Rehabilitation Flashcards

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1
Q

What are the 3 phases?

A

Inflammation (1-7d)
Fibroblastic (up to 2wks)
Maturation (wks to months)

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2
Q

Cellular recovery in phase 1

A

Plasma exucation
Incr proliferation
Incr capillary permeability

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3
Q

Rehabilitation principles in phase 1

A

PRICE/ POLICE - Protect, Optimal Load, Ice, Compress, Elevate

Minimise movement for 1-3 d
Compress with caution
AVOID ANTI-INFLAMMATORIES (PEACE) !!!!

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4
Q

When can you move to phase 2?

A

Stabilisation of oedema

Define degree of severity; if oedema stabilised at 2cm then you can move on

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5
Q

Cellular recovery in Phase 2

A

Increase of fibroblast concentration
Increase of collagen formation

Done by mechanotransduction

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6
Q

Rehabilitation principles in phase 2

A
Physiomodalities - minimise swelling
A-ROM - stretching exercises
Aerobic - maintain 60-70% max aerobic capacity
Strength
Proprioception
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7
Q

Progression of strength exercises

A

NWB –> PWB –> FWB
Double leg –> Single leg
Isometric –> Concentric –> Eccentric/ Functional
Closed chain –> Closed chain

2-5 exercises, 10-15 reps, 1-3 sets

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8
Q

Exercise regime/prescription for proprioception

A

2-5 exercises, 10-15 reps, 1-3 sets

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9
Q

When can you move to phase 3?

A

HOP TEST - 20 consecutive hops on one leg without any pain or discomfort; repeat for other side
No swelling
Equal ROM

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10
Q

Cellular recovery in Phase 3

A

Remodelling

Functional Recovery

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11
Q

Rehabilitation principles in phase 3

A

Sport-specific training with plyometrics (explosive exercises for power); return to full training

Plyometric exercises involve both conc and ecc exercises

  • Running, jumping, push ups + clap
  • Eccentric training; 2 sets, 10-20 reps, 2x/day
  • Trampoline training; 3-x20 forw-back + 3x20 sideways

Progression to land training –> run in a pattern

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12
Q

When can the athlete RTP?

A

No S&S
Aerobic and anaerobic capacity
Strength imbalance 20%
FASH (functional assessment scale of acute hamstring injuries)

Functional performance tests

  • SL Triple jump, for distance
  • SL Cross-over triple jump, for distance (difference should be <=5%)
  • Full sprint 90% at max speed for 30m
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13
Q

What is the controversy with the use of ice?

A

Analgesic effect
BUT can disrupt inflammation, angiogenesis/ revascularisation, delay neutrophil and macrophage infiltration, increase immature myofibres

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14
Q

What is the positive effect of compression?

A

Reduces intra-articular oedema and tissue haemorrhage

Controls inflammatory exudate to reduce the fibrin and thus scar tissue produces

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15
Q

Optimal Loading

A

Mechanical stress should be applied to the area early on. The load should be gradual and varied according to the pain levels. If pain free, it promotes remodelling, building tissue tolerance, and increases capacity.

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16
Q

PEACE & LOVE

A

PEACE - Avoid anti-inflammatories

LOVE - Optimism (negative attitudes can interfere)

17
Q

What are the risk factors for recurrence of injuries

A

Previous injury with inappropriate rehabilitation and earlier RTS

30% of athletes with ankle injury will be re-injured

18
Q

What is phase 4?

A

Prevention of re-injury

19
Q

Goal of Rehabilitation (definition)

A

A dynamic, structured process that aims to restore the injure athlete’s function and performance levels to above pre-injury level, return the athlete to sports in a safe and timely manner and prevent re-injury

20
Q

What is the aim of rehabilitation exercises

A

Target local tissue level and CNS

  1. Increase tissue load tolerance - Mechanotherapy
  2. Alter biomechanics - Unload injured tissue via altered movement and muscle activation patterns
  3. Maintain general condition - Alternative training
21
Q

Stages of Healing

A
  1. Bleeding and inflammation
  2. Proliferation
  3. Regeneration
  4. Remodelling
  5. Maturation