Week 1 Treatment Goals Flashcards
T or F, scar tissue is elastic
F it is Inelastic
Hypertrophic scar vs Keloid scar
A hypertrophic is raised within the boundaries of the injured site
A keloid scar extends beyond the boundary of the injured site
How can you limit Collagen synthesis at an injury site (to prevent scar tissue)
Applies prolonged pressure which limits O2 available
(scar tissue requires O2 to form)
Apply pressure garmets
When is it appropriate to apply compression to prevent scar tissue formation
Any time the scar tissue is still reddened but blanches with tension
How does chronic inflammation occur
Either due to immune response or due to repeated stress/trauma
Chronic low grade inflammation increases production of __________ and degradation of __________
immature collagen
normal mature collagen
Intrinstic vs Extrinsic healing factors
Identify the following:
Age
Education
Medical Complications
Home environment
Work Environment
Intrinsic- Age, Education, Medical Complications
Extrinsic - Home and Work environment
What is the best modaility for chronic inflammation
exercise
What is the definition of disability
Outcome or result of complex relationship between persons health condition and personal factors, and the external factors in their life
What deals more with anatomical abnormality or loss:
Pathology
Impairment
Functional Limitation
Disability
Impairment
What deals more with the limitationof preformance at the level of the person?
Pathology
Impairment
Functional Limitation
Disability
Functional Limitation
What deals with the limitations in performance of socially defined roles
Pathology
Impairment
Functional Limitation
Disability
Disability
What deals with a interuption of normal body processes
Pathology
Impairment
Functional Limitation
Disability
Pathology
Modalities are usually used to treat which level of disablement
Pathology
Impairment
Functional Limitation
Disability
Impairment
Which phase typically has pain with normal range of motion and overpressure?
Acute
Subacute
Chronic
Acute
Which phase typically has no pain with normal ROM, but pain with overpressure
Acute
Subacute
Chronic
Early subacute
What phase typically has pain with only the last part of overpressure
Acute
Subacute
Chronic
late subacute or chronic
What are the clinical signs of the acute stage?
What is the aim managing of the acute stage?
Clinical signs: Inflammation, Pain at rest
Aim: Reduce inflammation, Protect injury
Which massage techniques are appropriate for the acute stage?
Superficial and deep efflurage
Petrissage
What are 3 guidelines for managing the acute stage
Patient education
Protection of injured site
Prevent the adverse affects of immobilization
How long should a patient immobilize, ice, rest in and elevate in the first part of the acute stage?
24-48 hours
When is cryotherapy appriopriate on an acute injury?
first 24-48 hours, reduce pain and swelling
combine with compression
How can e-stim help an acute injury
Reduce pain and swelling
alter cell permeabiliy
When massaging a muscle during the acute stage, what position should it be in?
Shortened
lengthened
Stretched
Shortened so as not to separate the healing area
How can grade 1 and grad 2 joint mobilization help an acute injury
improve fluid dynamics
maintain cartilage health
inhibit pain
What kind of exercise is indicated during the acute stage
What is contraindicated
PROM within the limit of pain is indicated
AROM is contraindicated
T or F: you can still use AROM and resistive exercise for uninjured bodyparts during the acute stage
T
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
What is the expected time frame of the subacute phase
21 days to 6 weeks
Should you use cold or heat on a subacute njury?
Heat in order to promote circulation
however, use swelling as a precautionary indicator
What massage techniques can you use in the subacute phase?
All
What do you use cross friction massage for?
mobilizing ligaments, incision sites, tendon adhesions, or muscle scar tissue
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
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
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
What are the goals of managing the chronic stage?
Return to function
Develop functional independence
Work-hardening practice
What are the clinical signs of the chronic stage?
Absence of inflammation
pain in tissue only after resistance applied
What are the benefits of using deep heat for the chronic phase
increase circulation to deeper tissues, reduce pain, promote healing, increase tissue extensibility
Should you use heat in any stage if the tissue is swollen?
no
How can e-stim help in the chronic stage?
Stimulate muscle contraction/increase ROM and strength
promote neuromuscular control
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
Effects of heat as a modality on:
Metabolic rate
circulation
pain
muscle spasm
Increased metabolic rate
increase circulation
modulate pain
reduce muscle spasm
Effects of cold as a modality on:
Metabolic rate?
Edema?
Pain?
Muscle spasm?
Decreased metabolic rate
decreased edema
modulate pain
reduce muscle spasm
Effects of ultrasound as a modality:
Increase metabolism
Increase circulation
increase cell wall permiability
soften collagen
selectively heat tissue
Effects of BFR:
Increase muscle activation
Decrease circulation
increase hypertrophy
Increase muscle cross sectional area
