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MSK 1 > 10/25 - Rehab and Return to Sport Following Hip Arthoscopy > Flashcards

10/25 - Rehab and Return to Sport Following Hip Arthoscopy Flashcards

(41 cards)

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1
Q

what does the research say on post-op protocols

A

subjective in nature
- research isn’t great

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2
Q

what are the 4 concepts of post-op rehab

A
  1. provide environment to optimize healing
  2. initiate early/controlled ROM as an early approach to restore mobility
  3. restore neuromuscular control
  4. restore LE and lumbopelvic strength
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3
Q

what ab surgical procedures is a predictor of future fx

A

the more aggressively shaved down bone (like in CAM lesion) can inc risk of future fx

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4
Q

what should be avoided in femoroplasties

A

avoid spontaneous femoral neck fx

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5
Q

what should be limited with labral repairs

A

limited wt bearing x4wks

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6
Q

what is the main protocol w microfx

A

longer protection to encourage fibrocartilage healing response

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7
Q

expected timeline after a hip arthroscopy

A

phase 1: immediate rehab
- protection of healing structures & mobility

phase 2: intermediate rehab
- normalize gait
- initiate CKC activity

phase 3: advanced rehab
- strengthening

phase 4: sport specific training
- functional training

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8
Q

what are 5 goals of rehab in the immediate post-op phase

A
  1. minimize pain & inflammation
  2. protect surgical site
  3. compliance w HEP & precautions
  4. normal gait w AD and appropriate WB
  5. patient ed
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9
Q

what are 5 precautions in the immediate post-op phase

A
  1. no pivoting/rotating hip when amb
  2. avoid sx provocation during ADLs and ther-ex
  3. no active SLR / no hyper-ext
  4. protective WBing (typically 20% for 3-6wks)
  5. limit ER to 30deg w capsular shift
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10
Q

what are ROM interventions in the immediate postop phase (6)

A
  1. circumduction (reduce incidence of post-op intra-articular adhesions)
  2. flexion (0-90deg immediately)
  3. stationary bike (high seat <90deg hip flex, low resistance, upright posture)
  4. incision site scar mobility
  5. quadruped hip flex - moving back into child’s pose (partially loaded, pt controlled)
  6. stool rotations (active hip rotation, joint loading)
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11
Q

what strengthening treatment interventions are done in immediate post-op phase of rehab

A

transversus abdominus

isometrics
- quad set
- ABD/ADD
- glut squeeze
- prone heel squeezes

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12
Q

why are isometrics used to strengthen in the immediate post op phase of rehab

A

NO HIP FLEX
avoid challenging ant capsule
- hip flex, ext, ER, SLR

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13
Q

what is 5 milestones to progress to intermediate post-op phase of rehab

A
  1. 90deg hip flex w/o inc pain
  2. 10deg hip ext
  3. min pain at rest
  4. tolerates 10-15min of stationary bike
  5. normal gait w AD
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14
Q

what are 6 goals of intermediate post-op phase of rehab

A
  1. normal gait w/o AD
  2. restore full ROM
  3. no pain w ADLs
  4. protect hip flex
  5. NM control
  6. good lumbopelvic stability
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15
Q

what are 3 precautions in intermediate post-op phase of rehab

A
  1. AD until non-antalgic gait
  2. avoid sx provocation during ADLs and ther-ex
  3. avoid hip flex if sx
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16
Q

what are 3 interventions in the intermediate post-op phase of rehab

A
  1. joint mobs prn (6-8wks)
  2. CKC strengthening
    - hip hike, sumo walk, windmills
    - glut activation (ie bridging), min hip flex & TFL
  3. double limb -> SLS balance
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17
Q

what are 3 milestones to progress from intermediate to advanced post-op phase

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A
  1. full ROM
  2. normal gait w/o AD
  3. good pelvic control during SLS
18
Q

what are 5 goals of the advanced post-op phase of rehab

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A
  1. (I) w HEP & gym program
  2. full ROM (symmetrical)
  3. pain-free ADLs
  4. return to non-labor occupational duties
  5. good dynamic balance
19
Q

what are 2 precautions in the advanced post-op phase of rehab

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A
  1. sx provocation
  2. quality of movements and avoiding compensation is key w all activity
20
Q

what are 2 interventions introduced in the advanced post-op phase of rehab

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A
  1. progress lumbopelvic/core exercises
  2. initiate plyometrices
    - jumping on leg press -» then move to hopping
21
Q

what are 5 milestones to progress from advanced to sport specific training phase

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A
  1. hip/pelvic strength >80% of opposite limb
  2. ROM appropriate for work/sport demands
  3. lumbopelvic control w single leg activities
  4. good dynamic balance (30’’ SLS x3)
  5. cont amb >10min
22
Q

what are 2 goals of sport specific training

Study These Flashcards
A

(I) w HEP and gym program
min post-exercise reactivity

23
Q

what are 2 precautions w sport specific training

Study These Flashcards
A
  1. sx provocation
  2. maintain adequate strength for work / sport activity
24
Q

what are 5 interventions implemented in sport specific training

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A
  1. maintain strength and flexibility
  2. advanced plyometrics
  3. initiate running program
  4. dynamic balance activities
  5. agility drills
    - challenging positions & also for endurance
25
what are 4 return to sport criteria
1. cleared by MD 2. full ROM, strength (pain-free) 3. complete functional testing 4. sport-specific drills at full speed (pain-free)
26
what role does psychological readiness play in return to sport
likelihood of reinjury significantly higher in less psychologically ready - if don't feel ready, lot of apprehension
27
what are 7 qualities to consider when determining return to sport capability
1. impairment info 2. subjective/self report 3. hop testing 4. balance 5. agility 6. power 7. psychological readiness
28
what are outcome measures that can be used for return to sport
1. LE functional scale 2. hip outcome score 3. U of Wis Running Injury and Recovery Index
29
what are balance assessments that can be used (2)
1. star excursion balance test (SEBT) 2. Y balance test
30
star excursion balance test vs Y balance test assessments
star: - strength - flexibility - proprioception Y - ant, post-med, post lat
31
what are 2 types of strength tests for return to sport
drop jump hop testing
32
what are functional tests (4)
single leg squats lateral agility forward running backward running
33
in single leg squats, what are we looking for to consider it a pass (5)
30-60deg knee flex no knee valgus no locking knee no knee past toes upright trunk
34
in lateral agility of hopping side to side, what are we looking for to consider it a pass (5)
knee flex >30deg no knee valgus in landing boundaries <1'' landing phase upright trunk
35
what is a key quality that functional testing assesses
endurance
36
in forward and backward running running, what are we looking for to consider it a pass (6)
30-60deg knee flex in landing boundaries no knee valgus no locking knee <1'' landing phase upright trunk
37
what does a trendelenburg compensation indicate in functional testing
poor endurance
38
what are 2 agility and speed tests
T-test illinois
39
what do agility and speed tests require and what do we look for
rapid changes of direction look for if they are able to plant and change direction - or do they shift to stronger side to change direction
40
what is important in considering what clinical/functional tests are most beneficial in which patients
correlate individual demands of sport for each pt to a sound test
41
what should be considered when determining the interventions (5)
quality of tissue phase of healing baseline strength what ms should be activated what ms activation should be minimized

MSK 1 (31 decks)

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