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Injury & Rehab > Term 2 > Flashcards

Term 2 Flashcards

1
Q

when would an athlete consider using an assistive device?

A

Pre-injury prevention

After injury or surgery as rehabilitation and re-injury prevention

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2
Q

Common forms of assistive devices:

A

Bracing
Taping
Footwear/ Orthotics
Wheelchairs/ Prosthetics

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3
Q

Name the four knee brace designs

A

Upright- Double/ Single
Tibia straps- Prevent A/P motion
Hinge- Single-axis, Dual-axis or polycentric hinges
Upper- Encircle thigh and calf

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4
Q

What is a prophylactic knee brace used for?

A

To protect the knee from valgus injuries
Support the cruciate ligament through rotational stress
Used in contact sports

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5
Q

Effectiveness of prophylactic knee braces?

A

Effectively reduce injuries in some longitudinal studies, but have been associated with a decrease in performance

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6
Q

What is a functional knee brace used for?

A

Provide stability for unstable knee- used after torn ACL or post reconstruction
Typically double hinged upright

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7
Q

Effectiveness of functional knee brace?

A

Conflicting- can provide mechanical and preconceptive movements, bu has questionable generalisabiltiy to functional activities

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8
Q

Risks/Negatives of knee bracing:

A

Ligament preloading- there is an increase in static MCL/ LCL strain
Joint line contact- Contact of brace to knee concentrates forces rather than allowing broader distrobution
Centre axis shift- Braces shift central point of joint leading to excess stress on ligaments

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9
Q

Findings on knee taping:

A

effectively alleviates patellofemoral pain symptoms

Only subjects with already poor proprioception benefited regarding proprio aid

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10
Q

The 3 main types of ankle braces are:

A

Semi-rigid plastic
Lace-up fabric
Neoprene

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11
Q

Findings on ankle braces:

A

Reduce contact-related injuries but no change in incidence of non contact

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12
Q

Benefits and limitations of ankle taping:

A

+ves:
Reduced ROM alleviates stress on damages tissue
Improved proprioception

-ves:
Incorrect taping associated with inversion ankle injuries
Tape loses 50% of original supporting strength after 10-20 minutes

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13
Q

Name the types of walking aids:

A

Canes- improve stability, generate a moment, reduce limb loading
Crutches- Can transmit forces in the horizontal plane
Frames- Stability, Vertical and horizontal forces

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14
Q

Function of foot orphotics:

A

To adjust abnormal/irregular walking patterns

Comfort and efficiency

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15
Q

How can foot orphotics influence comfort and efficiency?

A

By altering the angle at which the foot strikes the ground

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16
Q

Name the 3 categories of foot orphotics:

A

Adjusting/Controlling foot function
Protective
Combination

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17
Q

Sport shoes must be designed to:

A

Improve performance- midsole energy return

Reduce injury- reduce impact forces

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18
Q

What is the purpose of sports equipment?

A

To modify the influence of the environment on the sports performer

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19
Q

Give some examples of sports equipment

A 
Striking objects
Protective equipment 
Sport and exercise clothing 
Sport surfaces 
Footwear-surface interface
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20
Q

What is meant by compliance regarding sports surfaces?

A

Flexibility- relates to deformation under load- how the surface can adopt to external change
Stiffer surfaces= increased performance but also increased injury risk
Non compliant= increased impact loading
Excessively compliant= high fatigue

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21
Q

What is meant by resilience regarding sports surfaces?

A

R=e2- the energy absorbed and then returned to the striking object
Lack of resistance= fatigue

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22
Q

Name the important impact variables for sports surfaces

A

Peak impact force (N)

Peak verticle loading rate (N/s)

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23
Q

Equation for loading rate:

A

Loading rate (N/s) = Impact peak force (N)/ time to impact (s)

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24
Q

Implications of hard vs artificial ground:

A

Hard ground:
increased incidence of tendon injuries
Inflamation of calf muscles
Microfractures- lead to reduction in shock absorbing capacity, so more demand on cartilage

Synthetic ground:
Reduce/ Eliminate sliding, higher resistance to rotation
200% increase in injury on tennis courts with reduced sliding
Severe friction burns

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25
Q

How can surface inclination effect injury risk?

A

Uphill running- greater stress on ankle plantar flexors and patella ligament
Downhill running- longer stride length= greater impact force and strain on anterior thigh muscles

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26
Q

What was Nigg (1993)’s finding on running shoes?

A

Sport shoes can alter forces in biological tissues by over 100%

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27
Q

Structure of a running shoe:

A

Midsoles and wedges- Shock absorption
Insole- reduced impact, comfort
Heal counter- rearfoot stability, reduced excessive pronation
Heel tab- hard/ too high= tendon inflamation

28
Q

Running shoe potential issues:

A

Insufficient rotational freedom between surface and footwear= injury
Poorly gripping footwear= balance issues in throwing sports
Hard surfaces= heel bruising

29
Q

What are the reasons for increased popularity in disability sports?

A

Recognition- Participation increase, Serious athletes
Acceptance- Paralympics
Opportunity- Technology, Diverse sports

30
Q

Spinal chord structure from top to bottom:

A 
Cervial- 7 
Thoracic- 12
Lumbar- 5
Sacrum- 5 (fused)
Coccyx- 3-5
31
Q

What are the types of spinal impairment?

A

Quadri/tetraplegia- Whole body
Paraplegia- Lower body- both sides
Hemiplegia- 1 side of the body
Diplegia- Both arms or legs

32
Q

What is cerebral palsy?

A

A motion and posture disorder due to a brain insult/ injury at birth
Can affect: Quadriplegia, Hemiplegia, Diplegia

33
Q

Loose classification of disability in sport:

A 
Amputees
Cerebral palsy
Spinal injuries
Blind/ Visually impaired
"Les Autres"- MS, Arthritis, Osteoparosis
34
Q

Common injuries in disability sports are:

A

-Lower extremity injuries- ambulatory athletes
-Upper extremity injuries- Wheelchair users
Most common overall type is soft tissue

35
Q

What to consider when designing prosthetics:

A

Patient pathology
Age and fitness
Finance available
Sport participantion

36
Q

What are the prosthetic design options for a lower limb amputee sprinter

A

No heel on flexible foot to imitate faster mid-foot strike running gait

37
Q

What are the prosthetic design options for lower limb amputee walking/jogging /running

A

Carbon fibre components to allow energy return

Telescopic limbs to reduce soft tissue damage from repeated impacts

38
Q

What are the prosthetic design options for a lower limb amputee jumper

A

High stability polycentric knee

Gel liners for reduced landing impact

39
Q

What are the prosthetic design options for a lower limb amputee Golfer

A

High stability and torque design of foot at ankle

Gel liners for long distance walking

40
Q

Implications of wheelchair design:

A

Performance may be significantly optimised
Increase in carpal tunnel syndrome in wheelchair athletes
Force generation pattern- increased upper body injury risk

41
Q

What is the role of bio mechanics in injury rehab and prevention

A

Gait analysis- Walking patterns, Force platforms
Technique analysis- Manual/automatic visual analysis systems
EMG- Prosthetics etc.

42
Q

Injury classification:

A

Acute- Single overload, Mechanism of injury

Chronic- Repeated overloads, Insufficient recovery

43
Q

What is stress vs strain?

A 
Stress= force/area
Strain= Tissue deformation
44
Q

Why might deficites in injury treatment remain?

A

Because of limited healing capacity of certain muscoloskeletal system tissues

45
Q

The ability of the tissue to tolerate stress depends on what factors?

A

Health of tissue
Previous injury
Nutritional status
Magnitude of loading

46
Q

What are the four tissue repair phases?

A

1 Bleeding
2 Inflammation
3 Proliferation
4 Remodelling

47
Q

What occurs at the bleeding stage of tissue repair?

A
  • Associated with the nature and/or location of injury
  • Bleeds for an average of 6-8 hours
  • Damage of the blood capillaries in the tissue= chemical signalling process
48
Q

What occurs at the inflammation stage of tissue repair?

A
  • Inflammation is necessary to ‘clear’ site and enable tissue repair, but must be controlled so as to limit secondary cell death
  • Response to tissue damage
  • Reaction is the same regardless of cause of tissue damage
  • Function- disposal and preparation of injured site for repair
49
Q

Name and explain the stages of inflamation

A
  • Vasodilation- an increased permeability allows defensive material to pass out of blood vessels
  • Phagocyte migration- Margination, Diapedesis, Chemotaxis
  • Repair
50
Q

Signs and causes of inflammation:

A
  • Heat- increased blood supply and metabolism
  • Swelling- Build up of fluid from vascular system
  • Redness- Increased blood supply
  • Pain- Increased tissue pressure, release of chemical mediators
51
Q

What occurs at the proliferation stage of tissue repair?

A

Fibroblastic repair phase- two categories

  • 1.Fibroplasia (laying down of new tissue)
    1. Angiogenesis (formation of new local circulation)
  • Fibroblasts lay down type iii collagen which becomes type i during remodelling stage
  • Some tenderness
  • Repair vs regeneration:
  • Repair= Lost tissue replaced by granulation tissue which matures to form scar tissue-majority of injuries
  • Regeneration- Specialised tissue replaced by proliferation of surrounding cells
52
Q

What happens during the remodeling stage of tissue repair?

A 
Orientation of collagen fibers 
Type iii becomes type i
Scar tissue contracts
Cross linking of collagen 
May require several years.
53
Q

What are the top 5 causes of children’s sport and recreational injuries?

A 
Playground-peaks at age 9
Bicycle- 14
Football- 14
Basketball- 14
American Football- 14
54
Q

What is the most common form of injury among 5-14 year olds?

A

Sprains/ Strains

55
Q

Name the risk factors for overuse injury in youth

A

-Knee injuries- Frequent in children- Catagorised as trauma or overuse
-out of 952 knee injuries 85% were overuse and 15% trauma
-Tumbling gymnastics was a risk for trauma
Participation over twice a week increased chances for both types

56
Q

Describe the characteristics of general joint hypermobility

A
  • Asymptomatic counterpart to joint hypermobility syndrome
  • Predisposition to a wide variety of tissue injuries and internal joint dearangement
  • Increased risk of injury
57
Q

Describe joint hypermobility syndrome

A
  • A joint that moves beyond what is considered normal range
  • Can cause chronic pain, fatigue and lack of desire to participate
  • Inherited disorder of connective tissue
58
Q

What is Ehler’s Danlos Syndrome?

A

Group of disorders that affect connective tissues supporting the skin,bones, blood vessels and other organs and tissues. Can range from mildly loose joints to life threatening.

59
Q

List the 2017 classification of 13 types of EDS:

A
  1. Classic
  2. Classic-Like
  3. Cardiac-valvular
  4. Vascular
  5. Hypermobile
  6. Arthrochalasia
  7. Dermatosparaxis
  8. Kyphoscoliotic
  9. Brittle cornea
  10. Spondylodyplastic
  11. Musculocontractual
  12. Myopathic
  13. Peridontal
60
Q

How is joint hypermobility measured?

A 
With 9-point Beighton score 
Finger
Thumb
Elbow
Knees 
hands to floor locked knees
61
Q

What are the phases of the connective exercise continuum?

A

Inhibit phase
Lengthen phase
Activate phase
Integrate phase

62
Q

During recovery and rehabilitation, an integrated assessment must first be undertaken- why, and what should it include?

A

To determine dysfunction
To design the corrective exercise program
It should include movement assessments, ROM assessments and muscle strength assessments.
This helps to determine which tissues need to be inhibited and lengthened and which need to be activated and strengthened`

63
Q

Describe the Inhibit phase of the corrective exercise continuum

A

The first phase.
Using inhibitory techniques, used to release tension or decrease activity of overactive neuromyofascial tissues in the body
e.g self- myofascial release

64
Q

Describe the Activate phase of the corrective exercise continuum

A

The third phase.
Using activation techniques, which are used to re-educate or increase activation of under-active tissues
e.g. isolated strengthening exercises and positional isometric techniques

65
Q

Describe the Integrate phase of the corrective exercise continuum

A

The fourth phase.
Using integration techniques, which are used to retrain the collective synergistic function of all muscles through functionally progressive movements
e.g. integrated exercise program

66
Q

Describe the Lenghten phase of the corrective exercise continuum

A

Using lengthening techniques which are used to increase extensibility,l length and ROM of neuromyofascial tissues in the body
e.g.static and neuromuscular stretching

Injury & Rehab (2 decks)

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