quiz #2- general treatment guidelines
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quiz #2- general treatment guidelines
How is the severity of tissue injury measured?
What are the characteristics of a Grade I tissue injury?
mild pain at time of injury or within 24 hours
mild swelling, local tenderness, and pain when tissue is stressed
What are the characteristics of Grade II tissue injuries?
moderate pain that requires stopping of activity
stress and palpation increases pain
for ligaments, some fibers torn with increased joint mobility
What are the characteristics of Grade III tissue injuries?
near complete or complete tear or avulsion with severe pain
stress to tissue is painless
if ligament then instable
What are the three stages of healing?
What are characteristics of the acute stage of healing?
exudation of cells and chemicals
early fibroblastic activity
What is a clinical sign of the acute stage of healing?
What are the goals during the acute stage of healing?
control inflammation and pain
decrease muscle guarding
maintain function of uninvolved areas
What are common treatment tactics during the acute stage of healing?
intermittent muscle setting
PROM within pain free ROM and outside plane of injury
massage with caution
modalities to decrease pain and swelling
gentle joint play
What is a precaution and contraindication during the acute stage of healing?
: no movement should increase pain or inflammation
: active movements at point of pathology
What are characteristics of the subacute stage of healing?
removal of noxious stimuli
growth of capillary beds into area
very fragile so easy to injure
What are clinical signs of the subacute stage of healing?
pain synchronus with tissue resistance
What are the goals of treatment for the subacute stage of healing?
decrease pain and guarding
increase ROM and strength
promote a functional, mobile scar
What are the treatment methods in the subacute stage of healing?
decrease support from assistive devices
progress from low intensity --> sub-max isometrics at one angle --> sub max isometrics at multiple angles --> max isometrics at 1 angle --> max isometrics at multiple angles
progress from no motion -->short arc --> full ROM (then add mild resistance)
progressively lengthen injured tissue
joint mobilization with pain limits
deep friction massage
What are precautions during the subacute stage of healing?
What are signs and symptoms of over activity?
loss of strength
increased swelling or inflammation
What are characteristics of the chronic stage of healing?
maturation of connective tissue
contracture of scar tissue
remodeling of scar
collagens aligns to stress
WHat are clinical signs of the chronic stage of healing?
absence of inflammation
pain after tissue resistance
function limited by muscle weakness, poor endurance or poor neuromuscular control
can last 6-12 months
What are the goals of the chronic stage of healing?
increase strength and motion
normal muscle balance
return to full function
What are the treatment methods for the chronic stage of healing?
mobilize any adhesions
aggresive stretching and mobilizations
continue strength training
What are indications for musculoskeletal surgery?
acutre traumatic rupture of muscle, tendon, ligament, cartilage
severe chronic joint destruction from RA, OA, or arthritis
correction of congenital or idiopathic defect
What are some adverse effects of surgery?
intubation and anesthesia
risk for pulmonary infection
post-op infection or vascular disorders (DVT, PE)
delayed healing of soft tissue and bone
adhesions and contractures of soft tissue and joints
What are some post-op problems?
increased risk for pulmonary or circulatory problems
increased risk for joint stiffness or loss of motion
increased risk of muscle atrophy
loss of strength and mobility
What are some general guidelines for the healing process?
respect healing process
go from submax to max
no motion --> mid range --> full ROM
want to overload, NOT overwhelm