modality cases from review class Flashcards
- Group 1: 26 year old presents with Rheumatoid Arthritis (newly diagnosed). Reports recent increase in stiffness causing difficulty making a fist.
Paraffin- loosen tissue/joints, it doesn’t have the weight of a hot pack
- Group 1: Your client had his external fixator removed from his distal radius three days ago. There is oozing of fluid from the site of attachment of the external fixator. He is fearful of moving and has some mild pain and significant loss of ROM in supination & pronation and all pivots of the wrist.
sterile whirlpool- increase ROM and it’s good for open wound. temp 95-100 degrees
hot pack- good for pain/stiffness, use more toweling so its not as hot.
cold pack will decrease inflammation
- Group 1: Your roomate reports pain in right dominant 1st dorsal compartment following making a poster using lots of manual handwriting and drawing two days ago.
DeQuervains
ice massage- reduce pain and swelling. small area, direct. it’s acute
cold pack or contrast bath
- Group 1: 47 year old factory worker presents following crush injury in a stamp imprint machine 16 weeks ago. Client received two therapy visits at 6 weeks then discontinued therapy due to ride difficulty. Is now stiff and hypersensitive wearing long sleeve to protect despite warm weather. No significant edema.
fluidotherapy good for hypersensitivity
whirlpool- aeration
Group 2: 42 year old right dominant client presents with right lateral epicondylitis. She began work as post office clerk 4 weeks ago. She describes pain when moving wrapped stacks of magazines with one hand which is a high frequency activity. Presents with pain in right proximal insertion of wrist extensors and has decreased ROM in wrist flexion.
ultrasound- decrease pain, 3MHz, heat continuous b/c of chronic, 6 min. 1.1-1.2
ice massage- small area, anesthetic affect for pain
- Group 1: Patient fell forward and injured hand in a snow blower six weeks ago. Multiple trauma, fracture to middle and ring proximal phalanx, surgery to re-attach index at PIP joint day after injury. Wounds and surgical incisions fully closed and appear to be healing well. Significant edema limits ability to flex or extend digits fully.
ice pack- reduce edema
whirlpool or contrast bath- both reduce edema, good for home
- Group 2: Same client following 4 weeks of treatment. Edema now minimal. Patient with full PROM however when attempts to make fist achieves only ¾ fist actively.
NMES- increase AROM
ultrasound- soften scar tissue
- Group 2: A 27 year old mother of infant triplets presents with DeQuervains Tenosynovitis from excess diapering and holding babies during nursing. She exhibits pain in first dorsal compartment and limited MP and IP flexion of right thumb with diminished pinch.
ultrasound- for inflammation, pulsed .8, 3 MHz
- Group 2: Your patient at the rehab facility presents with a shoulder subluxation. In supine you are able to observe fasciculation and possibly some movement of the mid-deltoid. However in sitting you observe nothing.
NMES- stimulate muscle, pads, mid deltoid, upper trap. make sure its not on bone.
- Select choices one from Group 1 and one from Group 2: 42 year old right dominant client presents with right lateral epicondylitis. She began work as post office clerk 4 weeks ago. She describes pain when moving wrapped stacks of magazines with one hand which is a high frequency activity. Presents with pain in right proximal insertion of wrist extensors and has decreased ROM in wrist flexion.
repeated question
- Select choices one from Group 1 and one from Group 2: Your 46 year old client had an elbow fracture 2 years ago following a motorcycle accident. He has 7/10 pain. He had hardware (screws) removed from the olecranon 12 weeks ago. He is well healed. He presents in a guarded position with his elbow in a sling. He is only moving 20 degrees each direction (elbow flexion/extension) and withdraws when you attempt to touch him.
group 1: hot pack- loosen upper trap, also on elbow
towels to prevent overheat
group 2: TENS, conventional (the whole treatment), low freq 1st cross pads (4)
- : Group 1: Your 32-year old client reports she attempted the home exercise program you suggested yesterday for her adhesive capsulitis. After one day she returns to the clinic early the next morning without an appointment with complaints of significant increase in pain in her shoulder that kept her awake last night. She points to her A-c joint and her upper trapezius as the location of pain.
cold pack- acute, good for inflammation
cryocuff- compression
- Select choices one from Group 1 and one from Group 2: Your 28 year old client presents with biceps tendonitis that began 5 weeks ago when he moved into a new apartment and carried heavy boxes and furniture. Reports pain on overhead reaching in the bicipital groove. Client works as a stock boy at the local grocery store.
chronic with acute features
group 1: ice massage- small area, direct and focused
group 2: ultrasound, phonophoresis, iontophoresis,
- Select choices one from Group 1 and one from Group 2: Your 39 year old well developed softball coach presents with pain and spasm in her right cervical area. You identify a trigger point in the mid upper trap but the point does not respond to manual release.
group 1: hot pack- help with spasm, relaxes muscle bringing blood flow to area
ice massage- relax spasm and muscle, gets trigger point, do it in circles
group 2: NMES, fatigue the muscle
ultrasound- heat/thermal 2-3 min.
