Osteoarthritis

Question 1

Primary osteoarthritis

Answer 1

localized or generalized joint involvement and no known cause

Question 2

Secondary osteoarthritis

Answer 2

related to trauma, congenital abnormalities, infection, or necrosis

Question 3

Bouchard’s nodes develop on the ___ joints

Answer 3

PIP

Question 4

Which type of nodes develop on the PIP joints?

Answer 4

Bouchard’s

Question 5

Heberden’s nodes on the ___ joints

Answer 5

DIP

Question 6

Which type of nodes develop on the DIP joints?

Answer 6

Heberden’s

Question 7

Symptoms of osteoarthritis include

Answer 7

joint pain, stiffness, limited ROM, and local inflammation and crepitus of the joint. Pain and stiffness occur with activity and are relieved by rest

Question 8

OT areas to evaluate with osteoarthritis

Answer 8

Occupations that rely on lower-extremity flexibility and strength should be evaluated for clients with knee or hip OA.

IADLs that require walking, standing, squatting, and balance are potentially problematic.

Rest and sleep may be disturbed by pain.
Job analyses for clients who are workers may be necessary.

The effect of OA on play and leisure activities should be explored.

Question 9

For clients with osteoarthritis, the main factors affecting participation are

Answer 9

pain and joint changes such as instability, loss of motion, weakness, and fatigue.

Question 10

In addition to physical factors, clients with OA should be screened for

Answer 10

cognitive and psychosocial deficits.

Question 11

Although OA does not directly affect cognition, symptoms such as pain, sleep disturbances, depres-
sion, and medications can all have an effect on

Answer 11

attention span, short-term memory, and problem-

solving skills.

Question 12

Psychosocial deficits in clients with OA include

Answer 12

fear of pain, changes in body image, perception of self as a sick person, continuous uncertainty about the course and progression of the disease, sexual dysfunction, altered roles, and loss of income because of the inability to work.

Question 13

TKR precautions include

Answer 13

not putting a pillow under the knee while in bed; resting feet on the floor when sitting to increase ROM; wearing an immobilizer as instructed; and avoiding kneeling, squatting, or twisting the knee

Question 14

Hand function related to thumb mobility may be severely restricted by pain and instability. OA of the thumb CMC joint should include an assessment of

Answer 14

thumb joint ROM and stability

Question 15

Additionally, a _______ evaluation should be performed in clients with OA

Answer 15

Driving

Question 16

What type of PAMS can be used for clients with OA?

Answer 16

Superficial heating agents such as paraffin, fluid

therapy, hot packs, microwave packs, hydrotherapy, and electric stimulation—can be used to reduce pain and increase ROM

Question 17

What type of ROM is best to encourage for clients with OA

Answer 17

AROM exercises are encouraged; PROM is used only if AROM is precluded.
2.
3. Pinching exercises may be contraindicated with CMC joint instability because of stresses on the
joint.

Question 18

What type of strengthening exercises are best for clients with OA

Answer 18

Isometric or isotonic strengthening exercises can be performed to tolerance. Low-impact aerobic
conditioning exercises can increase flexibility, strength, endurance, and cardiovascular fitness.

Question 19

_____ splints may be prescribed to provide stability to the CMC joint during pinching activities

Answer 19

Spica

Question 20

Principles of joint protection and fatigue management are as follows

Answer 20

1. Respect pain.
2. Maintain muscle strength and joint ROM.
3. Use each joint in its most stable anatomical and functional plane.
4. Avoid positions of deformity.
5. Use the strongest joint available.
6. Ensure correct patterns of movement.
7. Avoid staying in one position for long periods.
8. Avoid starting an activity that cannot be stopped immediately if it becomes too stressful.
9. Balance rest and activity.
10. Reduce force and effort.