RC, Arthritis, OI & Hips

Question 1

Conservative Tx for Rotator Cuff Tendonitis

Answer 1

Act mod avoiding shoulder level until pain subsides, edu on sleeping posture, decrease pain & restore pain free ROM, strengthening below shoulder level, occ/role training

Question 2

Post Op Tx for Rotator Cuff Tendonitis

Answer 2

PROM from 0-6wks w progression to AA/ROM, decrease pain starting w ice then heat, strengthening at 6 wks begin w isometrics then isotonics below shoulder level, act mod, leisure/work activities 8-12wk

Question 3

Adhesive Capsulitis or Frozen Shoulder

Answer 3

Restricted passive shoulder ROM; greatest restriction w ex rot, then aBduction, in rot & flex.
Glenohumeral ligaments and joint capsule

Question 4

Conservative Tx for Frozen Shoulder

Answer 4

Encourage active used thru ADL/role activities, PROM & modalities

Question 5

Post Op Tx for Frozen Shoudler

Answer 5

PROM imm following surgery, modalities for pain relief, encourage use of extremity for all ADL/role acts

Question 6

Shoulder Dislocation

Answer 6

Anterior most common - regain ROM while avoiding combo aBductio/ex rot, pain free ADL/role act, strengthen rotator cuff

Question 7

Rheumatoid Arthritis

Answer 7

Systemic, symmetrical & affects many joint, commonly attacks small joints of hand, characterized by remissions/exacerbation, begins in acute phase as an inflam process of synovial lining

Question 8

RA symptoms

Answer 8

Pain, stiffness, lim ROM, fatigue, weight loss, lim w ADLs

Question 9

Boutonniere Deformity

Answer 9

Flex of PIP and hyperex of DIP - prevent w silver ring spint

Question 10

Swan Neck Deformity

Answer 10

Hyperex of PIP and flex of DIP - prevent w silver ring spint

Question 11

Osteoarthritis

Answer 11

Degen joint disease, not systemic but wear/tear, commonly affects large weight bearing joints, attacks hyaline cartilage - can be genetic

Question 12

OA Symptoms

Answer 12

Pain, stiff, Lim ROM & bone spurs

Question 13

Heberden’s Nodes

Answer 13

Bone spurs at DIP joint

Question 14

Bouchard’s Nodes

Answer 14

Bone spurs at PIP joint

Question 15

With arthritis avoid

Answer 15

muscle testing unless requested by physicians & strengthening during inflam stage

Question 16

Tx for Arthritis

Answer 16

Resting hand splint for acute stages, wrist splint for worst arthritis, ulnar drift splint to prevent deformity, hand base thumb splint for CMC arthritis
*AROM is contraindicated esp in inflam stage

Question 17

Splint for Post Op MCP Arthroplasty

Answer 17

Dynamic MCP ex splint w radial pull

Question 18

Osteogenesis Imperfecta

Answer 18

Caused by dysfun of 1 of several genes responsible for producing collagen to strengthen bones. Genes can be inherited by 1 or both parents. Can being to malfun after child is conceived

Question 19

Signs/Symptoms of OI

Answer 19

Malformed bones: short/small body, triangular face, barrel-shaped rib-cage, brittle bones that fx easily, loose joints, sclera of eyes looks blue/purple, brittle teeth, hearing loss (20-30), resp probs and insufficient collage

Question 20

Types of OI

Answer 20

8 main types classified by involved genes: Types 2/3/7/8=severe, Types 4/5/6=mod & Type 1=mild

Question 21

Tx for OI

Answer 21

*Prevention of fx/deformities & AROM! Activity adapt/AT for safe participation, environmental mods, preventive positioning & protective padding/splinting, wt bear activities to facilitate bone growth, health edu, family edu for safety precautions, pain mngt

Question 22

3 types of hip fx

Answer 22

Femoral neck, intertrochanteric, subtrochanteric

Question 23

Tx for hip fx

Answer 23

Bed mobility/beside ADLs, UE strengthening, fx’al ambulation/transfers w app WB status/device, edu on AD, occ based with WB status/device

Question 24

THR most commonly d/t

Answer 24

Arthritis - surgery is elective

Question 25

Austin Moore hip replacement vs Tot hip joint implant

Answer 25

Partial - just replace femoral head & THJI replaces acetabulum too

Question 26

Posterolateral Hip Precautions

Answer 26

More common surgery - no flex beyond 90, no adduction/crossing legs/in rot, no pivot t hip. Raised chairs/toilet seats & trans sit>stand by keeping op hip slightly abducted/extended

Question 27

Anterolateral Hip Precautions

Answer 27

No ex rot, no hip exten > some surgeons follow a no restriction protocol

Question 28

Tx for THR

Answer 28

Instruct/practice use of long handled equip, transfer training, occ based w proper WB status/device

Question 29

Myofacial Pain Syndrome (MPS)

Answer 29

Persistent, deep aching pains in muscle - characterized by trigger points; nonarticular origin

Question 30

Fibromyalgia Syndrome

Answer 30

Musculoskeletal pain/fatigue disorder that varies in intensity. Widespread pain accompanied by muscle tenderness & adjacent soft tissues. Nonarticular rheumatic disease of unknown origin

Question 31

Pain scales that address fx’on

Answer 31

McGill- Self-admin; choose 3words from groups 1-10 to describe pain, 2words from groups 11-15, 1word from group 16, and 1word from groups 17-20; Pain Disability Index- measures degree to which aspects of life are affected by chronic pain & Fx’al Interference Estimate- 5-item self-report measure to assess degree to which pain interferes with daily functioning

Question 32

Tx for Pain

Answer 32

PAMs/Massage in prep for fx’al acts, proper positioning/posture, splint in resting position, gentle ROM, relaxation, proper body mechanics, modifications