Rheumatoid Arthritis

Question 1

Causes of RA

Answer 1

genetic, hormonal, environmental and lifestyle factors

Question 2

what is synovitis

Answer 2

inflammation of the synovial joints

Question 3

What is pannus

Answer 3

protein released from vascular cells and can lead to thickening of the synnovial membrane. can lead to pain and swelling

Question 4

cachexia

Answer 4

Wasting, low appetitie, they may lose muscle bulk and atrophy. goes along with advanced alcoholism.

Question 5

joint instability

Answer 5

if synovial fluid and synovial lining are not strong, we will get shifting and malalignment

Question 6

joint deformity

Answer 6

structures are weakened and distrupted. a lot in the hands and in the wrists.

Question 7

Symptons

Answer 7

symmetric, polyarticular pain and swelling during inflammatory stage

morning stiffness

malaise

fatigue

upper and lower limb involvement

Question 8

common stages of RA

Answer 8

acute -
subacute -
chronic active -
chronic inactive -
look these up in the book.

Question 9

Hand deformities can have what characteristics

Answer 9

persistent synovitis

disrupted joint structures

altered joint mechanics

normal and abnormal forces over joints

ulnar side of wrist is early site of inflammation - radial wrist deviation compression.

Question 10

Medical management of RA

Answer 10

no cure, early intervention can slow progression, pharmacotherapy, early drug therapies manage synovial tissues, reduce subsequent deformities, surgery, multidisciplinary team

Question 11

osteoarthritis is a

Answer 11

clinical syndrome of joint pin linked to degenerative joint changes

most commonly affect hip, knee and shoulder

most common form of arthritis

leading cause of disablity worldwide

most prevalent in women over 50 and men less than 45

Question 12

characteristcs of OA

Answer 12

loss of articular cartilage

remodeling of adjacent bone with new bone formation (osteophytes)

synobial membrane inflammation

Question 13

Osteophytes

Answer 13

remodeling of adjacent bone with new bone formation

Question 14

what is the onset of OA like

Answer 14

gradual onset, affects one or multiple joints, varied types of OA

Question 15

Characteristics of OA

Answer 15

joint pain, hand deformities

Question 16

How does OA impact occupational performance

Answer 16

with decreased grip and strength in can deter them from typical activities.
ADLs - little stuff like putting in contact lenses

Question 17

What are some self report measures for OA - Dont have to memorize these but know about them

Answer 17

Lychert scale assessements that look at pain, ROM, daily activity performance, etc.

• Health Assessment Questionnaire (HAQ) & HAQ-DI (disability index)
• Short-Form Valued Life Activities Scale (S-VLA)
• Measure of Activity Performance of the Hand (MAP-Hand)
• Patient Rated Wrist and Hand Evaluation (PRWE & PRWHE)
• Michigan Hand Outcomes Questionnaire

Question 18

intervention strategies for OA

Answer 18

respect pain
avoid fatigue
manage stress
prevent deformities
use thermal modalities with caution
use resistive exercise with caution
be aware of sensory impairments

Question 19

how should you use thermal modalities with OA

Answer 19

with caution. careful that they don’t burn themselves. Fluidotherapy can be good

Question 20

what the categories of intervention for OA

Answer 20

Patient education
Therapeutic activities and exercises
Orthotics
Modalities

Question 21

for weights what should you be aware of

Answer 21

if they have uneven joint alignment no resistance
1 lb is way different to a weak body than 5
resistence bands may be too much
careful that they aren’t doing too much

Question 22

how should you pair down your patient education

Answer 22

try to keep it to three things only. if they master that, give them more.

Question 23

compensatory strategies

Answer 23

rocker knives, …….

Question 24

How do we manage pain

Answer 24

hot and cold modalities, positioning, mindfulness based meditation, medication,

Question 25

ergonomic considerations

Answer 25

Limit strong grip, twisting movements, and sustained grips to reduce MCP forces.
Limit lifting heavy objects and sustained wrist radial positioning to reduce wrist volar and radial forces
Limit tight, prolonged key, tripod, and pinch grips

Question 26

how does mental health affect OA

Answer 26

sadness about not being able to do everything they used to, poor social support, work pressure.