Rehabilitation Flashcards
What are indication for rehab therapy and chronic pain management ?
Post injury
- bone, muscle, joint, or tendon
- neurological and degenerative dz
Post surgery
- orthopedic
- neurological
What are the goals of rehab?
Decrease pain
- swelling
- muscle spasm
- neurogenic
Improve function
-strength, flexibility
How would you initially evaluate a patient for rehab and chronic pain management ?
Presenting complaint History ->systemic illness, travel? (R/o infectious arthritis etc ) ->trauma, neurological deficits -> progression, treatments
Surgical history
PE _rule out systemic dz and ancillary testing
Gait evaluation
- > head bob -“down on the sound”
- > stride length, limb carriage, joint motion
Assessment of muscle mass
Full orthopedic and neurological exam
What are some of the outcome measurements?
Gait analysis
Lameness scoring
Force plate analysis
Pedometers
Joint function (goniometer for ROM)
Joint laxity
Muscle mass measurement
Pain assessment
What is cryotherapy? When do we use it?
Cold application
Acute phase of tissue damage
After exercise during rehab
What are the effects of cryotherapy?
Reduced blood flow
Reduced Cellular metabolism and permeability
Decreased nerve conduction, velocity
Analgesia
Prevent/reduce edema
Decrease muscle spasm
When do you use superficial thermal therapy?
After acute inflammatory phase of healing has resolved
Causes vasodilation, accelerated enzymatic and metabolic rx, increased O2 uptake —> accelerate superficial tissue healing
What are indications for passive range- of - motion?
Immediately post -surgery (before active weight bearing)
Prevention of joint contracture in paralyzed patients
—> patients have decreased pain and improved recovery rates
What is the application of additional pressure applied at the ends of ROM?
Stretching
What is active range of motion? How can you achieve increased joint flexion?
Motion of joint achieved by active muscle contraction
Swimming/walking in water Walk in snow, sand, tall grass Crawling through play tunnel Climbing stairs Cavaletti rails
What are the benefits of aquatic therapy?
Improves strength, muscular and CV endurance
Improve ROM, agility, and psychological well being
Minimize pain
Buoyancy decreased load on injured tissues
Water provides proprioceptive feedback
How does transcutaneous electrical nerve stimulation (TENS) work?
Low leaves electrical current through electrodes on skin
Analgesic —> stimulation of AB (touch, pressure) nerve fibers —> inhibit C (pain) fibers at level of spinal cord
Increase endogenous opioids
What are the effects of massage?
Increase lymphatic flow
Assists circulation in removal of inflammatory mediators and chemical irritants
Relieve muscle spasm, reduce adhesions, mobilize scar tissue
Relieve distress, anxiety, and discomfort
What are the massage techniques?
Stroking -med pressure, prox to distal
Effleurage -med pressure, distal to proximal (lymphatic drainage)
Compression - pressure to tense tissue
Percussion - clapping with cupped hands
Trigger point therapy -squeezing area of muscle spam
What is the effect of low-level laser therapy?
Analgesia and improved wound healing —> soft tissue/joints
Photoaactivation/modulation
- inhibit pain fiber
- endorphin release
- COX2 inhibitor
- increased NO
