pt problems

Question 1

29yo male with limited ankle dorsiflexion ROM after removal of cast
(5-instrument, settings, rational and contrai, time)

Answer 1

1. US on gastroc and stretch
2. settings: 1.5w/cm2, continous/ 1Hz for thermal
3. rationale: increase soft tissue extensibility
4. contraindication: child
   cancerous tissue
   superficial metal inplant
5. 10-12min

Question 2

18yo f rotator cuff repair shoulder pain and swelling post op

Answer 2

1. cold pack (in pillowcase)
2. rationale: minimize 2 hypoxia
   decrease pain and muscle spasms
   decrease nerve conduction veolcity
3. contrai: raynards, uticaria, regenerating nerve
4. time- 15-20m

Question 3

55yo male with acute low pack pain

Answer 3

1. TENS
2. rationale: gate theory of pain
3. contrai: sensitivity, superficial metal inplant, active cancerous tissue

Question 4

75yo m with poorly healing wound

Answer 4

1. e-stim- monophasic/ unipolar technique (+ pad on wound)
2. rationale: stimulates cells to go into second phase of healing
3. contrai: active infection
4. time: 1-2hrs/ 2x day

Question 5

30yo f with L wrist edema

Answer 5

1. electroosmosis (monophasic pulsatile)
2. rationale: mobilize edema with polarity
3. contai- active cancerous tissue
4. 20m

Question 6

21M GSW L upper arm- no wrist extension

Answer 6

1. R/d test (big electrode on back, small on motor point of extensor)
2. rationale: nerve fibers are more excitable than muscle fibers
3. contrai: active cancerous tissue

Question 7

79yo m CVA L hemi

Answer 7

1. NEMS (neuro remodeling), place on motor points and work with it
2. rationale: enhance cortical reorg
3. contrai- active cancerous tissue
4. time based on # contractions you want

Question 8

24yo male with chronic neck pain

Answer 8

1. conventional TENS
2. gate theory
3. contai- active cancerous tissue
4. time= 20m-24h

Question 9

33yo pt wtih R LBP (lower back pain) radiating down butt

Answer 9

1. positional traction
2. ly on left side and do left lat flexion and right rotation
3. rationale: decrease IV pressure
4. contai: hypermobility, osteop

Question 10

25yo pt with limited cervical ROM after immobilization in soft collar

Answer 10

1. cervical traction
2. do vertebral artery test and manual cervical traction to see how pt tolerates it
3. rationale; decrease IV pressure
4. contrai: hyermobility, osteo, sensitivity
5. rx time: 10 min (20lbs)

Question 11

60yo f with lymphadema in R forearm and hand

Answer 11

1. e-stim muscle pump (russian current with reciprocal tx)
2. muscle pump reduces edema
3. contra i: active cancerous tissue

Question 12

88 yo male with transfemoral amputation

Answer 12

1. sitting hot pack (12 layers)
2. promote relaxation/ reduce pain
3. contrai: acute inflammation, reduced sensation
4. time: 15-20m

Question 13

63yo femal wtih poor motor control in R ankle dorsiflexors

Answer 13

1. biofeedback

2. r= reference (closer to ground) , b= active, g= ground (make triangle)