Musculoskeletal Impairments

Question 1

Phantom sensation

Answer 1

A sensation that appears to occur in the missing limb

Question 2

transradial amputation

Answer 2

below the elbow

Question 3

transmetacarpal

Answer 3

below the wrist

Question 4

Preprosthetic Intervention

Answer 4

• coping with psychological aspects of limb loss, grief, anger
• coping w/body scheme, reduced self-esteem
• Desensitize residual limb

Question 5

Prosthetic Interventions

Answer 5

• Don/doff prosthesis
• training in limb hygiene
• wound healing w/whirlpools and massage
• limb shrinkage and shaping
• desensitization of the limb through WB on surfaces, massage, tapping/rubbing
• increasing flexibility/strength of limb to prevent flexion contractures

Question 6

Passive TD

Answer 6

realistic, nonfunctional hand worn for cosmetic purposes

Question 7

Active TB

Answer 7

body-powered, externally powered amputation

Question 8

Prothesis wearing schedule

Answer 8

• initial wearing time of 15-30 minutes

- examine area for redness

Question 9

Contractures

Answer 9

Fixed posture because of shortening of skin, ligaments, joint capsule, tendons and muscles resulting from conditions such as burns, wound healing, muscle imbalance because of peripheral nerve injury, SPC injury, increased muscle tone from a stroke, head injury, cerebral palsy.

Question 10

Treatment of contractures

Answer 10

1) superficial and deep heat to increase tissue extensibility
2) slow stretch
3) static splinting

Question 11

Fibromyalgia

Answer 11

widespread pain affecting the entire musculoskeletal system

OT Interventions

• Client education to avoid pain triggers/manage stress
• gentle regular aerobic exercise, gentle daily stretching, strengthening activities, cognitive-behavioral therapy
• fatigue managment
• memory aids

Question 12

Posterolateral hip precautions

Answer 12

• no hip flexion greater than 90 degrees
• no internal rotation
• no adduction

Question 13

Anterior Hip precaution

Answer 13

• no external roation
• no hip extenion
• no adduction

Question 14

Low Back Pain

Answer 14

Result of poor physical fitness, obesity, reduced muscle strength and endurance

Question 15

Sciatic pain

Answer 15

when the nerve is trapped by a herniated disc

Question 16

spinal stenosis

Answer 16

narrowing of the intervertebral foramen

Question 17

facet joint pian

Answer 17

inflammation or changes of the spinal joints

Question 18

spondylosis

Answer 18

stress fracture of the dorsal to transverse process

Question 19

spondylolisthesis

Answer 19

slippage of a vertebra out of position

Question 20

herniated nucleus pulposus

Answer 20

stress tearing of the fibers of a disc

Question 21

Lower back pain - OT Intervention

Answer 21

• neutral spine back stabilization techniques to decrease pain
• AE
• increase strength and endurance
• pain management, stress reduction, coping

Question 22

Standards of body mechanics

Answer 22

• bend from the hip
• avoid twisting
• maintain good posture
• carry loads close to the body
• lift w/a wide base of support

Question 23

Phantom Limp

Answer 23

the sensation that the missing limb is still there

Question 24

Chemotherapy Precautions

Answer 24

• Use a mask
• restricted diet
• screening for anxiety, depression, fatigue

Question 25

Radiation Precautions

Answer 25

• assistance to maintain ROM and avoid pulling the burned skin
• use water-based ointments

Question 26

osteoarthritis

Answer 26

noninflammatory condition that causes a breakdown in cartilage resulting in reduced joint space and eventually painful bone-on-bone contact.

OT Interventions

• paraffin, fluid therapy, hot packs, Estim=reduce pain and increase ROM
• AROM
• Isometric/isotonic strengthening

Precautions
-pinching exercises w/CMC joint causes stress on the joint

Question 27

Arthroplasty

Answer 27

joint replacement

Question 28

Principles of Joint Protection/Fatigue Management

Answer 28

• Maintain muscle strength and joint ROM
• Use each joint in its most stable anatomical/functional plane
• Avoid positions of deformity
• Use the strongest joint
• Avoid staying in one position for long periods

Question 29

Osteoporosis

Answer 29

progressive condition characterized by low bone mass/density leading to fragile/fractured bones

OT Interventions

• Adaptations/Modifications to compensate for pain, stiffness, decreased ROM (devices w/built-up or extended handles)
• Encourage low-impact WB activities=walking
• Encourage good positioning/posture during activities
• Home visit=to reduce chance of falls
• Energy conservation/joint protection

Question 30

Osteopenia

Answer 30

reversible weakening of the bone and is a precursor to osteoporosis

Question 31

Rheumatoid Arthritis (RA)

Answer 31

chronic, systemic, inflammatory condition of the synovial membrane of the joints that can lead to destruction of ligament, tendon, cartilage and bone.

Most common joints affected: PIP, MCP, all thumb joints, wrist, elbow, ankle

Symptoms
-pain, redness, warmth, tenderness, stiffness, ROM limitations, muscle weakness, weight loss, fatigue and depression

OT Interventions

• AE to compensate for ROM
• Superficial heat/cold
• ROM exercises:
  - AROM can be used through full pain-free range.
  - PROM used during acute flare ups to prevent stress on inflamed joints
• Isometric exercises
• Isotonic exercises can be used during remission of RA
• Aerobic exercises=low impact such as walking, stationary bicycling, dancing

-Splinting