RC, Arthritis, OI & Hips Flashcards
Conservative Tx for Rotator Cuff Tendonitis
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
Post Op Tx for Rotator Cuff Tendonitis
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
Adhesive Capsulitis or Frozen Shoulder
Restricted passive shoulder ROM; greatest restriction w ex rot, then aBduction, in rot & flex.
Glenohumeral ligaments and joint capsule
Conservative Tx for Frozen Shoulder
Encourage active used thru ADL/role activities, PROM & modalities
Post Op Tx for Frozen Shoudler
PROM imm following surgery, modalities for pain relief, encourage use of extremity for all ADL/role acts
Shoulder Dislocation
Anterior most common - regain ROM while avoiding combo aBductio/ex rot, pain free ADL/role act, strengthen rotator cuff
Rheumatoid Arthritis
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
RA symptoms
Pain, stiffness, lim ROM, fatigue, weight loss, lim w ADLs
Boutonniere Deformity
Flex of PIP and hyperex of DIP - prevent w silver ring spint
Swan Neck Deformity
Hyperex of PIP and flex of DIP - prevent w silver ring spint
Osteoarthritis
Degen joint disease, not systemic but wear/tear, commonly affects large weight bearing joints, attacks hyaline cartilage - can be genetic
OA Symptoms
Pain, stiff, Lim ROM & bone spurs
Heberden’s Nodes
Bone spurs at DIP joint
Bouchard’s Nodes
Bone spurs at PIP joint
With arthritis avoid
muscle testing unless requested by physicians & strengthening during inflam stage
Tx for Arthritis
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
Splint for Post Op MCP Arthroplasty
Dynamic MCP ex splint w radial pull
Osteogenesis Imperfecta
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
Signs/Symptoms of OI
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
Types of OI
8 main types classified by involved genes: Types 2/3/7/8=severe, Types 4/5/6=mod & Type 1=mild
Tx for OI
*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
3 types of hip fx
Femoral neck, intertrochanteric, subtrochanteric
Tx for hip fx
Bed mobility/beside ADLs, UE strengthening, fx’al ambulation/transfers w app WB status/device, edu on AD, occ based with WB status/device
THR most commonly d/t
Arthritis - surgery is elective
Austin Moore hip replacement vs Tot hip joint implant
Partial - just replace femoral head & THJI replaces acetabulum too
Posterolateral Hip Precautions
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
Anterolateral Hip Precautions
No ex rot, no hip exten > some surgeons follow a no restriction protocol
Tx for THR
Instruct/practice use of long handled equip, transfer training, occ based w proper WB status/device
Myofacial Pain Syndrome (MPS)
Persistent, deep aching pains in muscle - characterized by trigger points; nonarticular origin
Fibromyalgia Syndrome
Musculoskeletal pain/fatigue disorder that varies in intensity. Widespread pain accompanied by muscle tenderness & adjacent soft tissues. Nonarticular rheumatic disease of unknown origin
Pain scales that address fx’on
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
Tx for Pain
PAMs/Massage in prep for fx’al acts, proper positioning/posture, splint in resting position, gentle ROM, relaxation, proper body mechanics, modifications