Rehab of the Ortho Patient

Question 1

What does “challenging” tissues do when healing?

Answer 1

encourages optimal return to function

Question 2

What are the stages of healing?

Answer 2

• post-operative
• regeneration phase
• remodelling phase

Question 3

What period is the post operative phase?

Answer 3

24-48hrs

Question 4

What period is the regeneration phase?

Answer 4

day 5 - 3 weeks+

Question 5

What period is the remodelling phase?

Answer 5

6 weeks - 1 year

Question 6

What is the period for regeneration and remodelling phase for bone healing?

Answer 6

the same as tissue healing

Question 7

What are you expecting to see in the post-operative stage (24-48hrs)

Answer 7

pain, oedema and healing tissues

Question 8

What treatment would you do in the post-operative phase?

Answer 8

reduce pain (analgesia), cryotherapy, rest, easy movement only (non-weight bearing/supported weight bearing)

Question 9

What is cryotherapy used for?

Answer 9

reducing oedema

Question 10

What forms in the regeneration phase?

Answer 10

new collagen fibres

Question 11

What treatment would you do in the regeneration phase?

Answer 11

controlled lead exercise and passive/active range of motion

Question 12

What is the consolidation phase?

Answer 12

cellular to fibrous tissue, strength and alignment

Question 13

What is the maturation phase?

Answer 13

vascularity and metabolic rate returns to normal (10 weeks to 1 year)

Question 14

What happens in the regeneration phase of bone healing?

Answer 14

bridging callus forms

Question 15

What happens in the remodelling phase of bone healing?

Answer 15

clinical union of bone

Question 16

What are some common orthopaedic injuries?

Answer 16

• cruciate rupture
• forelimb lameness
• fractures
• jaw fractures
• angular limb disease
• joint replacements
• tendon damage

Question 17

What is a common factor of cruciate disease?

Answer 17

obesity

Question 18

What might you do before treating cruciate disease if a patient is overweight?

Answer 18

put them on a weight loss programme

Question 19

What is the most common surgery performed to treat cruciate disease?

Answer 19

TPLO tibial plateau levelling osteotomy

Question 20

What does fracture rehab depend on?

Answer 20

• degree of fractures and site
• pre-existing disease
• degree of soft tissue damage
• presence of open wounds

Question 21

What is an example of a rehabilitation plan for a fracture patient?

Answer 21

• 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

Question 22

What does an external fixator do?

Answer 22

keeps the limb flexed in a natural position

Question 23

What is important to do with a patient who has an external fixator?

Answer 23

exntend the limb

Question 24

What would you provide immediately post-op after joint surgery?

Answer 24

cryotherapy

Question 25

How long would you keep a pressure dressing on for after joint surgery?

Answer 25

12-24hrs

Question 26

What are the advantages of PROM?

Answer 26

maintains normal range of motion, blood and lymphatic circulation and stimulates sensory awareness

Question 27

What are examples of joint surgeries?

Answer 27

total hp replacement, total knee replacement, elbow replacement

Question 28

What is important to do with joint replacement surgery patients post-operatively?

Answer 28

- 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

Question 29

When can you start PROM after tendon surgery?

Answer 29

after 3 week rest

Question 30

How long should exercise be limited for with tendon surgery patients?

Answer 30

3-6weeks

Question 31

What is the primary goals for recovery of orthopaedic patients?

Answer 31

- weight bearing - active range of motion - muscle building

Question 32

What does rehabilitation assist with?

Answer 32

return to function, minimising stress on the surgical site

Question 33

What does subjective mean in terms of rehabilitation?

Answer 33

how we think the patient is doing

Question 34

What does objective mean in terms of rehabilitation?

Answer 34

measuring muscle mass, stepping over poles/height, recording what the patient can achieve

Question 35

What is the pre-emptive/pre-surgical management for rehabilitation?

Answer 35

- cryotherapy - support dressing - weight bearing - pain management - assessment of other conditions/lifestyles

Question 36

What are the benefits of cryotherapy?

Answer 36

- vasoconstriction - analgesia effect - reduced tissue oedema

Question 37

When is the best time to perform cryotherapy?

Answer 37

initial 72 hours

Question 38

What temperature is best for heat (warm) therapy?

Answer 38

46 degrees

Question 39

When is the best time for providing heat therapy?

Answer 39

before exercise which leads to increased blood flow increasing elasticity

Question 40

What are the benefits of massaging?

Answer 40

- 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

Question 41

What is physiotherapy?

Answer 41

assisted and active therapeutic exercises

Question 42

What are examples of assisted therapeutic exercises?

Answer 42

- assisted standing - weight shifting - side bending and cervical flexion/extension - balancce boards/swiss ball - muscle stimulation

Question 43

What are examples of active therapeutic exercises?

Answer 43

- slow walks - stair climbing - sit to stand, down to sit - treadmill walking - advanced exercises e.g dancing, wheel barrowing, hydrotherapy

Question 44

How can you communicate effectively a patients rehabilitation plan and how they are doing?

Answer 44

- 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