Musculoskeletal Impairments Flashcards
Phantom sensation
A sensation that appears to occur in the missing limb
transradial amputation
below the elbow
transmetacarpal
below the wrist
Preprosthetic Intervention
- coping with psychological aspects of limb loss, grief, anger
- coping w/body scheme, reduced self-esteem
- Desensitize residual limb
Prosthetic Interventions
- 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
Passive TD
realistic, nonfunctional hand worn for cosmetic purposes
Active TB
body-powered, externally powered amputation
Prothesis wearing schedule
- initial wearing time of 15-30 minutes
- examine area for redness
Contractures
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.
Treatment of contractures
1) superficial and deep heat to increase tissue extensibility
2) slow stretch
3) static splinting
Fibromyalgia
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
Posterolateral hip precautions
- no hip flexion greater than 90 degrees
- no internal rotation
- no adduction
Anterior Hip precaution
- no external roation
- no hip extenion
- no adduction
Low Back Pain
Result of poor physical fitness, obesity, reduced muscle strength and endurance
Sciatic pain
when the nerve is trapped by a herniated disc
spinal stenosis
narrowing of the intervertebral foramen
facet joint pian
inflammation or changes of the spinal joints
spondylosis
stress fracture of the dorsal to transverse process
spondylolisthesis
slippage of a vertebra out of position
herniated nucleus pulposus
stress tearing of the fibers of a disc
Lower back pain - OT Intervention
- neutral spine back stabilization techniques to decrease pain
- AE
- increase strength and endurance
- pain management, stress reduction, coping
Standards of body mechanics
- bend from the hip
- avoid twisting
- maintain good posture
- carry loads close to the body
- lift w/a wide base of support
Phantom Limp
the sensation that the missing limb is still there
Chemotherapy Precautions
- Use a mask
- restricted diet
- screening for anxiety, depression, fatigue
Radiation Precautions
- assistance to maintain ROM and avoid pulling the burned skin
- use water-based ointments
osteoarthritis
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
Arthroplasty
joint replacement
Principles of Joint Protection/Fatigue Management
- 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
Osteoporosis
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
Osteopenia
reversible weakening of the bone and is a precursor to osteoporosis
Rheumatoid Arthritis (RA)
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
