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Musculo > Bae's Last Lecture 8/9 (10-1/6) > Flashcards

Bae's Last Lecture 8/9 (10-1/6) Flashcards

1
Q

What does a grade 1 mean for non thrust

A

barely touching the skin and small amplitude

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2
Q

What does a grade 1 non thrust do

A

stimulates mechanoreceptors and inhibit nocioceptors

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3
Q

What does a grade 2 mean for non thrust

A

Starting to feel something is happening and large amplitude

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4
Q

What does a grade 2 non thrust do

A

Takes patient to point of first resistance

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5
Q

What does a grade 3 mean for non thrust

A

Some tissue resistance and large amplitude

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6
Q

What does a grade 3 non thrust do

A

Takes patient past point of first resistance making some sort of impact on mobility

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7
Q

What does a grade 4 mean for non thrust

A

End range pushing into barrier and small amplitude

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8
Q

What does a grad 4 non thrust do

A

Brings patient to second resistance (end range)

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9
Q

How long do you do grade 1 and 2 non thrusts for

A

60 seconds

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10
Q

How long do you do grade 3 and 4 non thrusts for

A

3-5 minutes

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11
Q

What are something you can do with a patient in the inflammatory stage (3)

A
  1. Gentle sub maximal isometrics
  2. Retrograde massage
  3. Maintain function where/if appropriate
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12
Q

What is the purpose of gentle sub maximal isometrics (2)

A
  1. Increase blood flow

2. Maintenance of strength

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13
Q

True or False:

Gentle sub maximal isometrics are usually not pain free or comfortable

A

True

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14
Q

What is the purpose of retrograde massage

A

Trying to work fluid back towards the heart

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15
Q

What are the goals of the proliferation phase (4)

A
  1. Promote tissue growth
  2. Continue protection as needed
  3. Encourage safe controlled mobility
  4. Progress to more active rehab
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16
Q

What is the general intervention principle of the proliferation phase

A

Do interventions that are safe and progress tissue loading

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17
Q

What should you educate the patient about during the proliferation phase (3)

A
  1. Signs of inflammation
  2. Tell them exactly what they can’t do
  3. Sometimes you have to inform other people of what to do
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18
Q

What does often mean during the proliferation phase

A

Too much too soon

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19
Q

What does maybe mean during the proliferation phase

A

Not enough too late

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20
Q

What are things that should be done during the proliferation phase (4)

A
  1. AROM
  2. Multiangle sub maximal isometrics
  3. Muscle endurance
  4. Initiation and progression of stretching
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21
Q

Where should AROM be done during the proliferation phase

A

Within available pain free ROM

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22
Q

What do multiangle sub maximal isometrics do

A

Initiate muscular control and strengthening

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23
Q

What muscle fibers are first to atrophy

A

Slow twitch

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24
Q

What are 2 ways to initiate and progress stretching

A
  1. PNF inhibition techniques

2. Joint mobilization

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25
What does PNF stand for
Proprioceptive neuromuscular facilitation
26
How do you improve endurance during the proliferation phase
Low load and cyclic loading for extended periods of time
27
What are the goals of the maturation phase (2)
1. Progress functional activities | 2. Continue tissue reorganization
28
How long does it take collagen to rearrange completely
12-18 months
29
What are the general intervention principles of the maturation phase (3)
1. Prepare to return to full ADLs 2. Secondary prevention 3. Complete D/C plan
30
What are 2 types of secondary prevention
1. Maintenance exercise plan | 2. Lifestyle alteration
31
Activities/therapeutic exercise should not have persistent discomfort beyond how long
4-24 hours
32
What is a key thing to look for during the maturation phase
Signs of inflammation returning
33
What is chronic inflammation
A chemical process
34
What causes repetitive microtrauma and/or strain overload
Not giving the tissue a break
35
What are 3 types of inflammation that can perpetuate
1. Chronic inflammation 2. Repeated microtrauma 3. Repeated strain overload
36
What should you do with the 3 perpetuated types of inflammation
Treat them as if they were in the inflammatory stage of healing
37
Why would the inflammatory process perpetuate (10)
1. Muscle length and strength imbalances 2. Rapid or excessive repeated eccentric demand 3. Muscle weakness 4. Bone misalignment or weak structural support 5. Change in usual intensities or demands 6. Return to activity too soon 7. Sustained poor posture or motion 8. Environmental factors 9. Age related 10. Training errors
38
What are 4 typical musculoskeletal impairments of body structure
1. Impaired joint mobility 2. Impaired muscle performance 3. Tissue reactivity 4. Impaired motor performance
39
What are 3 causes of impaired joint mobility
1. Inextensible capsule/ligament 2. Inflexible muscle 3. Excessive laxity of capsule or ligament
40
What are 3 types of impaired muscle performance
1. Strength (decreased force magnitude 2. Endurace (decreased force duration) 3. Hypertonicity (elevated resting tone)
41
What are 2 types of tissue reactivity
1. Compression load intolerance | 2. Tension load intolerance
42
What are the 2 types of direct interventions PT can do with patients with musculoskeletal dysfunction
1. Add cyclic biomechanical load | 2. Remove biomechanical laod
43
What are the 2 reactive tissue load intolerance questions
1. Was the premorbid tissue "normal" | 2. Were the premorbid biomechanical loads "normal"
44
What do you look at to determine if the premorbid tissue was "normal" (3)
1. Length abnormality 2. Contractile abnormality 3. Infrastructure abnormality
45
What are examples of length abnormalities (2)
1. Inelastic | 2. Inflexible
46
What are examples of contractile abnormalities (2)
1. Strength | 2. Endurance
47
What are examples of infrastructure abnormalities (3)
1. Degeneration 2. Osteoporosis 3. Post immobilization
48
What do you look at to determine if the premorbid loads were "normal" (3)
1. Excessive intensity 2. Excessive frequency 3. Excessive duration
49
What type of tissue load intolerance is more severe in nature
Premorbid tissue: abnormal | Premorbid biomechanical loads: abnormal
50
What type of tissue load intolerance is some degenerative changes, older patient, integrity of tissue is abnormal making normal load more difficult
Premorbid tissue: abnormal | Premorbid biomechanical loads: normal
51
What type of tissue load intolerance is some one who helped you move in or weekend warriors
Premorbid tissue: normal | Premorbid biomechanical loads: abnormal
52
What type of tissue load intolerance is healthy people, not patient, potential clients
Premorbid tissue: normal | Premorbid biomechanical loads: normal
53
True or False: | there is a window of appropriate cyclic loading
True
54
What is the stress shield
"elastic" activity tissue
55
What happens when you exceed the physiologic limit
Tissue disruption
56
True or False: | It is ok to exceed the physiolgic limit as long as it doesn't can any damage
False
57
What are the parameters for working on strength
6-12 reps | 3-5 sets
58
What are the parameters for working on endurance
20-30 reps | 3-5 sets
59
What are the parameters for working on tendons
30-40 reps | 3-5 sets
60
What are the parameters for working on ligaments
1000s of reps
61
What are the parameters for working on cartilage
Hours of reps
62
What is the window of where you are confident you won't make the patient worse
Clinical confidence interval
63
What does the top of the box represent
The threshold of making the patient worse
64
What does the bottom of the box represent
Not make them worse or better
65
What happens if you don't get into the box
The patient gets better but not as quickly
66
What happens if you do not impart enough stress
No change in patients functional levels
67
What happens if you push the patient too hard
They may get better for a bit but after a while they will get worse
68
True or False: | You should treat the impairments and treat the activities they are having trouble with
True
69
What do you do if gravity is too much for the patient to do the motion (4)
1. Manual assist 2. Change patient position 3. Water buoyancy 4. Counterweight and pulley

Musculo (18 decks)

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