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Veterinärmedicinsk rehabilitering > Rehabilitering för den ortopediska patienten > Flashcards

Rehabilitering för den ortopediska patienten Flashcards

1
Q

Ge exempel på ortopediska tillstånd som involverar ben och/eller led

A
  • Elbow dysplasia
  • Patellar luxation
  • Hip dysplasia
  • Osteoarthritis
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2
Q

Ge exempel på ortopediska tillstånd pga trauma

A
  • Fractures
  • Carpal hyperextension
  • Hip dislocation
  • Multi-trauma
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3
Q

Ge exempel på ortopediska tillstånd som involverar mjukdelar

A
  • Tendinopathy & tendon injuries
  • Muscle strains
  • Ligament injuries
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4
Q

Ge exempel på tillstånd som sekundärt kan ge ortopediska problem

A

Primarily endocrine/metabolic, autoimmune, inflammatory issues

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5
Q

Vad är viktigt att ha i åtanke (frågor som är viktiga att ställa/ta reda på) vid rehab av ortopediska tillstånd?

A

• What “structure” is involved?
• What is its action/purpose?
• What are other structures that…
- Do the same (agonists)?
- Support the involved structure?
- Are under more stress/strain due to the injury to the involved structure?
• In what phase of healing (or degeneration) is the structure? How strong is it? What stresses can it tolerate?
• Does it need to be protected? Is there inflammation? Is there pain? Is the structure ready to be strengthened? Can it tolerate gravity or an applied load?
• How will the body be oriented during rehabilitation? What stresses/strains will be on the body (or on the involved structure)? What variables can be altered—& when they are altered, how does the body (or involved structure) respond?

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6
Q

vad är elbow dysplasia?

A

• Malformation/abnormal development of elbow joint resulting in “medial compartment disease”

  • Fragmented coronoid process (FCP)
  • Osteochondrosis (OCD)
  • Joint incongruity
  • Cartilage anomaly
  • Ununited anconeal process (UAP)
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7
Q

Ge exempel på rehabövning vid elbow dysplasia och vilken effekt det kan ge

A

walking through cavalettis will increase active ROM, promote weight bearing & more symmetrical stepping

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8
Q

Vad är patellaluxation och vad innebär de 3 graderna?

A

Kneecap slides or pops out of the trochlear groove

  • Grade1: A knee cap that can beluxating with manual pressure but is otherwise is within the groove.
  • Grade2: The knee cap spontaneously luxates, is typically associated with a skipping lameness when the knee cap moves
  • Grade3: The knee cap is permanently luxated but can be manually replaced in the groove.
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9
Q

Ge exempel på rehabövning vid patellaluxation och vilken effekt det kan ge

A

standing weight shifting exercises with a balance board will encourage co-contractions of muscles at the hip & stifle

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10
Q

Vad innebär höftdysplasi?

A

A developmental disease in which the hip joint(s) fail to develop normally, gradually deteriorating, & leading to loss of function

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11
Q

Ge exempel på rehabövning att göra vid höftdysplasi och vad det kan ge för effekt

A

standing with support of a PhysioRollor “peanut” with incremental weight shifting to the hind limbs can build strength in the core musculature & glutealsin a hip-extendeposture.

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12
Q

Vad innebär osteoartit och vad kan det ge för symptom?

A
  • Osteoarthritis is a joint disease that results from breakdown of cartilage & underlying bone
  • Signs
  • Primary: joint pain & stiffness
  • Secondary: weakness, reduced mobility/activity, restricted ROM
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13
Q

Ge exempel på rehabövning att göra vid osteoartit och vad det kan ge för effekt

A

swimming will allow tolerable range of motion against resistance with no impact/stress to joints.

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14
Q

Ge exempel på rehabövningar att göra vid fraktur och vad det kan ge för effekt

A

• Unweight limb to reduce stress on fracture

  • Sling (bärsele/band) or harness
  • Promoting healing of bony (& other) tissues

For example: gentle sit to stand exercises with manual correction (& with sling assist) will move all hind limb joints through a full, functional ROM.

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15
Q

Vad är carpal hyperextension och vad kan orsaka det?

A

Breakdown of carpal ligaments

Can be caused by repetitive jumping, connective tissue disorders, painful hind limb conditions (causing weight to be shifted to forelimbs)

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16
Q

Ge exempel på rehabövning att göra vid carpal hyperextension och vad det kan ge för effekt

A

Unweight limb to reduce stress on injury/surgical site, mha sling (bärsele/band) or harness

For example: digging exercises will strengthen inter-carpal/inter-digital muscles.

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17
Q

Vad innebär hip dislocation (höftledsluxation) och vad kan det ge för symptom?

A
  • Femoral head dislocates from shallow acetabulum (tearing the joint capsule) & is positioned cranio-dorsally
  • Signs
  • Unable to weight bear
  • Reduced limb length
  • Hip rotation
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18
Q

Ge exempel på rehabövning att göra vid höftledsluxation och vad det kan ge för effekt

A

NMES of the gluteal musculature will help to support the hip joint.

19
Q

Vad innebär multitrauma?

A

Injuries caused by an accident, involving >2 “systems”

20
Q

Ge exempel på rehabövning att göra vid multitrauman och vad det kan ge för effekt

A

PROM & massage can safely help improve mobility & comfort.

21
Q

Vad innebär tendinopathy?

A

Tendinopathy: failed healing response of a tendon

22
Q

Ge exempel på rehabövning att göra vid senskador och vad det kan ge för effekt

A

Crawling exercises can safely teach correct movement/position of scapula in supraspinatus tendinopathy.

23
Q

Vad kan muskelsträckning bero på och vad innebär de tre graderna av sträckning?

A

Overstretching or tearing of muscle fibers due to fatigue, overuse, or improper use of a muscle

  • Grade1: Mild damage to individualmusclefibers (less than 5% of fibers), causes minimal loss of strength & motion
  • Grade2: More extensive damage, more musclefibers involved (the muscle is not completely ruptured)
  • Grade 3: Complete rupture of muscle
24
Q

Ge exempel på rehabövning att göra vid muskelsträckningar och vad det kan ge för effekt

A

Slowly restore functional range of motion & flexibility

- PROM, stretching & manual therapy

25
Q

Hur kan ligament skadas?

A

Ligaments serve to maintain stability within a joint & can be strained, overstretched, or torn/ruptured

26
Q

Vad vill man fokusera på vid rehab av Cranial cruciate ligament rupture (kranial korsbandsruptur)? Exempel på rehabövning?

A

Focus on restoring normal joint biomechanics & pain free range of motion, reducing inflammation, improving “stability” of joint, improving weight bearing tolerance, & improving strength of supporting muscles

Ex: walking over cavalettirails for improved weight bearing & range of motion after TPLO.

27
Q

Vad kan endokrina, inflammatoriska eller autoimmuna tillstånd (addisons, cushings, diabetes, pancreatic/liver/kidney disease) orsaka för ortopediska skador?

A
  • Muscle atrophy
  • Reduced activity levels
  • Altered metabolism -> overweight/obesity
  • Osteopenia
  • Weakening of connective tissues
28
Q

Varför är det viktigt att hålla djuren i bra hull, vad kan övervikt leda till?

A

Can lead to chronic diseases including OA, cardiovascular disease, ruptured ligaments, respiratory issues, fatigue, diabetes mellitus, liver disease, etc.

29
Q

Vilka är läkningsfaserna?

A

Hemostasis -> inflammatorisk fas -> reparationsfas -> mognadsfas/remodelleringsfas

30
Q

När en sena läkt efter skada, hur stor del av styrkan den hade från början återfås?

A

Final strength only 2/3 of normal

31
Q

Vad kan påverka läkningen och läkningstiden?

A 
•	Age
•	General health
•	Presence of infection
•	Nutrition
•	Location of injury
-	Status of circulation to/around injury
-	Presence of soft tissue
•	Amount of damage
•	Type of “repair”
-	Surgical vs. Coaptation
•	Physical demands on the tissue
32
Q

Vad kan vi använda för olika utvärderingsmetoder vid ortopediska tillstånd?

A 
•	ROM
•	Flexibility
•	Strength
-	Girth measures (omkrets)
•	Postures
•	Functional mobility/transitions
•	Gait
-	Weight bearing/lameness
•	Special tests
-	Tibial thrust/cranial drawer
-	Ortolani sign
•	Palpation
33
Q

Hur kan vi bedöma/utvärdera styrka/muskler?

A

• Equipment:

  • Flexible tape measure or Gullick
  • Calipers (skjutmått)
  • Diagnostic musculoskeletal ultrasound
34
Q

Vad vill man ta med i beaktning vid bedömning/utvärdering av rörelse/rörelsemönster?

A
  • Symmetry
  • Weight bearing/shifting
  • ROM
  • Flexibility
  • Muscle – strength, muscle tone, atrophy
  • Rotation of trunk & dissociation of limbs from trunk
  • Posture & base of support (BOS)
  • Motor control
35
Q

Ge exempel på olika smärtbeteenden

A
  • Antisocial
  • Aggressive
  • Altered eating, drinking, sleeping patterns
  • More vocal
  • Excessive grooming
  • Panting, altered RR
  • Agitation
  • Changes in posture, mobility
  • Altered tail, ear, or head posture
36
Q

Vad kan vi ha för mål med rehab vid otropediska tillstånd?

A 
Sänka:
•	Inflammation
•	Pain
•	Muscle spasm/trigger points
•	Contracture, fibrosis, scar tissue formation
•	Gait deviations/lameness
Öka:
•	Strength
•	Range of motion
•	Flexibility
•	Endurance
•	Weight bearing tolerance
•	Function
•	Healing
•	Sensation/proprioception
•	Balance/coordination/motor control
37
Q

Vad innebär pre-habilitation och vad har det för syfte?

A
  • Vad? Prior level of activity/fitness will influence recovery rate
  • Syfte? For scheduled surgical procedures, pre-hab can prepare patient (mentally & physically) for surgery & post-surgical rehab
  • Manage pain & inflammation
  • Introduce manual therapies & PROM
38
Q

Vad är syftet/målen med postop-rehab (kan börja direkt efter op)?

A 
•	Faster recovery with fewer complications
•	Goals:
-	Manage pain & inflammation
-	Increase ROM & flexibility
-	Prepare for weight bearing
-	Strengthen
39
Q

Vad är terapeutiska övningar och vad är syftet med att göra dessa?

A

• Performance or execution of physical movements or activities intended to enable the patient to:

  • Remediate or prevent impairments of body functions & structures
  • Enhance activities & participation
  • Reduce risk
  • Optimize overall health
  • Enhance fitness & well-being
40
Q

Vad kan man använda för redskap vid terapeutiska övningar?

A

• Inflatables
- Examples – physioBall, PhysioRoll (AKA peanut), Donut, BOSU
- Goals – Weight bearing/shifting, Core strength, Dynamic balance, Promote confidence by maintaining weight bearing on strong limbs initially
• Resistive/assistive tools
- Tex hands, TheraBand or TheraTubing (band att assistera hunden med)
• Obstacles
- Cavalettis, Step, Ramp, Agility or Schutzhund obstacles
• Weight bearing surface variation
- Examples – Air mattress, Balance pods, Foam mattress/pad
- Goals - Core strength, Weight shifting/weight bearing, Sensory stimulation

41
Q

Vad innebär fitness?

A

Adaption to stress (kroppen anpassar sig efter tid och kommer kräva mindre ansträngning i övningarna)

42
Q

Vad finns det för typer av vattenträning?

A

• Pool
- Swimming

• Underwater treadmill

  • Walking, trotting, & swimming
  • Reduced weight bearing
  • Reduced joint stress
  • RROM
  • Functional therapeutic exercise

• Whirlpool

  • Wound care
  • Thermal effects
  • Buoyancy vs. Resistance
43
Q

Vad finns det för fördelar med vattenträning?

A
  • Reduced weight bearing (body weight support)
  • Reduced joint stress/compression
  • Assistance with functional mobility, upright posture, & AAROM
  • Reduced inflammation/swelling distally
  • Improved trunk support for upright postures
  • Improved cardiovascular/respiratory support

Veterinärmedicinsk rehabilitering (13 decks)

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