Prac Exam 1 Flashcards
Massage Contraindictions
✘ Acute bruising
✘ Acute inflammatory conditions
✘ Severe varicose veins
✘ Open wounds/Abscesses
✘ Skin infections
✘ Failed or incomplete fracture healing
✘ Thrombophlebitis andembolisms
Massage Purposes
Reasoning for choosing the Intervention
✓ Increase range of motion
✓ Stretch scar tissue/adhesions
✓ Alleviate muscle cramps
✓ Decrease pain
✓ Remove edema
✓ Increase blood flow
Petrissage VS Effleurage Massage ~ WHEN TO USE
- Use Effleurage primarily for warming up muscles, promoting relaxation, transitioning between techniques, and treating sensitive areas.
- Opt for Petrissage when addressing chronic pain management, rehabilitation needs, athletic preparation/recovery, or targeting specific muscle groups
Steps to applying COLD Therapy
- Introduce yourself
- Explain proposed treatment
- State Contraindictions
- Gain consent
- Perform a sensory test
- Prepare ice with approp. layers + warnings
- Give the patient a bell to alert you
- Check in with patient/under towel in 5 mins
- Leave on for max time ~ 20 mins every hour
Steps to applying HEAT Therapy
- Introduce yourself
- Explain proposed treatment
- State Contraindictions
- Gain consent
- Perform a sensory test
- Prepare heat with approp. layers + warnings
- Give the patient a bell to alert you
- Check in with patient/under towel in 5 mins
- Leave on for max time ~ Until it cools
How many layers of towel for:
HEAT Therapy
COLD Therapy
Heat Therapy ~ Minimum 8 layers around Heat pack
Cold Therapy ~ Minimum 4 layers of Towel around Ice pack
Heat Therapy Contraindications
Musculoskeletal Conditions
✘ Tuberculous joints
✘ Osteomyelitis
✘ Acute injury
Dermatology
✘ Impaired sensation
✘ Wet dressing/Adhesive tape
✘ Open wounds
Other
✘ Unreliable patient
✘ Excessive oedema
✘ Acute infection
✘ Malignancy
Cardiovascular conditions
✘ Ischaemia
✘ Haemorrhage
✘ Deep vein thrombosis/phlebitis
✘ Cardiac conditions
✘ Abnormal BP
Cold Therapy Contraindictions
✘ Sensory disturbances
✘ Open wounds
✘ Hypertension
✘ Hypersensitivity to cold
✘ Impaired circulation
Heat Therapy Purpose
Reasoning for choosing the Intervention in the Exam
✓ Alleviate pain by increasing temperature of the affected area
✓ Help reduce discomfort and improve mobility
✓ Enhanced circulation delivers more oxygen and nutrients to the tissues = Promotes healing and recovery
✓ Helps relax tense muscles by reducing muscle stiffness and improving flexibility
✓ Improves elasticity of connective tissues = Makes them more pliable and easier to stretch
✓ Reduce joint stiffness by loosening tight joints, making it easier for patients to perform range-of-motion exercises
✓ Psychological Comfort = The soothing effect of warmth
Cold Therapy Purpose
Reasoning for choosing the Intervention in the Exam
✓ Used to reduce pain
✓ Numb the affected area, decreasing nerve activity and providing an analgesic effect
✓ Controls inflammation by causing vasoconstriction, which reduces blood flow to the injured area
✓ Decrease in blood flow = Minimizes swelling and tissue damage following an injury
✓ Reduce edema (swelling) that often accompanies injuries
= Essential for maintaining joint mobility and function during the recovery process
✓ Alleviate muscle spasms by slowing down nerve conduction velocity and reducing muscle spindle activity
= Improving range of motion and comfort for patients undergoing rehabilitation
✓ Allows for earlier mobilization post-injury or surgery
= Preventing stiffness and promoting faster recovery
Cold Therapy VS Heat Therapy ~
WHEN TO USE
HEAT
~ Feeling ‘sore’, ‘stiff’ or ‘achy’
~ Chronic pain
~ Muscle relaxation
COLD
~ Acute injuries
~ Inflammation or Swelling
~ Pain numbing
Cold Therapy VS Heat Therapy ~
WARNINGS
HEAT
Fainting
Burns
COLD
Ice burns
Oxford Scale Grades 3-5
Grades 3-5 (Muscle is acting on limb against gravity)
- 3 ~ Can move limb through ROM against gravity
- 4 ~ Can move limb through ROM against gravity and moderate resistance applied by therapist
- 5 ~ Can move limb through ROM against gravity and maximal resistance applied by therapist
Isometric Muscle Strength Testing
(Manual Muscle Testing)
Grades 3-5 (Muscle is acting on limb against gravity)
- 3 ~ Can move limb through ROM against gravity / can hold against gravity at the ROM to be tested
- 4 ~ Can hold limb in position against gravity and moderate resistance applied by therapist
- 5 ~ Can hold limb in position against gravity and maximal resistance applied by therapist
Setting up Axilliary Crutches
- Check Stoppers
- Set Crutch Height ~ 2 fingers between handle & Armpit
- Check and adjust if necessary
- Demonstrate Gait pattern
✓ Commonly used following an acute, short-term injury
✓ Recommended for those who are only able to bear weight on one leg
Use for: NWB on Affected limb
Setting up Elbow Crutches
- Check Stoppers
- Set Crutch Height ~ Handle at Wrist height, Forearm cuff an inch below elbow
- Check and adjust if necessary
- Demonstrate Gait pattern
✓ Commonly recommended for long-term use
✓ May not be quite as stable with a full load
✓ Ideal for those who can bear weight on both legs, but who require the additional support
Use for: PWB, WBAT, PTWB
How to use Pick up Frame
Stand up straight and walk at a safe pace
Handle height at wrist crease
* Frame Forward
* Bad leg
* Weight through their hands
* Good leg
✓ Make sure all four legs of the frame are on the ground before stepping
✘ DO NOT put the frame too far in front of you
How to use Two-Wheel Frame
Stand up straight and walk at a safe pace
Handle height at wrist crease
* Slide Frame Forward
* Back to Legs in line with tops of Shoes
* Bad leg
* Weight through their hands
* Good leg
✓ Make sure all four legs of the frame are on the ground before stepping
✘ DO NOT put the frame too far in front of you
When to use each Gaid Aid?
Day 1 or 2 after surgery, NWB, Postoperative ~ Frames
Day 8 or more after surgery, PWB ~ Crutches
- Pick up Frame ~ Assist individuals who have difficulty standing up from a seated position, NWB
- Two wheel Frame ~ Individuals who can walk but require assistance with balance and mobility, PWB
- Elbow Crutches ~ PWB, WBAT, PTWB
- Axiallary Cructhes ~ NWB on the affected leg
List the 4 Key Gait Patterns
- 2 Point Gait ~ Right Crutch, Left leg, Left Crutch, Right leg
- 3 Point Gait ~ Both crutches forward, Weak Leg, Good Leg
- 4 Point Gait ~ Left crutch, Right leg, Right Crutch, Left leg
- Swing through ~ Both Crutches move forward, then both legs swing forward
Quick Reference
a) Walking Pattern with Aid
b) Going up Stairs
c) Going down stairs
a) Crutch, Bad Leg, Good Leg
b) ABC ~ Able Leg, Bad Leg, Crutch
c) CBA ~ Crutch, Bad Leg, Able leg
‘Good Leg to Heaven/Bad leg to Hell’
List the Steps of a Mobility Assessment
- Introduction of self, any assistant, role, explanation, plan, gain consent
- Movement precautions relevant to injury/surgery
- Weight bearing status
Mobility assessment (Risk assessment)
1. Lower limb sensation (light touch)
- Deep vein thrombosis (DVT) check
- Patient lower limb AROM (ankles, knees and hips)
- Patient lower limb strength (ankle plantar flexion and dorsiflexion, quads over fulcrum, SLR, hip abduction, bridge, ability to move around bed)
- Patient upper limb ROM and strength (pull up on bar or push down through arms to lift bottom off bed)
- Reaction to sitting on edge of bed (dizziness/vaso-vagal)
