Musculoskeletal Conditions Flashcards
Disarticulation amputation
amputation across a joint
syme’s amputation
amputation at ankle
when is the preprosthetic phase
post surgery to receiving prosthesis
when is the prosthetic phase
after receiving the prosthesis
what are the typical limitations of UE amputations
manipulation of objects
what are the typical limitations of LE
functional mobility
OT eval during post-op phase of amputation
- pain and edema
- skin complications
- bone spurs, neuromas
- phantom pain and sensation
OT eval of prosthetic phase
- changes in sensation, pain
- body image
- skin, pressure injuries
- strength, flexibility, edema
Cause of pressure injuries with prosthesis
ill-fitting socket or wrinkles in sockets
cause of sebaceus cyst with prosthesis
torque of socket
cause of edema with prosthesis
ill-fitting socket or too tight
preprosthetic training interventions
- limb hygiene and wound care
- limb shrinkage and shaping
- ADL retaining
how is limb shrinkage done
elastic bandage worked up to elastic compression once drainage stops
w/c set up with amputations
- residual limb support
- rear wheels placed further back
- antitippers
describe terminal device on prosthesis
foot or hand
body powered prosthetic system
cable driven with gross proximal movement
electrically powered prosthetic system
- muscle surface electricity
- must have 2 muscle sites in prosthesis
hybrid prosthetic system
- body-powered and electrical
- commonly for transhumeral amputation
passive prosthetic system
static prosthesis
activity specific prosthetic system
designed for particular task
prosthetic training
- donning/doffing prosthesis
- wearing schedule
- limb hygiene
- prosthetic care
- functional training and driving
wearing schedule during prosthetic training
- initially 15-30 minutes checking for irritation
- if not irritated after 20 minutes, increase 15-30 minute increments until wearing full day
prosthetic care
- daily cleaning with soap and water
- replace batteries
contracture
shortening of skin, ligaments, joint capsule, tendon, muscles
soft tissue contracture
responds to therapy
boney block contractures
require surgery to release
OT eval of contractures
- PROM and AROM
- impact on function
OT intervention for contractures
- superficial and deep heat to increase elasticity
- slow stretch
- static splinting
- serial static splinting
- dynamic splinting
describe fibromyalgia
- widespread pain and tenderness and stiffness independent of injury and lesion
- excessive tenderness in 11-18+ trigger points
OT eval of fibromyalgia
- impact on function
- cognition and psychosocial assessment
- pain assessment and diary
OT intervention of fibromyalgia
- education to manage pain and avoid triggers
- gentle exercise, stretching and strengthening
- sleep hygiene
- pain management
- modification or AE
risk factors of hip fractures
osteoporosis and reduced mobility
what is the most common cause of hip fractures
falls
describe femoral neck fracture
slight trauma or rotational force
describe intertrochanteric fractures
direct force between greater and lesser trochanters
describe subtrochanteric fractures
direct trauma to lesser trochanter
medical management of hip fractures
closed manipulation or ORIF
Non-weight bearing
0%
toe-touch weight bearing
10% for balance only
Partial weight bearing
50%
full weight bearing
100%
weight bearing as tolerated
weight bearing based on pain
when is a hip replacement indicated
joint diseases, arthritis, pain
posterior THA precautions
no hip flexion past 90, internal rotation, or adduction
anterior THA precautions
no external rotation, extension, adduction
OTs role in hip replacements
- education on precautions
- psychosocial aspects
- home safety and return to work
indications for knee replacement
- pain and loss in function
- joint disease, arthritis or trauma
- symptoms compounded by obesity or aging
medical management of knee replacement
- aleviate pain, increase motion, maintain joint alignment and stability
- knee imobilizer or brace
- avoid excessive rotation 12 weeks
partial/unicompartmental knee arthroplasty
medial or lateral compartment
total knee arthroplasty
damage to 2+ compartments of knee
Role of OT with TKA
- education of WB restrictions and precautions
- teach safety with transfers, ADLs, LB dressing
- AE recommendations
goals of rehab for low back pain
-body positioning and ergonomics
- pain management
what is sciatic pain
pinched nerve from herniated disc
what is spinal stenosis
narrowing of intervertebral foreamen
what is facet joint pain
inflammation/change of spinal joints
what is spondylolysis
stress fracture of dorsal transverse process
spondylolisthesis
slippage of vertebra out of position
what is herniated nucleus pulposis
stress tearing of fibers of disc causing outward bulging
what is compression fracture typically caused by
osteoporosis
formal assessments for low back pain
- COPM
- Brief Pain inventory
- Beck Depression Inventory
- Pain Self-efficacy questionnnaire
OT intervention of low back pain
- neutral spine stabilization techniques
- body mechanics
- pain management
- ADL retraining
semi-squat
face object, lower knees, straight back
lifting considerations for large or heavy objects
lower 1 knee to floor, keep object close to body
lifting considerations for light, balanced loads
carry close to body with straight spine
bathing suggestions for low back pain
- HHSH or long handle sponge to reduce twisting
- hygiene at kitchen skink vs bathroom sink
- sit for dressing and laydown for pulling clothes up
primary vs secondary osteoarthritis
- primary is localized with unknown cause
- secondary is related to trauma, infection, necrosis or congenital abnormalities
symptoms of osteoarthritis
- joint pain and stiffness
- local inflammation
- crepitus
- worsens with activity and may disturb sleep
- relieved by rest
Buchard’s nodes are located where
PIP joints
Heberden’s nodes are located where
DIP joints
evaluation of osteoarthritis
- ROM and strength
- cognitive and psychosocial assessment
- posture, pain, deformity, inflammation
Intervention for osteoarthritis
- PAMS
- Ther ex and AROM
- occupational retraining
- symptom management and joint protection
what is Osteoporosis
progressive low bone mass and density
OT eval of osteoporosis
- strength and ROM
- Assess sleep and work
- assess fall risks
