Musculoskeletal PT Flashcards
Goals
- Maximize function
- Alleviate pain
- Decrease abnormal stress on joints
- Promote proper posture
- Promote tissue healing, ROM, flexibility, and strength
Measuring pain
Before/after treatment to determine effectiveness of treatment
- use same scale throughout episode of care for patient
Postural assessment
Evaluates the position maintained by the body when standing and sitting in relation to space and other body parts
- view patient from all angles
ROM
Measure the amount of motion available at certain joints
-measured in degrees with a goniómetro
AROM
Active range of motion
- performed entirely by patient
PROM
Passive range of motion
- patient doesn’t do anything
Manual muscle testing
Evaluates the relative strength of specific muscles
- identifies patterns of muslcle weakness (0-5)
Functional assessment
Variable - determines effect of a condition on functional life/work abilities (questionnaire)
Deep tendon reflexes
Assess neuromuscular integrity
Gait analysis
Visual assessment of gait
Therapeutic exercises
Exercises: - strengthening - stretching - balance/coordination - ROM
Improve function, strength, endurance, and flexibility
Modalities
Ice, heat, US, IFC
Manual therapy
Soft tissue work
Patient edu
Ongoing and age specific
Physiological changes
- Increase circulation - decrease pain - decrease edema - decrease muscle spasm
Exercise parameters
- established by PT or PTA
- Should be appropriate for each patient and stage of injury recovery or disease process
- Frequency (sets, reps), duration, intensity, type
PROM interventions
- Performed by PT/PTA or mechanical device
- Will not increase strength
- Appropriate when muscle weakness. Inability to move joint, post surgery, decrease pain, prevent joint contracture
Joint mobilization
- Passive accessory joint mobilization are performed by PT/PTA
- Will not increase strength
- Appropriate to decrease joint stiffness and decrease pain
AROM interventions
- Performed by PT
- Will increase strength but not ROM
- Appropriate to increase mm strength, promote soft tissue integrity, increase circulation, and prepare for functional activites
AAROM interventions
Assisted AROM
- Performed by PT with PT/PTA help
- Will increase strength but not ROM
- Appropriate when less than full AROM, decreased quality of ROM, and all benefits of AROM
Closed kinetic chain
- Distal end of limb on ground or firm surface
- More advance form of exercise
- Movement at one joint causes movements at other joints
Open kinetic chain
- distal end of limb free to move in space (not fixed)
- typically uses individual mm groups and no weight bearing postures
Isometric exercises
- muscle contraction without joint movement
- promotes increased circulation, decreased mm spasm
- usually for patient with joint motion contraindicated
- cautioned for patients with CV disease
Isotonic exercies
- Exercies with constant load but not constant speed
- load is moved through ROM
Stretching exercises
- increase extensibilty of soft tissue and improves ROM
- static
- ballistic
- self-stretching
- contract/relax
Modalities
Whirlpool - infrared - electrical stimulation - heat - cold - traction - paraffin - ultrasound - biofeedback
Patient edu
- creates positive environment for patient from the beginning of pt
- clear and simple communication
- EVERY session
- return demonstration to ensure comprehension
Musculoskeletal examination
- PMH and MOI
- observation of pt (before and after exam)
- exam of pt movement
- special tests
- reflexes
- joint play movements - passive
- palpation
- evaluation of diagnostics
Pain description
- Location of pain
- Radiating pain
- Intensity
- Duration
- Onset
- Frequency
- Progression
- Aggravating or relieving factors
