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Analysis of Human Activity & Occupational Performance II > Week 3 > Flashcards

Week 3 Flashcards

1
Q
  • a disabled employee receives a portion of his or her usual monthly salary during the disability and may receive more for permanent physical injuries, or if he or she has dependents.
  • federal statutes are limited to non-military, federal employees - state statutes - each has its own individual program
A

worker’s compensation

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2
Q

name 4 things that worker’s compensation provides.

A
  • fixed monetary awards for injuries and illnesses
  • medical care and expenses due to the injury/disability
  • funding for job retraining
  • benefits for dependents of workers killed because of work-related accidents or illnesses
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3
Q

form of insurance providing wage replacement and medical benefits in exchange for relinquishing the right to sue the employer for negligence.

A

worker’s comp

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4
Q

misclassifies employees to avoid having to pay a workman’s comp insurance premium

A

fraud by employer

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5
Q

prohibits discrimination on the basis of disability in local programs and activities benefiting from federal financial assistance

A

rehab act of 1973

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6
Q

name 4 “realizations” of veterans/service members.

A
  • psychosocial - PTSD, depression
  • TBI
  • amputation
  • SCI
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7
Q

name 6 problems with returning to work for serviceman/veterans.

A
  • servicemen and women are young
  • many have little or no previous work experience
  • training received in armed services may not be helpful in process of finding employment after disabling condition
  • many want to return to the field
  • considerations regarding pay and benefits
  • now really beginning to see the importance of psychosocial needs, recreation and emotional support - enhance adaptive stress reactions
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8
Q
  • required mainstreaming of children with disabilities into classrooms
  • required the establishment of IEPs
  • early intervention
  • now called individuals with disabilities education act (IDEA)
A

the education for all handicapped children act of 1974

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9
Q
  • injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and spinal discs
  • painful disorder of muscles, tendons, nerves, etc.
A

musculoskeletal disorders (MSD)

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10
Q

work-related musculoskeletal disorders (WMSDs) are conditions in which what 2 things…

A

-work environment and performance of work contribute significantly to the condition
and/or
-condition is made worse or persists longer due to work conditions

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11
Q

___ ___ are the predominant occupational health problem in most industrialized countries.

A

musculoskeletal disorders

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12
Q

how do MSDs occur??

A

overuse, repetitive NOT traumatic

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13
Q

t/f - MSDs can result in loss of productivity.

A

true

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14
Q
  • a class of musculoskeletal disorders in which chronic discomfort, pain, and functional impairment may develop over time resulting from frequent, sustained, and repetitive motions.
  • a group of painful disorders of muscles, tendons, and nerves. work activities which are frequent and repetitive, or activities with awkward postures cause these disorders which may be painful during work or rest
A

work-related MSDs (WRMDs)

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15
Q

what % of reported WRMDs are UE symptoms?

A

20-30%

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16
Q

WRMDs cause more ___ or ___ than any other group of diseases.

A

absenteeism, disability

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17
Q

name 8 risk factors for WRMDs.

A
  • high reps
  • high force
  • awkward postures
  • psychological
  • direct pressure
  • contact pressure
  • vibration
  • prolonged static position
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18
Q

lead to tissue and microtrauma and fatigue

A

repetitions

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19
Q

proportional to the amount of force and duration of the force application

A

fatigue

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20
Q

lead to increased intramuscular pressure, leading to decreased blood flow, leading to muscular energy crisis and pain

A

repetition and force

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21
Q

name 4 aspects of treatment for repetition and force injuries.

A
  • rest
  • splinting
  • anti-inflammatory meds
  • RICE
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22
Q

describe recovery for repetition and force injuries regarding time.

A
  • sufficient time may increase strength of tissue

- insufficient - muscular injury

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23
Q

awkward postures may lead to which 2 things…

A
  • muscular imbalance - weakness, pain, muscular lengthening/shortening
  • reiterative problem
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24
Q

name 4 aspects of treatment for awkward posture injuries.

A
  • ergonomic modifications
  • rest/modalities
  • alternative postures
  • fitness
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25
Q

name 5 components of a job that can lead to psychological distress.

A
  • job repetition, dissatisfaction
  • anxiety
  • depression
  • pain
  • lack of job rotation
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26
Q

describe treatment for psychological job stressors.

A
  • comprehensive approach to treatment required

- goal-directed and education approach gives clients sense of control and relief

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27
Q

incompatibility between volume of PN structure and anatomical space available to nerve

A

nerve compression (entrapment) syndrome

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28
Q

inflammation of tendon and synovial membrane of tendon sheath

A

tendonitis

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29
Q

name 4 tendon-related disorders.

A
  • tenonitis
  • dequervain’s
  • dupuytren’s
  • trigger finger
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30
Q

name 2 nerve-related disorders.

A
  • carpal tunnel

- cubital tunnel

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31
Q

name 3 muscle-related disorders.

A
  • tension neck
  • muscle sprain or strain
  • myalgia
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32
Q

name 2 vascular-related disorders.

A
  • hypothenar hammer syndrome

- raynoud’s

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33
Q

name 1 joint-related disorder.

A

osteoarthritis

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34
Q

name 2 types of tendonitis of the shoulder.

A
  • rotator cuff muscles

- biceps brachii (long head)

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35
Q

name 2 types of tendonitis of the elbow.

A
  • lateral (Extensor) epicondylitis

- medial (Flexor) epicondylitis

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36
Q

what does inflammation and thickening of a tendon indicate?

A

compression of nerve and vascular supply

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37
Q

what do hormone changes indicate?

A

nerve compression

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38
Q

which type of involvement is more involved in nerve compression injuries?

A

sensory more than motor involvement

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39
Q

name 4 symptoms of nerve compression.

A
  • pain
  • tingling
  • numbness
  • weakness
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40
Q

aching and tiredness of limb during work but disappears at night/days off. no reduction of work

A

early symptoms of WMSD

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41
Q

aching and tiredness of limb occurs early in work day, persists at night, reduced capacity for repetitive work

A

intermediate symptoms of WMSD

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42
Q

all symptoms persist at rest, inability to sleep and perform even light duties

A

late symptoms of WMSD

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43
Q

describe the cycle of tendonitis.

A

overuse = micro trauma = swelling, pain, less motion followed by rest, disuse, and weakness

44
Q

the 5 functional grades of CTD go from __ to __.

A

least severe to most severe

45
Q
  • pain after activity, resolves with rest
  • no decrease in amount or speed of work
  • no objective findings
A

Grade 1 - Functional Grades of CTD

46
Q
  • pain while working, resolves with rest
  • productivity mildly affected
  • may have objective findings
A

Grade 2 - Functional Grades of CTD

47
Q
  • pain in 1 or more sites while working
  • pain after activity stops
  • productivity affected, many breaks needed
  • may affect activity outside of work
  • weakness, loss of dexterity, tingling, numbness
  • may have active or latent trigger points
A

Grade 3 - Functional Grades of CTD

48
Q
  • all common uses of hand and UE cause pain 50%-75% of the time
  • may be able to work or work in limited capacity
  • objective findings - weakness, loss of control and dexterity, tingling, numbness, trigger points
A

Grade 4 - Functional Grades of CTD

49
Q
  • loss of ability to use hand/UE due to chronic unrelenting pain
  • usually unable to work
  • symptoms may persist indefinitely
A

Grade 5 - Functional Grades of CTD

50
Q

name 3 general aspects of OT treatment for WRMDs.

A
  • variety of treatment recommendations but no one will work for all patients
  • OT must take active role in investigating relationship between injury and activity
  • OT doesn’t make diagnosis but results of careful eval. will be valued by MD- special tests can assist helping to dx
51
Q

name 6 specific OT treatment methods for WRMDs.

A
  • restriction of movement - RICE
  • application of heat/cold/modalities - US, paraffin, iontophoresis
  • exercise/gentle stretch
  • k tape
  • medication surgery
52
Q

describe phase 1 of OT treatment. (2 aspects)

A
  • symptom control and teach self-management

- gentle ROM/then strengthening-home program - can only begin when symptoms begin to subside

53
Q

which 2 braces/splints are recommended for patients with lateral epicondylitis.

A
  • inelastic, non-articular, proximal forearm strap

- wrist splint

54
Q

describe phase 2 of OT treatment. (3 aspects)

A
  • conditioning - when acceptable strength has returned but endurance is needed, all symptoms resolved
  • ergonomic assessment/recommendations - esp. effective in acute phase
  • return to work - job analysis, physical capacity eval. (PCE)
55
Q
  • person as client
  • OT works with variety of rehab professionals to find suitable employment for injured worker
  • as job options are developed, OT reviews for physical appropriateness, suggests supports and adjustments.
A

vocational model

56
Q
  • OT works as consultant to insurance company
  • follows injured worker through medical and rehab. process
  • coordinates services, stays in communication with worker
  • facilitates progression worker through WC system so that time is not wasted and person returned to work.
A

case management model

57
Q
  • intervention on site includes: occupational health RN, risk manager, MD, supervisor, ergonomist
  • ergonomic training of employees and supervisors, on site evals, prevention of injury
  • screening of new employees to comply with ADA
A

industrial model

58
Q

name the 3 intervention models.

A
  • vocational model
  • case management model
  • industrial model
59
Q

name 4 ways in which OTs can prevent WMSDs.

A
  • job design - mechanization, rotation, enlargement/enrichment, teamwork
  • workplace design
  • tools and equipment design
  • work practices
60
Q
  • objectively measures an injured employee’s capability, not DISABILITY, by identifying safe performance capabilities and comparing them to the job requirements detailed in the job analysis.
  • evaluates an individual’s capacity to perform work activities.
  • and other IADL areas that support work can be evaluated
  • usually measures ability to perform physical demands but can include cognitive demands if warranted
A

functional capacity evaluation (FCE)

61
Q

name the 3 priorities of the FCE.

A
  • patient safety
  • reliability
  • useful measures
62
Q
  • designed to maximize the individual’s ability to return to work
  • interdisciplinary
  • progressively improve the biomechanical, neuromuscular, cardiovascular/metabolic and psychosocial functions
  • transition between acute care and return to work
  • addresses the issues of productivity, safety, physical tolerances, and worker behaviors
A

functional capacity eval. (FCE)

63
Q

name 6 aspects of the OTs role in the FCE for a job.

A
  • determine goals for rehab or readiness for discharge
  • determine if/when person can safely return to work (RTW)
  • determine readiness for work for vocational rehab
  • worker’s compensation case settlement ($$$)
  • determine a person’s ability to meet job demands as part of hiring process
  • results of FCE can also be used to determine ability to meet demands of other activities
64
Q

what are the time requirements for the FCE?

A

usually 2-8 hours

65
Q

name 3 types of people who should be referred for FCE.

A
  • have reached maximum medical benefits and are awaiting case closure.
  • need function quantified prior to RTW
  • have history of subjective complaints but without objective findings
66
Q

the FCE should take place where?

A

within the context of the demands of the job

67
Q

rehab phase of returning a person injured on the job to the workplace

A

work hardening

68
Q

name 5 components of developing a client’s program.

A
  • simulation activities
  • conditioning activities
  • activity
  • education
  • documentation
69
Q

___ ___ are important components of your OT tx session.

A

simulation activities

70
Q
  • may include simple stretching and flexibility exercises
  • vary strengthening, aerobics, etc.
  • encourage client to perform exercises intermittently at the workstation to avoid muscular fatigue and reinjury
A

conditioning activity

71
Q

making a small injury look bigger than it is

A

inflating injury

72
Q

getting injured at home and saying it happened at work

A

remote injury

73
Q

you’re getting better but you’re not saying so

A

malingering injury

74
Q

happened a while ago but reporting it now

A

old injury

75
Q

how does contact pressure occur?

A

while holding tools

76
Q

describe splint laws at work.

A

by law can’t have rigid parts while working - other ones that are less rigid are better

77
Q

what should we use to help classify and specify disorders?

A

special tests

78
Q

regarding nerve compression syndromes, ___ issues are harder to address.

A

sensory

79
Q

attachment of the muscle is where the injury is

A

tendonitis

80
Q

golfer’s elbow

A

medial epicondylitis

81
Q

tennis elbow

A

lateral epicondylitis

82
Q

vascular, caused by vibration of something

A

white finger vibration syndrome

83
Q

used to be used a lot for tendonitis

A

iontophoresis

84
Q

used for elbow injuries - lateral and medial epicondylitis

A

k tape

85
Q

portable form of iontophoresis

A

hybresis

86
Q

come in different sizes, not easy, painful to do the first time even if done correctly, should practice on yourself first before you instruct patients

A

therabar

87
Q

can be done in outpatient with weights, therabands, putty, etc.

A

work conditioning

88
Q

very specific to specific work tasks, how do we have pt. work up to those, how do we simulate in the clinic, true work tasks, getting the person back to what they’re doing

A

work hardening

89
Q

the FCE shows what and not what?

A

shows what the worker is capable of, not what the injury or disability is limiting
capability not disability

90
Q

tool to help simulate work easily, has different attachments

A

baltimore therapeutic exercise (BTE)

91
Q

specialized standardized test that measures work-related skills

A

valpart

92
Q

name 3 reasons why we use ergonomics at workstations.

A
  • to make them safe, comfortable, and productive.
  • to maintain neutral body posture where joints are naturally aligned.
  • to eliminate or reduce stress and strain that leads to the MSD that we as OTs treat.
93
Q

if a workstation is set up properly, a worker may have less… which 5 things?

A
  • eyestrain
  • headaches
  • neck pain
  • back pain
  • tendonitis, bursitis, joint pain - which can all be linked to doing repetitive tasks
94
Q
  • the posture the body assumes in microgravity (weightlessness, or g-force close to zero)
  • adopting any other position while floating assumes muscular effort
  • maintain natural alignment as much as possible - wrist, elbow, cervical, thoracic, and lumbar vertebrae.
A

neutral body posture

95
Q

how is position of rest determined?

A

by passive tendons in opposing muscle groups

96
Q

describe finger position at rest.

A

-at rest, fingers in slightly flexed position and partly spread. small finger is usually most flexed and index finger is least flexed

97
Q

name the 3 principle injury factors for workers who do repetitive tasks.

A
  • working posture
  • repetition rate
  • force application
98
Q

describe why injuries occur regarding wrist position.

A
  • repeated forceful gripping and turning action with wrist in deviated position.
  • gripping actions alone less likely to cause injury if wrist is in neutral
99
Q

describe percentages of grip strength regarding wrist position (5 things).

A
  • neutral = 100%
  • RD - 80%
  • UD - 75%
  • extension - 60%
  • flexion - 45%
100
Q

eliminate working with a deviated wrist by… (name 4 things).

A
  • redesigning hand tools - to offer better grip and more mechanical advantage
  • changing height of work surface or making it adjustable
  • tilting work surface or work pieces towards the worker
  • tilting containers for ease of access
101
Q
  • jobs that remain in these categories fall into high risk category
  • prevalence of musculoskeletal problems increases and these workers become our patients
A

production line workers

102
Q

if you’re unable to change the rate of repetitions, what should you change instead?

A

reduce force (muscle effort)

103
Q

if non-powered tools must be used, to avoid injury we need which 3 things?

A
  • less force
  • less repeated movement
  • less awkward positioning
104
Q

fingers flex around object and clamp it against palm

A

power grip

105
Q

object is held between the tips (pads or sides) of the thumb and one or more fingers

A

precision grip

106
Q

closed kinetic chain - parts of hands used in mechanical opposition to each other, exerting force on the object and holding in place

A

gripping action

Analysis of Human Activity & Occupational Performance II (6 decks)

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