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A: ther ex: UQ > Post Op Care > Flashcards

Post Op Care Flashcards

1
Q

During RCR phase 1 , what PROM are u doing from weeks 2-4

A
  • flexion to 90°
  • abduction to 90°
  • ER 30°
  • IR 30°
  • extension 30°

(ER/IR in scapular plane as well as flexion)

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2
Q

What kind of joint mobs would u do for weeks 2-4 if RCR phase 1

A

Grade 1 and 2 for pain relief

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3
Q

When should u initiate scapular isometrics and rhythmic stabilization drills for RCR

A

Weeks 2-4

Put in about 90° for the deltoid

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4
Q

What PROM are u doing during weeks 4-5 for RCR phase 1

A
  • flexion to 120°
  • abduction to 120*
  • ER to 30°
  • IR to 45°
  • extension to 30°
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5
Q

When would u use heat during RCR

A

Prior to ROM exercises

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6
Q

What PROM can u do in weeks 5-6 for RCR phase 1

A

PROM in all directions as tolerated

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7
Q

When do u start AAROM and stretching exercises to fain full motion for RCR

A

Weeks 5-6

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8
Q

When does the sling usually come off during RCR

A

6 weeks

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9
Q

What is the criteria needs to advance to phase 2 for RCR

A
  • improving PROM
  • flexion PROM : > 125°
  • ER PROM in scapular plan to > 75° ( if uninvolved shoulder PROM > 80)
  • IR PROM in scapular plan to > 75° ( if uninvolved shoulder PROM > 80)
  • abduction PROM to > 90° in scapular plane
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10
Q

When is phase 2 during RCR

A

Usually between weeks n 6-14

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11
Q

When will surgeons say to start strengthening for RCR

A

Around weeks 8-12

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12
Q

What shoudl focus be on in RCR phase 2

A

Dynamic stability

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13
Q

What is the criteria to advance to Phase 3 for RCR

A

• Full AROM and PROM.
• Pain free with all strengthening exercises.
• Dynamic shoulder stability

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14
Q

When is RCR phase 3

A

Usually between weeks 15-24

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15
Q

When do u start to work on power for RCR

A

Phase 3 - weeks 15-24

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16
Q

There should be no ___ patterns during strengthening activities during what phase of RCR

A

Substitution

Phase 3

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17
Q

What is the criteria needs to advance to phase 4 (return to sport) fort RCR

A
  • Maintenance of full pain-free ROM.
  • Functional use of upper extremity.
  • Full muscular strength and power
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18
Q

What is a consideration if the subscapularis tendon is respected and then repaired through the deltopectoral approach

A

Requrires slow progression of ROM into ER and delayed IR strengthening

If the mm is anchored in a shortened position then shoulder alignment and mobility is affected

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19
Q

What could a concomitant rotator cuff repair lead to

A

Excessive strain on teh RC during rehab or increased glenoid stress —> leading to re rupture

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20
Q

The size of the ___ ___ component may decrease strain on the rotator cuff but could lead to limitations in
range of motion.

A

Humeral head

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21
Q

What does a reverse TSA involve the switching of

A

The humeral head prosthetic component wiht the glenoid component —> this lengthens the lever arm during mm activation allowing for increased deltoid activation and limited RC engagement

Bigger head= decrease mobility , but increased stability vise versa

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22
Q

When would u perform a reverse TSA

A

If rotator cudd integrity is poor

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23
Q

For a TSA what are the goals int he immediate phase

A
  • reduce pain , inflammation and muscular inhibiton
  • gradually increase PROM of shoulder and restore AROM of elbow , wrist and hand
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24
Q

How long should a sling be worn for a TSA

A

For 3-4 weeks

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25
In the immediate phase of a TSA there should be no stretching to what
No extension or anterior capsule stretch — pillow under elbow when supine
26
What motions should not be done i the imedadite phase for a TSA
Behind the back , especially into ER
27
What is the criteria for progression to phase 2 for a TSA
* tolerate PROM program * achieves at lease 90° of isolated flexion and abduction PROM * achieved at least 45° of ER PROM in scapation plane * achieves at least 70° of IR PROM in scpation plane
28
There is no combined what motions in the first stage of TSA
Flexion and abduction
29
What is phase 2 for TSA
Early strengthengin phase
30
How long should u wait for soft tissue healing for a TSA
4-6 weeks
31
What are teh goasl fro phase 2 for TSA
• Restore full PROM and gradually restore AROM • Re-establish dynamic shoulder stability
32
How much can u lift in phase 2 for TSA
No heavier then a coffee cup
33
What may u being in phase 2 for a TSA
* AAROM and transition to AROM as tolerated * shoulder sub maximal shoulder isometrics in neutral * horizontal adduction AAROM
34
What is the criteria for progression to phase 3
• Tolerates PROM/AAROM, isometric program • Achieves at least 140 degrees flexion PROM • Achieves at least 120 degrees abduction PROM • Achieves at least 60 degrees ER PROM in plane of scapula • Achieves at least 70 degrees of IR PROM in plane of scapula • Actively elevate shoulder against gravity with good mechanics to 100 degrees
35
What is phase 3 for TSA
Moderate strengthening phase
36
What are the goals from phase 3 for a TSA
• Gradual restoration of strength, power and endurance • Optimize neuromuscular control • Gradual return to functional activities
37
How heavy can u lift in phase 3 for a TSA
No heavier then 6 lbs
38
What can u initiate in phase 3 for TSA
Assisted behind the back motions
39
When can u initiate aside behind the back motions for a TSA
Phase 3
40
What phase for a TSA do u wean from a sling completely
Phase 3
41
When do u Begin progressive supine elevation strengthening with progress to standing for TSA
Phase 3
42
What is the criteria to progress to phase 4
• Tolerates AAROM/AROM/strengthening • Flx to 140, ABD to 120, ER to 60, IR to 70 deg • Actively elevate shoulder against gravity with good mechanics to 120 degrees
43
When do u begin resisted shoulder IR and ER motions in scapular plane for a TSA
Phase 3
44
What is phase 4 for TSA
Advance strngthing phase
45
What is the goasl from phase 4 for TSA
• Maintain non-painful AROM • Enhance functional use of upper extremity • Gradual return to more advanced functional activities • Progress weight-bearing exercises as appropriate
46
What motions are no combined in TSA phase 4
ER and abduction above 80
47
When can u start gradual return to recreational hobbies, gardening, sports, golf, doubles tennis for TSA
Phase 4
48
What is the criteria for discharge for TSA
• Able to maintain non-painful AROM • Maximized functional use of upper extremity • Maximized strength, power, endurance • Has returned to advanced functional activities
49
What is phase 1 for type 2 SLAP repair
Protected motin phase
50
What weeks is phase 1 for a type 2 SLAP repair
Weeks 1-6
51
What is the goasl from phase 1 for type 2 SLAP repair
• Re-establish non-painful range of motion • Decrease pain and inflammation
52
How long do people wear slings for type 2 SLAP repair
All times for 4 weeks
53
How much flexion is allowed in phase 1 for a type 2 SLAP repair
AROM of 60*
54
There is no isolated ___ contractions in phase 1 for type 2 SLAP repair
Biceps
55
How much PROM can u do flexion phase 1 type 2 SLAP repair Flexion ER IR
Flexion: 60-75° ER: 10-15° IR: 45°
56
What is phase 2 for a type 2 SLAP repair
Moderate protection phase
57
What weeks is phase 2 for type 2 SLAP repair
6-12 weeks
58
Can u do bicep strengthening in phase 2 for type 2 SLAP repair
No
59
What is the criteria to progress to phase 3 from type 2 SLAO repair
• Full non-painful AROM • No pain and tenderness • Satisfactory stability • Muscular strength rated as good
60
What is phase 3 from type 2 SLAP repair
Minimal protection phase
61
What weeks is phase 3 for type 2 SLAP repair
12-20 weeks
62
What can u initiate for phase 3 type 2 SLAP repair
Light strengthening , including resisted biceps and supination , progressing to light olyometirc and endurance
63
What is the criteria to progress to phase 4 for type 2 SLAP repair
• Full, non-painful AROM • Muscular strength of 75-80% of contralateral side
64
What is phase 4 for type 2 SLAP repair
Advance strengthening phase
65
What weeks is phase 4 for type 2 SLAO repair
20-26
66
What is the goasl for phase 4 type 2 SLAP repair
• Strength, power, and endurance • Progress functional activities • Maintain shoulder mobility
67
What can u initiate in phase 4 type 2 SLAP repair
Interval sports
68
What is the criteria to progress to phase 5 type 2 SLAP repair
Full functional ROM
69
What is phase 5 type 2 SLAP repair
Return to activity
70
What time frame is phase 5 type 2 SLAP repair
Months 6-9
71
When can u initiate PT for. Post cervical fusion
4-6 weeks post op
72
When is scar mobilization okay to do for cervical fusion
When it is closed about 6-8 weeks
73
When can u initiate jogging for a post cervical fusion
After.6 months
74
What are the goals during cervical fusion phase 2 ( weeks 4-6)
* control pain * wound healing * improve endurance
75
What are some cervical/upper extremity/ core conditioning for phase 2 cervical fusion
* general cervical tucks * scapular retraction * biceps/triceps/ shoulder ER /IR /flex / ext * fine motor * core : TrA/ multifidi/ glute med/max
76
What are some flexibility and mobility u can do in phase 2 for cervical fusion phase 2
* soft tissue mobs * grade 1-2 joint mobs above and below * encourage movement
77
What should u avoid during phase 2 cervical fusion
* lifting , pushing > 20 lbs up to 3 months post op * end range cervical stretching * overhead lifting
78
When is phase 3 for cervical fusion
Week 6- 3 months
79
When should u avoid over head stretching for cervical fusion
Until 8 weeks - phase 3
80
How mcuh should u avoid listing up to 2 months post op for cervical fusion
> 20lbs
81
What kind fo exercseis should u avoid for cervical fusion phase 3
AROM or prone exercise
82
How long should u avoid horse back riding and running after cervical fusion
6 months
83
What ohase should u discharge cervical collar for cervical fusion
Phase 4 (3-6 months)
84
When can u initiate elliptical training from cervical fusion
In phase 4 (3-6 months)
85
What are some stabilization exercseis for the trunk and LE during phase 4 for cervical fusion
* bridges * planks * upward/downward chops * walkouts/rollouts on stability ball * loaded carries *paloff press
86

A: ther ex: UQ (10 decks)

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