Week 7 (ROM Impairments) Flashcards
1
Q
Reasons for reduced AROM
A
- Neurally mediated: spasticity
- Non-neurally mediated: changes in muscle tendon unit structure
- Joint stiffness: secondary to OA or injury
- Pain, muscle guarding, fear
- Weakness: inability to move through ROM but it is available
- Swelling and scarring: secondary to burns, surgeries
2
Q
Reasons for reduced PROM
A
- Neural component (neurological disorders): spasticity
- Non-neural: structural changes in muscle tendon unit
- Muscle/tendon and/or other joint soft tissues: post-immobilisation for fracture
3
Q
Results of reduced ROM
A
- Interfere with ADL, function, physical performance
- Interfere with self-care/hygiene
- Pain
- Pressure areas
- Visual deformity
4
Q
Stretching methods
A
- Ballistic
- Dynamic
- Active
- Passive
- Static
- Isometric
- PNF
- Dynamic splint
- Functional limb positioning
- Serial casting
5
Q
Evidence on ROM
A
- Immediate increases in joint ROM
- Moderate evidence for no worthwhile short term or long-term effects of stretching in neurological patients
- Weak/variable evidence of small or no effect in other conditions
- Any effects may be due to reduced sensitivity to stretch
- No long-term studies (most 4-8 weeks)
6
Q
What to do when research evidence is contradictory to clinical observations?
A
- Clinical observations are biased
- Trials can be biased and flawed
- Not the same treatment/patient/outcomes
- Costs and harm of the intervention
7
Q
Stretching principles
A
- Patient generated/independent
- Frequent 5-6 times/week
- Total time/week more important than hold time or session time
- Patient/muscle relaxed
- Use any new range actively - functional integration
- Move attachments away from each other
- Stretch the right tissue; hamstrings vs knee extension
8
Q
Treatment of rotator cuff tear
A
Look at strengthening to remove range issues
9
Q
Treatment of frozen shoulder
A
Need to do stretching because joint issue
10
Q
Treatment of neurological condition
A
Treatment by botox to reduce stiffness and tone
11
Q
Treatment of post-surgical scar from TKR
A
No stretching right away if acute: ice, elevation, compression and heat
