q

for achilles tendinopathy what should u used to decrease pain and improve function for patients with midportion Achilles tendinopathy without presumed frailty of the tendon structure.

A

use mechanical loading

  • isometrics early for pain control
  • progress to eccentric drills
42
Q

For patients with nonacute midportion Achilles tendinopathy, clinicians should advise that complete rest is ___ indicated and that they should continue with their recreational activity within their pain tolerance while participating in rehabilitation

A

not

43
Q

Use ____ with ____ to decrease pain and improve function in patients with acute midportion Achilles tendinopathy

A

iontophoresis with dexamethasone

44
Q

what outcome measures shoudl u use for plantar fasciitis

A

FAAM
FHSQ
FFL
LEFS

45
Q

for plantar fasciitis you should Use ___ ___ to treat relevant LE joint mobility and calf
flexibility deficits

A

manual therapy

46
Q

what kind of stretching should u use to provide short-term (1 week to 4 months) pain relief for
individuals with heel pain/plantar fasciitis. Heel pads may be used to increase the benefits of stretching.

A

plantar fascia specific and gastroc and soleus stretching

47
Q

for plantar fasciitis Use _____ taping for immediate (up to ___ weeks) pain reduction and improved function for individuals with heel pain/plantar fasciitis. Additionally, clinicians may use ___ therapeutic tape applied to the gastrocnemius and plantar fascia for short-term (1 week) pain reduction.

A

anti pronation
3

elastic

48
Q

for plantar fasciitis Use foot ___, either prefabricated or custom fabricated/fitted, to support the medial longitudinal arch and cushion the heel in individuals with heel pain/plantar fasciitis to reduce pain and improve function for short- (2 weeks) to longterm (1 year) periods, especially in those individuals who respond positively to antipronation taping techniques

A

oorthoses

49
Q

should people w heel pain/plantar fasciitis wear a night splint

A

yes

50
Q

what is the diagnosis for plantar fasciitis

A
  • positive windlass test (bolded)
  • abnormal foot posture index score (bolded)
    -tight hammy
  • limited active and passive talocrual joint DF ROM
    pain w palpation of the proximal insertion of the plantar fascia
51
Q

what is the tarsal tunnel syndrome

A

Pain over the tarsal tunnel radiating to the arch
and plantar foot.
 Pain may radiate up to the calf.

52
Q

what will a pt report if they have tarsal tunnel syndrome

A

sharp shooting foot pain
plantar numbness
paraesthesias alone posterior tibia never
pain at end range DF and eversion

53
Q

when is tarsal tunnel syndrome worse and better

A

worse at night , walking standing or activity

better w rest

54
Q

how is the tarsal tunnel syndrome severity rating rated

A

10 is normal
0 indicates that the conditions symptoms are severe

55
Q

what are teh 5 symptoms for the Tarsal Tunnel Syndrome
Severity Rating

A

• Spontaneous pain or pain with movement
• Burning pain
• Tinel sign
• Sensory disturbance
• Muscle atrophy or weakness

56
Q

where is the lisfranc joint

A

medial cuneiform to 2nd MT to 3rd MT to 4th MT

57
Q

in the lisfranc joint where are the ligaments located

A

between the medial cunifomr and the 2nd MT

58
Q

what are the symptoms of a lisfranc injury

A
  • dorsum of foot is swollen/painful
  • bruising on the bottom or top of foot (most commonly on plantar)
  • pain that is worse w standing or walking
  • abnormal widening of foot
59
Q

for a post op ankle what is usually NWB and what is WBAT

A

plate is NWB
intramedullary nail is WBAT

60
Q

what motion is likely to be limited w screws connecting tibia and fibula

A

DF

61
Q

what has the purpose to stimulate bone growth
using distraction osteogenesis
(pulling apart bone to stimulate new
bone growth)

A

Ilizarov Frames

62
Q

what MUST u do for a Ilizarov Frames

A

WBBBBBBBB

63
Q

what are some DF stretching/ROM exercises

A

sitting - heel slide under chair
standing - knee flexed or extended near a wall

64
Q

what are ROM/strtching exercseis for PF

A

mobs and AROM
quadruped stertch

65
Q

when it MTP extension critical for and how can u increase ROM or stretch

A

terminal stance

heel raises in sitting

66
Q

what can u use soft issue massage for

A

calf’s
peroneals
anterior tibialis
plantar fasciitis

67
Q

what STM for dr P like for planar fascia

A

self massage

68
Q

what are some examples of NM control for the foot/ankle

A

marble pick up for toe flex , PF and inv and Ev
toerl scrunches for toe flexors
rocker board/BAPD board

69
Q

what is Dr. P go to for NM control and strength for post tib and foot intrinsics

A

arch raises (short foot)

70
Q

what are some toe isolation exercises for NM control , strength

A
  • toe yoga
  • splay toes
  • toe resistance activation
71
Q

how can u progress CKC exercseis for the foot and ankle

A

start in bilateral stance and progress to SLS

add perturbations

72
Q

what are dynamic strengthening for PF and DF

A

 PF – heel raises; squats
 DF – walk on heels

THER EX 2: LQ (9 decks)

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