Rehab of the Ortho Patient Flashcards
What does “challenging” tissues do when healing?
encourages optimal return to function
What are the stages of healing?
- post-operative
- regeneration phase
- remodelling phase
What period is the post operative phase?
24-48hrs
What period is the regeneration phase?
day 5 - 3 weeks+
What period is the remodelling phase?
6 weeks - 1 year
What is the period for regeneration and remodelling phase for bone healing?
the same as tissue healing
What are you expecting to see in the post-operative stage (24-48hrs)
pain, oedema and healing tissues
What treatment would you do in the post-operative phase?
reduce pain (analgesia), cryotherapy, rest, easy movement only (non-weight bearing/supported weight bearing)
What is cryotherapy used for?
reducing oedema
What forms in the regeneration phase?
new collagen fibres
What treatment would you do in the regeneration phase?
controlled lead exercise and passive/active range of motion
What is the consolidation phase?
cellular to fibrous tissue, strength and alignment
What is the maturation phase?
vascularity and metabolic rate returns to normal (10 weeks to 1 year)
What happens in the regeneration phase of bone healing?
bridging callus forms
What happens in the remodelling phase of bone healing?
clinical union of bone
What are some common orthopaedic injuries?
- cruciate rupture
- forelimb lameness
- fractures
- jaw fractures
- angular limb disease
- joint replacements
- tendon damage
What is a common factor of cruciate disease?
obesity
What might you do before treating cruciate disease if a patient is overweight?
put them on a weight loss programme
What is the most common surgery performed to treat cruciate disease?
TPLO tibial plateau levelling osteotomy
What does fracture rehab depend on?
- degree of fractures and site
- pre-existing disease
- degree of soft tissue damage
- presence of open wounds
What is an example of a rehabilitation plan for a fracture patient?
- adequate analgesia for the patient
- restricted exercise
- cold compress
- encourage use of the limg such as ROM, PROM can be started but minimal
- supportive dressings
What does an external fixator do?
keeps the limb flexed in a natural position
What is important to do with a patient who has an external fixator?
exntend the limb
What would you provide immediately post-op after joint surgery?
cryotherapy
How long would you keep a pressure dressing on for after joint surgery?
12-24hrs
What are the advantages of PROM?
maintains normal range of motion, blood and lymphatic circulation and stimulates sensory awareness
What are examples of joint surgeries?
total hp replacement, total knee replacement, elbow replacement
What is important to do with joint replacement surgery patients post-operatively?
- walk in a controlled m anner
- expert staff only to prevent injury
- keep patient calm and settled
- clear signage on kennel so everyone is aware of how to handle them
When can you start PROM after tendon surgery?
after 3 week rest
How long should exercise be limited for with tendon surgery patients?
3-6weeks
What is the primary goals for recovery of orthopaedic patients?
- weight bearing
- active range of motion
- muscle building
What does rehabilitation assist with?
return to function, minimising stress on the surgical site
What does subjective mean in terms of rehabilitation?
how we think the patient is doing
What does objective mean in terms of rehabilitation?
measuring muscle mass, stepping over poles/height, recording what the patient can achieve
What is the pre-emptive/pre-surgical management for rehabilitation?
- cryotherapy
- support dressing
- weight bearing
- pain management
- assessment of other conditions/lifestyles
What are the benefits of cryotherapy?
- vasoconstriction
- analgesia effect
- reduced tissue oedema
When is the best time to perform cryotherapy?
initial 72 hours
What temperature is best for heat (warm) therapy?
46 degrees
When is the best time for providing heat therapy?
before exercise which leads to increased blood flow increasing elasticity
What are the benefits of massaging?
- increases blood flow
- improves oxygen supply
- aids removal of waste products
- helps muscle work more efficiently and alleviates pain
- settles the patient
- venous and lymphatic return
- mobilises adhesions
- prepares muscles for exercise and aids recovery after exercise
- good warm up for physiotherapy
What is physiotherapy?
assisted and active therapeutic exercises
What are examples of assisted therapeutic exercises?
- assisted standing
- weight shifting
- side bending and cervical flexion/extension
- balancce boards/swiss ball
- muscle stimulation
What are examples of active therapeutic exercises?
- slow walks
- stair climbing
- sit to stand, down to sit
- treadmill walking
- advanced exercises e.g dancing, wheel barrowing, hydrotherapy
How can you communicate effectively a patients rehabilitation plan and how they are doing?
- write clear, precise details on patients progress and any procedures carried out
- take photos and videos of the patient walking oro photos of the wound
- discuss with the team
