Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HL 20536 - Sports and Exercise Medicine > Principles of Rehabilitation (Week 19) > Flashcards

Principles of Rehabilitation (Week 19) Flashcards

You may prefer our related Brainscape-certified flashcards:
Sports Trivia flashcards
1
Q

explain what it is meant by the key term - ‘soft tissue injury’ (STI)

A

STI: not bony, not dislocated, not external bleeding

usually thought of not being as severe, but can be very severe (e.g. - muscles up the spinal cord)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the main method of assessing soft tissue injuries?

A

SALTAPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

walk through and explain the SALTAPS acronym

A

S - see what happens

A - ask what happened, get individual to describe the injury

L - look at the injured site

T - touch the surrounding area (with consent) to assess pain

A - active movement (can they move it?) - need to know what they can do before you move it

P - passive movement (can you move it?)

S - strength (resisted and functional)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

state 2 uses of SALTAPS

A

1) if at any stage of the assessment it is clear that the injury is serious, then the assessment is stopped, and the player is removed from the field of play if it is safe to do so
2) can be used to see if a player can continue or not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

soft tissue injuries - what situations should you refer the individual ?

A
  • if they are unable to weight bear
  • if the limb/joint looks to have an unnatural shape/position
  • if they cannot move the joint
  • if pain and/or distress is uncomfortable
  • IF IN DOUBT!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

briefly explain what occurs in the acute stage of an injury (4 points)

A

1) chemically mediated cascade of inflammation
2) inc^ blood flow + capillary permeability
3) various cells diverted to area
4) brain response - nociceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

state 2 facts about pain with regards to assessing injury

A
  • hormones and other substances can interfere with the pain response (pain can be delayed)
  • pain is not a reliable source of injury severity as it is different with everyone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

is inflammation bas? (4 points)

A
  • the body is clever and good at fixing itself
  • inflammation indicates the healing process
  • inflammation protects the area from further damage
  • inflammation prevents us from using that area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

state 3 basic considerations to be made about inflammation

A
  • non-selective
  • can be excessive
  • it effects muscle function and mobility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the previous reasoning when it comes to injury healing ? (3 points)

A
  • if we protect the area we reduce further damage
  • we need to rest to let the body recover
  • if we reduce inflammation, we will reduce the amount of scar tissue from forming and therefore speed up recovery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the evidence for protection ? (3 points)

A
  • protect from further damage
  • protection - relative to strength
  • loading = important in later stages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the evidence for rest ? (5 points)

A
  • loading = important stimulus for healing
  • Wolf’s law
  • mechanotherapy - loading can reduce pain in tissue
  • perhaps a controlled stress is important. but when? dose?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the evidence for icing ? (4 points)

A
  • level of icing usually used does not induce vasoconstriction (i.e. - 5 mins)
  • cryogenic effect - reduces pain - focuses response to injured area
  • reduces peripheral nerve conduction speed (reduces pain)
  • effects proprioception - mask pain and lead to further injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the evidence for compression ? (4 points)

A
  • aids VR
  • may impair lymphatic drainage
  • neural compression (reduces nerve velocities) - however, evidence that taping improves nerve velocities via tactile stimulus?
  • could improve proprioception and support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the evidence for elevation ? (3 points)

A
  • reduces swelling as gravity reduces blood flow
  • aids VR
  • how long does effect last?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what did (Bleakley et al., 2012) find on the basic use of icing ? (3 points)

A
  • (Orchard et al., 2008) recommends use of ice following expert consensus
  • (Bleakley et al., 2011) found human studies on icing for muscle injury is lacking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

explain the findings from (Bleakley et al., 2012) on the ideal temperature obtained from cooling (5 points)

A

1) shown to reduce muscle temp in animal studies to 10℃ (Schaser et al., 2007)
- in 5-15℃ ideal range for slowing cell metabolism and enzyme action limiting ischaemic and enzymatic damage in early stages (Merrick et al., 1999)
2) muscles are more sensitive than other tissues to ischaemic conditions so greater risk of secondary injury
3) most human studies failed to cool muscles below 25℃ despite cooling periods up to 50 mins (Bleakley et al., 2011)
4) lowest reported human muscle cooling was 21℃ (Myrer et al., 2001)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the effect of adipose on tissue healing ? (Bleakley et al., 2012)

A
  • (Myrer et al., 2001) found that more adipose tissue reduces the rate of muscle cooling
  • it is also very difficult to induce cooling deep into muscle tissue
  • Van’t Hoff’s law states for every 10℃ reduction in muscle temp, cellular metabolism reduces 2-3 times
  • therefore, a change in depth of 2cm could be clinically important, particularly in preventing secondary injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the future research highlighted by (Bleakley et al., 2012)

A
  • more research into use of ‘platelet-rich plasma’ (PRP) and should be factored into clinical trials
  • IOC proceeding with caution of PRP - must be in clinical trials
  • benefit of PRP is that they ensure direct administration of the ‘active’ agent to the injured area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the new acronym that replaces PRICE?

A

POLICE

P - protect
OL - optimal loading
I - ice
C - compression
E - elevate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

explain Protection in POLICE ?

A

protect your injury from further damage. you’ll need to rest immediately after the injury, but not for long. depending on the injury, consider using some form of support

22
Q

explain optimal loading in POLICE ?

A

get active sooner rather than later. start to put weight on your injury and build up your range of movement. do this gradually and be guided by what feels right for you

23
Q

explain ice in POLICE ?

A

place a cold compression such as a bag of ice onto the painful area. do this four around 20 minutes every couple of hours for the first two to three days

24
Q

explain compression in POLICE ?

A

compress the injured area using a bandage to help reduce the swelling

25
Q

explain elevate in POLICE ?

A

elevate your injury above the level of your heart. put arm injuries in a sling and rest leg injuries, while sitting or lying, on a chair with a cushion

26
Q

state 2 issues with PRICE as identified by (Bleakley et al., 2012)

A

1) a paucity of high quality research

2) lack of empirical evidence to support the various components of PRICE

27
Q

what did (Bleakley et al., 2012) state about functional rehabilitation (3 points)

A
  • mechanical loading prompts cellular responses that promote tissue structural change (Kahn et al., 2009)
  • consistent findings that mechanical loading in animals up regulates mRNA associated with key proteins associated with tissue healing (Bring et al., 2009)
  • the difficulty in rehabilitation is finding the balance between loading and unloading. therefore, protection can still aid the recovery process
28
Q

what is it meant by optimal loading ? (3 points)

Bleakley et al., 2012

A

means replacing rest with a balanced and incremental rehabilitation programme where early activity encourages early recovery

injuries vary so there is no one dose fits all

loading strategy could reflect the unique mechanical stress stress placed on the injured area, which varies across type and location of anatomical region (e.g. - upper arm probs needs more cyclic loading whereas lower limb gets more through walking)

29
Q

state what it is meant by the key term - ‘optimal loading’

Bleakley et al., 2012

A

an umbrella term for any mechanotherapy intervention and includes a wide range of manual techniques currently available

30
Q

what is the point of POLICE ?

A

acts as a reminder to clinicians to think differently and seek out new and innovative strategies for safe and effective loading in acute soft tissue injury management

research must include more rigorous examinations into the role of ICE in acute injury management

31
Q

state what it is meant by the key term - ‘rehabilitation’

A

rehabilitation is treatment aimed at the recovery of musculoskeletal function, particularly recovery from joint, tendon, or ligament damage

32
Q

state 3 general facts about rehabilitation programmes

A

1) a program to return to play in the shortest time possible
2) an active approach (by individual and specialist)
3) a goal-oriented intervention programme

33
Q

state 4 characteristics of a successful intervention programme

A
  • specific (factors related to life, injury, where they want to be)
  • desired framework
  • goal setting
  • full return to sport
34
Q

state 5 characteristics of an unsuccessful rehabilitation programme

A
  • returned too soon
  • re-injury
  • poor performance
  • other injury
  • no return to sport
35
Q

what is the purpose of the rehabilitation cycle?

A

at any point in time, you know where you are, you know where you want to be, and if you are not getting closer you can adapt the strategy and re-evaluate progress

36
Q

state the 3 parts of the rehabilitation cycle

A

1) expectation
- injury, goals, plans

2) action
- what, why, how?

3) evaluation
- did it work?
- modifications?

37
Q

what are the 6 steps of rehabilitation, in order?

A

1) acute injury resolution (pain, swelling)
2) regain movement (not strength and overload)
3) regain strength (progressive, optimal loading)
4) regain proprioception (regain neural ending and train those structures)
5) functional exercises (controlled and isolated; not sport specific)

6) sport specific exercise (e.g. - running, kicking)
- place system under more stress; challenge control of system more

38
Q

state 2 considerations to be made for rehabilitation programmes

A

1) analyse and make specific to the individual’s sport

2) shouldn’t move through phases without good outcome measures from the previous step

39
Q

what can be done during a rehabilitation programme?

A

the athlete can spend time working on fitness components and skills which don’t involve the injured area. this can help improve performance and/or prevent future injury

40
Q

what do you do to evaluate a rehabilitation programme ?

A
  • SALTAPS
  • pain free? (may have some pain in each stage of progression, may not be a bad sign, can be a warming sign, but everyone is different)
  • no swelling
  • full ROM
  • full strength
  • functional co-ordination
  • sport specific skill set
41
Q

what is Mechanotransduction ? (Kahn & Scott., 2009)

A

mechanotransduction refers to the process by which the body converts mechanical loading into cellular responses. the cellular responses, in turn, promote structural change

e.g. - bone adapting to load via mechanotransduction

42
Q

what are the 3 stages of mechanotransduction ?

Kahn & Scott., 2009

A

1) mechanocoupling
2) cell-to-cell communication
3) the effector response

43
Q

state what it is meant by the key term - mechanocoupling

Kahn & Scott., 2009

A

mechanocoupling refers to the physical load (often shear or compression forces) causing a physical perturbation to cells that make up a tissue

e.g. - with every step the Achilles tendon goes under tensile loads

44
Q

state 2 facts about mechanocoupling

Kahn & Scott., 2009

A
  • tendons can experience compression forces which cause deformation and can trigger a wide array of responses depending on the type, magnitude, and duration of loading
  • the key to mechanocoupling is the direct or indirect physical perturbation of the cell, which is transformed into a variety of chemical signals both within and among cells
45
Q

what are the signalling molecules in cell-to-cell communication?

(Kahn & Scott., 2009)

A

calcium and inositol triphosphate

46
Q

the process of cell-to-cell communication is best understood by the following process:

(Kahn & Scott., 2009)

A

1) tendon tissues provide an example
2) intact tendon consists of matrix (including collagen) and specialised cells (arrowheads)
3) cells are physically in contact throughout the tendon
4) gap junctions are the specialised regions through which cells connect and communicate small, charged particles
5) they can be identified by the specific protein called connexin
6) a chemical signal is received, not a mechanical signal

47
Q

what is the effector cell response (4 points)

Kahn & Scott., 2009

A

1) process harnessed by mechanotherapy to promote tissue repair and remodelling
3) mechanotransduction stimulates protein synthesis at the cellular level

48
Q

explain mechanotherapy research done in tendons

Kahn & Scott., 2009

A

1) tendon’s up-regulate IGF-1 in response to load
- up-regulation associated with proliferation and matrix remodelling of the tendon
- recent studies show other growth factors also have a key role (Oleson et al., 2007)

2) (Alfredson et al., 2004) examined tendons with ultrasound in Achilles tendinitis patients
- found 19/26 treated with loading had a full recovery in 3 year follow up
- proves tendons need loading for recovery

3) research into the specific loading conditions for different types of tendons is still ongoing

49
Q

explain the current research on mechanotherapy for muscles

Kahn & Scott., 2009

A

1) overload leads to immediate up regulation of mechano growth factor (MGF) (Goldspink., 2003)
- MGF leads to hypertrophy by activating satellite cells
- clinical application based on animal studies (Jarvinen et al., 2007)
2) benefits include alignment of myotubes, faster and more complete regeneration of muscle, minimisation of atrophy surrounding myotubes

50
Q

explain the current research of mechanotherapy for articular cartilage

(Kahn & Scott., 2009)

A

1) populated by mechanosensitive cells (chondrocytes) which signal via highly analogous pathways
2) (Alfredson., 1999) treated 57 patients with patellar cartilage deficits with ‘continuous passive motion’ (CPM)
- 76% using CPM achieved an excellent outcome compared to 56% who didn’t use it
- tissue repair not directly studied, but results encourage further research into tissue response and optimising loading parameters

51
Q

explain the current research of mechanotherapy in bone

Kahn & Scott., 2009

A

1) osteocytes are the primary mechanosensors in bone
2) clinical study (Challis et al., 2006; 2007; 2008) used mechanotherapy in bone fractures
- increased strength by 12-26% and range of motion by 8-14% during immobilisation period vs group who didn’t do this treatment
3) future, larger studies planned to confirm effects of compression on healing itself

52
Q

what is inflammation? (2 points)

Scott et al., 2004

A
  • a complex interaction of cellular signals and responses
  • we pay attention to the mechanisms of 9 interacting cells that participate in the acute and chronic responses to injury

HL 20536 - Sports and Exercise Medicine (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions