PT504 E1

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Author:
Jstory
ID:
172579
Filename:
PT504 E1
Updated:
2012-09-22 20:37:07
Tags:
Principals Guidelines Musculoskeletal Rehabilitation
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EXAM 1
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  1. Early Inflammation: INTERVENTION
    • Goal: limt/curtail inflammatory response, treat pain, effusion, immobilization.
    • 1. control pain and swelling
    • 2. Injury protection
    • 3. modalities and meds
    • 4. gentle soft tissue mobz, to reduce pain, guarding, edema
    • 5. Gentle passive movements
    • 6. CMP w/in pain fre raing; no stretching
    • 7. posssible Grade 1 oscillatory techniques
    • 8. muscle setting
    • 9. no pain or inflammation
  2. Intermediat stage of Inflammation: Characteristics
    • Sub Acute: 4-14 days Repair & Healing
    • 1. removal of noxious stimuli
    • 2. growth of capillary beds into area
    • 3. collagen proliferation
    • 4. muscle strenght is decreased 2nd to immobilization, inhibited by pain & joint effusion leading to atrophy. 
  3. Intermediate stage of Inflammation: Clinical Signs
    • 1. Decrease inflammation
    • 2. Pain- intermittent, felt during movement, synchornous w/ motion barrier, porximal -> distal w/ repeated movements. 
    • 3. Motion Barrier: Muscular (fast-slow garding)
  4. Intermediate stage of Inflammation: Intervention
    • 1. Pain contorl: meds as needed
    • 2. gentle movement (low grade mobz 1-2)
    • 3. AROM/PROM in pain free range
  5. Intermediate stages of Inflammation: Inert Tissues
    no stretching of joint capsule if effusion is present. 

    can begin gnetle capsular stretching and joint mobz. 
  6. Intermediate stages of Inflammation: Contractile Tissue
    • 1. begin isometric resistance exercises
    • 2. begin gentle stretching techniques
    • 3. gentle transverse friction massage
    • 4. Muscle Tears: develope mobile scar and parallel alignment of CT
    • 5. Tendon Lesions: promote parallel alignment of collagen fibers. 
  7. Intermediate stages of Inflammation: Precautions
    some discomfot will occur w/ exercise during this stage, but it should not alst longer than couple hours
  8. Intermediate stages of Inflammation: Signs and Symptoms of Excessive Activivty
    • 1. prolonged pain
    • 2. pain with rest
    • 3. increse in swelling, heat, stiffness, or weakness
    • 4. muscle guarding
    • *Activitiy levle must be decreased if these signs occur. 
  9. Late stages of Inflammation: Characteristics
    • Chornic: 14-21 days until there is pain free functional use; Maturation and Remodeling.
    • 1. maturation of CT
    • 2. contracture of scar tissue
    • 3. appropriate stressin of collagen = parallel fibe alingment and improved proliferation of elastin. 
  10. Late stages of Inflammation: Clinical Signs
    1. absense of inflammatory signs & symptoms
  11. Late stages of Inflammation: Pain
    • 1. not severe
    • 2. proximal location
    • 3. only felt w/ forceful movements
    • 4. felt after motoin barrier (overpressure)
  12. Late stages of Inflammation: Motion Barrier
    Capsular
  13. Late stages of Inflammation: Intervention
    • 1. vigorous soft tissue, joint mobz (grades 3-4), stretcheing 
    • 2. decreased ROM: isometirc exercises at various ranges to maintain/imporve strength
    • 3. adequate ROM: progressive strengthening, endurance, and functional exercises
  14. Late stages of Inflammation: Inert Tissue
    vigorous capsular stretching and joint mobz if joint play is restricted and no effusion
  15. Late stages of Inflammation: Contractile Tissues
    Dynamic Resistance exercisese (eccentric): Parallel scar tissue increase tensile strength, and increases PSCA which results in decreased stress on injury site. 

    Functional Retraining 
  16. Maitland describes the irritability of a disorder as: 
    • 1. its susceptibility to becom painful
    • 2. how painful it becomes
    • 3. the lenght of time this pain takes to recover
  17. PROM: High Irritability/Reactivity
    • 1. Pain b4 motin barrier. 
    • 2. empty or muscular end feel (fast guarding)
  18. PROM: Moderate Irritability / Reactivity
    • 1. pain synchronous with motion barrier
    • 2. muscualr end feel ( fast-slow guarding) 
  19. PROM: Low Irritability/Reactivity
    • 1. pain felt after motion barrier (overpressure)
    • 2. capsular (firm) end feel

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