Musculoskeletal Impairments Flashcards
prosthesis wearing schedule
- initial time should be 15-30 min
- remove and examine stump for reddened areas
- if no reddened areas apparent after 20 min, the wearing time is increased in 15-30 min. increments until the client wears for full day
- any reddened areas that do not disappears after approx. 20 min should be reported to the prosthestist so it can be adjusted
prosthesis control training
operation of each component of the upper limb prosthesis
prosthesis use training
integration of prosthesis comments for efficient assist during functional use
prepositioning training
identification of the optimal position of each positioning unit (e.g. wrist, elbow) to perform an activity or grasp an object
prehension training
TD control during grasp activities
functional training
control and use of the prosthesis during functional activities
- incorporation of the TD as a functional assist
- focus on a problem-solving approach
anti deformity (safe position) burn splint
wrist 20 degrees extension, MCP joints 90 degrees flexion, PIP and DIP joints 0 degrees extension
elbow or knee extension splint
positions in as much extension as possible
wrist extension splint
to prevent wrist drop
functional splint with 45 degrees of wrist ext. worn during day
thumb abd. splint
to prevent them add. contracture
splint forms a C bar between the dumb and index web space
lumbrical bar splints
to reduce MCP hyperextension and IP flexion contractors
MCPs are splinted to block hyperextension
resting hand, ball, and cone anti spasticity splints
to decrease tone in the hand and UE
soft neoprene splints
to position thumb and forearm
commonly used with client with RA or CP to increase functional use of the hand
splint to prevent foot drop
below the knee to keep ankles at 0 degrees for possible future amb.
serial casting
use of fiberglass or plaster of paris materials to position clients with increfsedtone and over time stretch out soft tissue contractures
dynamic splinting
may involve metal and loop components
angle of pull needs to be 90 degrees for most effective outcome.
posterolateral approach
no hip flexion greater than 90 degrees, no IR, no add.
anterolateral approach
no ER, no /, no add.
bouchards nodes
bone spurs on PIP joints
heberdens nodes
bone spurs in the DIP joints
TKR precautions
not putting pillow under knee while in bed
resting foot on the floor when sitting to increase ROM
wearing an immobilizer as instructed
avoiding kneeling, equating, or twisting the knee
OA intervention
AROM exercises, PROM only if AROM is preluded
isometric or isotonic strengthening exercises to be performed to tolerance.
low impact aerobic condition exercises
pinching exercises may be CONTRAINDICATED with CMC joint instability b/ of stresses on the joint
spica splint
Osteoporosis
low bone mass or density and deterioration leading to bone fragility and pathological fractures, particularly WB bones.
osteopenia
precursor to osteoporosis. weakening of the bone
Osteoporosis intervention
occupation-based retraining with adaptations or mods to accommodate or compensate for pain, stiffness, decreased ROM and instability
low impact WB activities such as walking
encourage good positioning and posture during physical activity.
environmental mods to improve access and reduce fall risk.
body mechanics, energy conservation, and joint protection.
boutonniere deformity
flexion of the PIP joint and hyperextension of the DIP joint
swan neck deformity
hyperextension of the PIP joint and flexion of the DIP joint
mallet finger
flexion of the DIP joint
ulnar drift
radial deviation of the wrist and ulnar deviation of the MCP joints
mutilans deformity
characterized by floppy joints with shortened bones and redundant skin. most common in MCP ,PIP, radoiocarpal and radioulnar joints
acute RA
pain and tenderness at rest that increased with movement, limited ROM, overall stiffness, weakness, tingling or numbness, hot, red joints, cold, sweaty hands, low endurance, weight loss or decreased appetite, fever.
subacute RA
reduced pain and tenderness, morning stiffness, limits movement, tingling or numbness, pink warm joints, low endurance, weakness, weight loss or decreased appetite, mild fever
chronic active RA
low grade inflation, decreased ROM, less tingling, pain and tenderness primarily with movement, low endurance
chronic inactive RA
no signs of inflation, low endurance, pain from stiffness and weakened joints, morning stiffness primarily related to disuse, limited ROM, weakness and muscle atrophy, contractures.
RA intervention
limit activities during acute flareups.
assistive devices
physical agent modalities, superficial heat and cold can be used to control symptoms
AROM can be used through full pain free range
PROM may be more appropriate during acute flare ups to prevent stress on inflamed joints
isometrics exercises within pain free exertions are appropriate during acute flare ups.
isotonic progressive resistive exercise can be performed as tolerated when the client is in remission.
aerobic exercises
resting hand splint.
