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BPT11 - MSK Rehab > OA & Exercise Prescription > Flashcards

OA & Exercise Prescription Flashcards

1
Q

What is OA?

A

OA is the most common form of arthritis, affecting the cartilage of a joint. It’s a degenerative disease.

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2
Q

What is the pathophysiology?

A

Cartilage degradation, bone remodeling, osteophytes formation & synovial inflammation

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3
Q

What is the pathophysiology?

A

Cartilage degradation
Bone remodeling
Osteophytes formation
Synovial inflammation

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4
Q

Main risk factors?

A

Age
Genetics
Joint injury or overuse
Gender (female>50yo ++)
Obesity

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5
Q

Which body functions & structures are affected by OA?

A
  • Pain
  • Range of motion
  • Muscle weakness
  • Balance
  • Bone enlargement
  • Fatigue
  • Sleep disturbances
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6
Q

Which types of exercise should compose the program for patients w/ OA?

A
  • Range of motion & stretching
  • Muscle strengthening
  • Aeorobic exercise
  • Recreation
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7
Q

On what should OA management be based on?

A
  • Pain relief
  • Function & independence
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8
Q

What is recommended for OA patient?

A
  • Exercise (Balance,strengthening)
  • Weight loss (knee & hip OA)
  • Self-efficacy & self-management programs
  • Tai chi ( Knee & hip OA)
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9
Q

SMART in OA

A

S : start low, slow, then progress radially
M : modify activity
A : activity joint friendly (walking, cycling, dancing)
R : recognize safety (group class?)
T : talk -> specialist, health care professional

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10
Q

FITT for strengthening exercise in OA

A

F : min 2d/w
I : w/ resistance -> enough to challenge muscle in a pain free ROM
T : 1 set of 8-12 reps
T : strengthening exercise

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11
Q

FITT aerobic endurance exercises in OA

A

F : 150 min / week
I : moderate (Talk test)
T : 10 min intervals/day
T : low impact aerobic ex ( walking, biking, swimming, water aerobic..)

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12
Q

FITT flexibility exercises in OA

A

F : 3-5d/w
T : 5-10 reps/day, hold 15-30s
T : Flexibility -> ROM exercises

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13
Q

What are the symptoms of OA?

A
  • Pain surrounding groin/ant hip
  • Stiffness (morning++)
  • Worst at the end of the day (if standing or walking ++)
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14
Q

Hip OA test cluster

A
  1. Reduced PROM hip (<25°)
  2. (+) Scour test
  3. Squatting aggravates symptoms
  4. Pain w/ active hip extension
  5. Lateral pain on active hip flexion

(+) test if >4/5 (+) signs

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15
Q

How to assess improvement?

A

-HOOS
-WOMAC

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16
Q

Example of muscle strengthening ex for hip OA

A

-Standing : hip extension, abduction, flexion, hamstring curls
-Supine : bridging
-Side lying : clam
- W/ or w/o support : Squat, Sit-to-stand, heel raises

17
Q

In which side of the knee is OA more frequent?

A

In the medial compartment

18
Q

Main risk factors for Knee OA

A
  1. Trauma
  2. Obesity
  3. Impaired muscled function
19
Q

Clinical signs & symptoms of knee OA

A
  • Persist knee pain, worst w/ activities & relieving w/ rest
  • AM stiffness
  • Possible joint effusion
  • Loss of knee ROM
  • difficulty in functional activities (STS- walking..)
    X-ray indicates joint space narrowing/&/or osteophytes
20
Q

What exercise or PA is recommended in management of knee OA?

A
  • Tai chi
  • Yoga
  • Cycling
  • Walking
  • Aquatic ex
  • Strength training
  • Neuromuscular training
21
Q

Knee OA common muscle strengthening exercises

A
  • Straight leg raise
  • Squats
  • STS
  • Knee extension from sitting (using elastic band) -> Quadriceps
  • Knee flexion (up, supine..) -> Hamstrings
22
Q

How many repetitions for muscle strengthening in knee OA exercise?

A

Dépends on each patient, ask patients to try until it gets too difficult, monitor quality of their mvt, stop if they are not doing the mvt correctly anymore

23
Q

NEMEX program

A

→ Neuromuscular training programme for severe hip or knee OA
1. Warm up (cycle ergo meter)
2. Circuit program :
Type -> -Core stability/ postural function
- Postural orientation
- Lower extremity muscle strength (OKC & CKC ex)
Time -> 1 or 2 ex for each circle, 2-3 sets of 10-15 reps
-> 3 levels of difficulty
3.Cool down

24
Q

What’s the difference between NEMEX & common strength training programs?

A

Core stability > no WTB ex
Lower extremity muscle strength > isolated muscle training
FUnctional WTB ex > some multiple joint WTB ex
Quality > quantity

25
Q

Signs & symptoms of Hand OA

A
  • Deep aching pain usually at base of thumb
  • Stiffness
  • Swelling
  • Deformities (Bouchard’s nodes, Hebeden’s node)
  • Difficulties w/ ADLS -> weak grip & reduced pinch strength
26
Q

Risk factors in hand OA

A
  • Female gender
  • Aging -> After menopause
27
Q

What are the goal of hand OA exercises?

A
  • Maximizing a stable & pain-free functional ROM of the finger joints
  • Incr. functional strength
  • Maintaining joint stability
  • Preventing or delaying the dvlp of fixed deformities
28
Q

Exemples of hand OA exercises

A
  • Making a hook fist
  • Making a full fist
  • Wrist extension & flexion
  • Thumb flexion, ADD, ABD, opposition
  • Finger ABD, ADD
  • Forearm supination
  • also incorporate ex for shoulder girdle & upper arm
29
Q

Which shoulder ex can you give to complement hand OA exercise?

A
  • Shoulder extension (sitting w/ elastic band)
  • Biceps curl (standing w/ eb)
  • Shoulder flexion (up w/ eb)
30
Q

Hand OA dosage exercise

A

3x/week
1 set of 10 reps for 1-7 ex -> for 2 weeks
Incr. reps to 15 over the next 10 weeks
Moderate intensity, gradually incr bad resistance over time

BPT11 - MSK Rehab (21 decks)

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