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COTA Musculoskeletal Dx and Biomechanical Interventions > Biomechanical Approach > Flashcards

Biomechanical Approach Flashcards

1
Q

Proprioception

A

knowing where your body is in space without looking, needed for smooth coordinated movements

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2
Q

Stereognosis

A

identifying an object with touch only, vision occluded

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3
Q

Kinesthesia

A

awareness of the position and movement (direction; how fast; force) of the parts of the body by means of sensory organs (proprioceptors) in the muscles and joints

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4
Q

Figure-Ground

A

screening out other things around to pick one object

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5
Q

Biomechanical Practice Model

A

applied to people with LROM, decreased muscle strength and/or endurance, intact CNS

Focus is on performance skills in motor and sensory areas and regaining skills in areas of occupation

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6
Q

Biomechanical Treatment

A

Prevention and maintenance- body mechanics, joint protection techniques, splints, positioning.

Restoration-increase ROM, muscle strength, endurance and stability.

Compensation

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7
Q

Manual Muscle Testing Scores

A

0: None

1,Trace: No motion, palpable/visible contraction

2-,Poor-: < full ROM, gravity eliminated

2,Poor: Full ROM, gravity eliminated

2+,Poor+: Full ROM, gravity eliminated, Min resist

3-,Fair-: < full ROM, agnst gravity

3,Fair: Full ROM, agnst gravity

3+, Fair+: Full ROM, agnst gravity, Min resist

4,Good: Full ROM, agnst gravity, Mod resist

5,Norm: Full ROM, agnst gravity, Max resist

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8
Q

Shoulder Flexion/Extension

A

flx 0-180 ext 0-40 to 60

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9
Q

Shoulder ABD/ADD

A

ABD 0-180 ADD 180-0

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10
Q

Shoulder Horizontal ABD/ADD

A

Horiz ABD 0-45 Horiz ADD 0-90

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11
Q

Shoulder Internal/External Rotation

A

0-90 both

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12
Q

Elbow Flexion/Extension

A

FLX 0- 135-150 EXT 0

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13
Q

Forearm Supination/Pronation

A

SUP 0-90 PRO 0-90

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14
Q

Wrist Flexion/Extension

A

FLX 0-90 EXT 0-70

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15
Q

Ulnar/Radial Deviation

A

ULN 0-35 RAD 0-25

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16
Q

MCP/PIP/DIP Flexion

A

MCP 0-90

PIP 0-120

DIP 0-80

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17
Q

Thumb MCP/IP Flexion

A

Thumb MCP 0-50 Thumb IP 0-90

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18
Q

Volumeter

A

Edema assessment

Significant change in edema would be more than 10ml

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19
Q

Sensation Testing

A

Demo testing w/vision, then vision occluded

Test uninvolved side first

SCI tested proximal to distal following dermatomes

Neurological disorders assess for dermatome pattern

Peripheral nerve injuries tested distal to proximal.

Assess order: pain, moving touch, static light touch, and touch localization

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20
Q

Purdue Pegboard

A

Test of fingertip dexterity and assembly job simulation

Scoring: 30sec test is the # of pins placed on board in 30sec. Assembly is the # of parts assembled in 1min

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21
Q

Minnesota Manual Dexterity Test

A

test of gross hand and arm movements

Scoring: time to complete board.

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22
Q

O’Connor Tweezer Test

A

Test of eye-hand coordination

Scoring: # of pins in board using tweezers

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23
Q

Crawford Small Parts Dexterity Test

A

Test fine motor dexterity using small tools

Scoring: time to complete assembly

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24
Q

Nine Hole Peg Test

A

Measure finger dexterity

Scoring: time for each hand to place nine pegs in a square board and remove them

25
Jebson Hand Function Test
Test hand function. 7 subtests: Writing Simulated page turning Picking up common objects Simulated feeding Stacking Picking up large light objects Picking up large heavy objects Scoring: time to complete each subject
26
Differential Tendon Gliding
prevent/reduce tendon adhesion. allow each tendon to reach its greatest amount of movement. also help to reduce hand swelling.
27
Blocking Exercises
used to isolate individual join motion. pt instructed to hold end range position for 3-5 sec
28
Isometric Exercise Contraindication
contraindicated for persons with hypertension and cardiovascular problems. increase b/p and HR
29
Scar Sensory Reduction/ Desensitization
Post-surgery, begin in periphery of the scar and as tolerated work over the scar Massage Textures Vibration Three-phase desensitization kit Fluidotherapy Avoid use of hands where vision is occluded
30
Splinting for Brachial Plexus Injury
flail arm splint
31
Splinting for Radial Nerve Palsy
Dynamic wrist, finger, and thumb ext splint
32
Splinting for Carpal Tunnel
wrist splint positioned 0-15 ext
33
Splinting for DeQuervain's
long thumb splint, includes wrist, IP joint free
34
Splinting for CMC Arthritis
hand based thumb splint
35
Splinting for Arthritis
resting hand splint
36
Splinting for Flaccidity
resting splint
37
Splinting for Spasticity
spasticity splint or cone splint
38
Splinting for Muscle Weakness
balanced forearm orthosis, deltoid sling/suspension sling
39
Splinting for Axillary Burns
airplane splint
40
Heat Therapy Benefits and Precautions
Benefits Relieves pain; increases ROM; assists w/wound healing; decreases muscle spasms Precautions Do not use with postsurgical repairs; acute injuries; impaired sensation; impaired vascular supply
41
Application of Hot Packs
Check skin prior to and after application Check temp of hydrocollator (165\*) Check skin after 5min Hot pack removed after 20min
42
Application of Paraffin
Check skin prior to and after application Check temp of paraffin (125-130\*)
43
Application of Whirlpool
# Fill tank w/water at 100-108\*; if treating burns, water should be set at body temp Maintain sterile technique Treatment lasts 20min
44
Benefits and Precautions of Cryotherapy
Benefits Relieves pain; controls edema; decreases abnormal tone; facilitates muscle tone; treats acute injuries and postsurgical repairs Precautions Do not use with sensory deficit including hypersensitivity; impaired circulation; Raynaud's disease
45
Application of Ice Pack
Check skin prior to and after application Apply wet/dry towel between client's skin and cold pack Check after 3-5min Use for up to 10min Ice massage- used for smaller areas; applied directly to skin for 3-5min
46
Electrical Stimulation Benefits and Precautions
Benefits Pain control; decreases swelling; stimulates and strengthens muscles; muscle reeducation; stimulates denervated muscles Precautions Cardiac pacemaker; phrenic or urinary bladder stimulators; presence of thrombosis or thrombophlebitis; over carotid sinus
47
General Contraindications for PAMs
Cancer Pacemaker Pregnancy Cognitive Impairment Sensory Impairment Vascular Impairment DVT
48
Treatment for Swan-Neck Deformities
Treatment Daily ROM to each finger joint and gentle stretches for the PIP joints and intrinsics Splinting Three-point finger splint for the PIP joint to prevent hyper-ext Methods to Avoid Isotonic, isometric, and resistive exercise
49
Boutonniere Deformity
Treatment Daily ROM to each finger joint, gentle assisted and active ext of the PIP joints, and active DIP flx with the PIP extended Splinting Ext mobilization or resting splints for the PIP joints Methods to Avoid Isotonic, isometric, and resistive exercise
50
Trigger Finger
Treatment Tendon protection techniques- heat/ice inflammation Splinting Trigger finger splint Avoid Repetitive gripping activities
51
MP Ulnar Drift
Treatment Daily ROM to MP joints with emphasis on MP ext and radial deviation; joint protection techniques Splinting Soft ulnar deviation splints during the day; immobilization splints with MP joints in neutral deviation and 30\* flx at night Avoid Isotonic, isometric, and resistive exercise; positions of deformity
52
MP Volar Subluxation-Dislocation
Treatment AROM of MP joints emphasizing ext; joint protection techniques Splinting Resting splints at night Avoid Positions of deformity
53
Wrist Subluxation
Splinting Wrist support during the day and immobilization splint at night
54
Sexual Positioning for Spasticity
Lying on affected side while propped w/pillows allows the unaffected right extremities to remain free, and provides weight bearing to the affected side to assist with tone reduction. The pillows behind the individual allow support, and the individual may lean against the pillows to also provide pressure relief as needed to the affected side, because sensation may be reduced on that side along with movement.
55
To improve extension of the PIP for functional use of the hand, what is the BEST use of limited therapy time?
prefabricated dynamic PIP extension assist splint
56
Arthrogryposis
characterized by joint contractures. Angled utensils promote independence with feeding by allowing a client with contractures in the arms and hands to put food into the mouth.
57
A client with a chronic median nerve compression at the carpal tunnel has severely diminished functional pinch. In what position should the thumb be splinted to facilitate functional pinch?
The thumb should be splinted in opposition and palmar abduction to facilitate thumb-to-tip prehension.
58
A client sustained partial-thickness and deep-thickness burns over a total body surface area of 60%, including bilateral arms and legs. Which factors should the COTA® focus on in the acute phase of burn intervention?
Reducing edema Prevent the development of deformity and contracture. Independence in ADL skills can improve the client’s sense of control and promote improved ROM.

COTA Musculoskeletal Dx and Biomechanical Interventions (3 decks)

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