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Week 1 Treatment Goals Flashcards

1
Q

T or F, scar tissue is elastic

A

F it is Inelastic

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2
Q

Hypertrophic scar vs Keloid scar

A

A hypertrophic is raised within the boundaries of the injured site

A keloid scar extends beyond the boundary of the injured site

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3
Q

How can you limit Collagen synthesis at an injury site (to prevent scar tissue)

A

Applies prolonged pressure which limits O2 available

(scar tissue requires O2 to form)

Apply pressure garmets

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4
Q

When is it appropriate to apply compression to prevent scar tissue formation

A

Any time the scar tissue is still reddened but blanches with tension

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5
Q

How does chronic inflammation occur

A

Either due to immune response or due to repeated stress/trauma

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6
Q

Chronic low grade inflammation increases production of __________ and degradation of __________

A

immature collagen

normal mature collagen

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7
Q

Intrinstic vs Extrinsic healing factors

Identify the following:

Age

Education

Medical Complications

Home environment

Work Environment

A

Intrinsic- Age, Education, Medical Complications

Extrinsic - Home and Work environment

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8
Q

What is the best modaility for chronic inflammation

A

exercise

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9
Q

What is the definition of disability

A

Outcome or result of complex relationship between persons health condition and personal factors, and the external factors in their life

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10
Q

What deals more with anatomical abnormality or loss:

Pathology

Impairment

Functional Limitation

Disability

A

Impairment

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11
Q

What deals more with the limitationof preformance at the level of the person?

Pathology

Impairment

Functional Limitation

Disability

A

Functional Limitation

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12
Q

What deals with the limitations in performance of socially defined roles

Pathology

Impairment

Functional Limitation

Disability

A

Disability

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13
Q

What deals with a interuption of normal body processes

Pathology

Impairment

Functional Limitation

Disability

A

Pathology

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14
Q

Modalities are usually used to treat which level of disablement

Pathology

Impairment

Functional Limitation

Disability

A

Impairment

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15
Q

Which phase typically has pain with normal range of motion and overpressure?

Acute

Subacute

Chronic

A

Acute

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16
Q

Which phase typically has no pain with normal ROM, but pain with overpressure

Acute

Subacute

Chronic

A

Early subacute

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17
Q

What phase typically has pain with only the last part of overpressure

Acute

Subacute

Chronic

A

late subacute or chronic

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18
Q

What are the clinical signs of the acute stage?

What is the aim managing of the acute stage?

A

Clinical signs: Inflammation, Pain at rest

Aim: Reduce inflammation, Protect injury

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19
Q

Which massage techniques are appropriate for the acute stage?

A

Superficial and deep efflurage

Petrissage

20
Q

What are 3 guidelines for managing the acute stage

A

Patient education

Protection of injured site

Prevent the adverse affects of immobilization

21
Q

How long should a patient immobilize, ice, rest in and elevate in the first part of the acute stage?

A

24-48 hours

22
Q

When is cryotherapy appriopriate on an acute injury?

A

first 24-48 hours, reduce pain and swelling

combine with compression

23
Q

How can e-stim help an acute injury

A

Reduce pain and swelling

alter cell permeabiliy

24
Q

When massaging a muscle during the acute stage, what position should it be in?

Shortened

lengthened

Stretched

A

Shortened so as not to separate the healing area

25
How can grade 1 and grad 2 joint mobilization help an acute injury
improve fluid dynamics maintain cartilage health inhibit pain
26
What kind of exercise is indicated during the acute stage What is contraindicated
PROM within the limit of pain is indicated AROM is contraindicated
27
T or F: you can still use AROM and resistive exercise for uninjured bodyparts during the acute stage
T
28
What are the goals for managing the subacute stage?
Decrease inflammation Promote healing Develop mobile scar tissue Promote function and non-destructive AROM Carefully progress to resistive exercise
29
What is the expected time frame of the subacute phase
21 days to 6 weeks
30
Should you use cold or heat on a subacute njury?
Heat in order to promote circulation however, use swelling as a precautionary indicator
31
What massage techniques can you use in the subacute phase?
All
32
What do you use cross friction massage for?
mobilizing ligaments, incision sites, tendon adhesions, or muscle scar tissue
33
4 kinds of exercises in subacute stage
Multiple angle submaximal isometrics AROM Muscle endurance (slow twitch fiber training) w/ low intensity Protected weight bearing exercises
34
How to initiate and progress stretching during the subacute phase?
**Warm** the tissue first -> use muscle **relaxation** technques (hold relax)/(contract relax) for inhibition -> Use **stretching** techniques -> **Use new ROM** in an exercise to maintain this new ROM
35
Signs of excessive stress w/ exercise
Soreness doesn't decrease after 4 hours soreness is not relieved after 24 hours Progressive increased feelings of stiffness/decreasing ROM Swelling/redness increasing progressive weakness decreased functional usage of involved body part
36
What are the goals of managing the chronic stage?
Return to function Develop functional independence Work-hardening practice
37
What are the clinical signs of the chronic stage?
Absence of inflammation pain in tissue only after resistance applied
38
39
What are the benefits of using deep heat for the chronic phase
increase circulation to deeper tissues, reduce pain, promote healing, increase tissue extensibility
40
Should you use heat in any stage if the tissue is swollen?
no
41
How can e-stim help in the chronic stage?
Stimulate muscle contraction/increase ROM and strength promote neuromuscular control
42
Exercise progression for chronic stage
**Submaximal to maximal** exercises focus on normal muscle **strength and flexibility** resistive **concentric** to **eccentric** progressive trunk stability/ postural control/ **balance** teach **safe body mechanics** and use activities that replicate their work environment
43
Effects of heat as a modality on: Metabolic rate circulation pain muscle spasm
Increased metabolic rate increase circulation modulate pain reduce muscle spasm
44
Effects of cold as a modality on: Metabolic rate? Edema? Pain? Muscle spasm?
Decreased metabolic rate decreased edema modulate pain reduce muscle spasm
45
Effects of ultrasound as a modality:
Increase metabolism Increase circulation increase cell wall permiability soften collagen selectively heat tissue
46
Effects of BFR:
Increase muscle activation Decrease circulation increase hypertrophy Increase muscle cross sectional area

Ther-ex (11 decks)

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