biomechanical approach intervention Flashcards
(150 cards)
1
Q
biomechanical approach
A
focuses on the ROM, strength, and endurance required to perform an occupation
2
Q
functional ROM
A
needed to perform functional movements (e.g., reach to top of head, small of back)
3
Q
AROM
A
active ROM - movement produced by one’s own muscle
4
Q
PROM
A
passive ROM - movement produced by an external force
5
Q
AAROM
A
active assist ROM - movement produced by one’s own muscles and assisted by an external force
6
Q
examples of conditions where therapist should consult with physician to determine ROM
A
- bone metastasis
- unhealed fracture or recent dislocation
- infection
- post surgery
- unstable joints
- joint inflammation
- skin grafts
7
Q
MMT test position
A
gravity eliminated (lessened) or against gravity
8
Q
MMT stabilization
A
usually proximal to the joint the muscles crosses over. do not hold over the muscle being testes
9
Q
MMT restistance
A
- applied in opposite direction of movement; should be gradual
10
Q
what is used to evaluate grip strength
A
dynamometer
11
Q
what is used to evaluate grip strength in older adults or a person with arthritis
A
sphygmomanometer cuff, vigorimeter, or hand held bulb dynamometer
12
Q
muscular endurance
A
- count number of repetitions per unit of time
- measure time until fatigue while holding isometric contraction
13
Q
cardiorespiratory endurance
A
- use MET levels
- measure frequency, intensity, and time to complete activity
14
Q
isometric
A
muscle lengths remain the same
15
Q
isotonic
A
involve muscle contractions where muscle changes length
16
Q
shoulder flexion ROM
A
0-170
17
Q
shoulder extension ROM
A
0-60
18
Q
shoulder abduction ROM
A
0-170
19
Q
shoulder horizontal abduction ROM
A
0-40
20
Q
shoulder horizontal adduction ROM
A
0-130
21
Q
shoulder internal rotation ROM
A
0-70
22
Q
shoulder external rotation ROM
A
0-90
23
Q
elbow and forearm flexion ROM
A
0-135/150
24
Q
wrist flexion ROM
A
0-80
24
elbow and forearm supination ROM
0-80/90
24
elbow and forearm pronation ROM
0-80/90
25
wrist extension ROM
0-70
26
wrist ulnar deviation ROM
0-30
27
wrist radial deviation ROM
0-20
28
thumb MP flexion ROM
0-50
29
thumb IP flexion ROM
0-80/90
30
thumb adduction ROM
0-50
31
finger MP flexion ROM
0-90
32
finger MP hyperextension ROM
0-15/45
33
finger PIP flexion ROM
0-110
34
finger DIP flexion ROM
0-80
35
finger abduction ROM
0-25
36
hip flexion ROM
0-120
37
hip extension ROM
0-30
38
hip abduction ROM
0-40
39
hip adduction ROM
0-35
40
hip internal rotation ROM
0-45
41
hip external rotation ROM
0-45
42
knee flexion ROM
0-135
43
plantar flexion ROM
0-50
44
ankle and foot dorsiflexion ROM
0-15
45
ankle and foot inversion ROM
0-35
46
ankle and foot eversion ROM
0-20
47
edema
body's initial response to injury
48
pitting edema
acute; finger makes an identation
49
brawny (nonpitting) edema
chronic; firm to touch
50
evaluation of edema circumference
measure tape; figure of eight method
51
measurement tool for edema of hand and arm
volumeter
52
5 (muscle grading)
normal; moves through full ROM against gravity and takes maximal resistance
53
4 (muscle grading)
good; moves through full ROM against gravity and takes moderate resistance
54
3+ (muscle grading)
fair plus; moves through full ROM against gravity and takes minimal resistance before it breaks
55
3 (muscle grading)
fair; moves through full ROM against gravity and is unable to take any added resistance
56
3- (muscle grading)
fair minus; moves less than full ROM against gravity
57
2+ (muscle grading)
poor plus; moves through full ROM in a gravity-eliminated plane, takes minimal resistance, then breaks
58
2 (muscle grading)
poor; moves through full ROM in a gravity eliminated plan and no resistance
59
2- (muscle grading)
poor minus; moves less than full ROM in a gravity eliminated plan and no resistance
60
1 (muscle grading)
trace; tension is palpated in the muscle or tension but no motion occurs at the joint
61
0 (muscle grading)
zero; no tension is palpitated in the muscle or tendon
62
how to demonstrate sensory test
with vision; then occlude vision for actual testing
- test uninvolved side first
63
0 (edema scale)
no edema
64
1 (edema scale)
- barely discernible pit; immediate rebound
- normal foot and leg contours
65
2 (edema scale)
- deeper pit (<5mm); a few seconds to rebound
- fairly normal foot and leg contours
66
3 (edema scale)
- deep pit (5-10mm); 10-12 seconds to rebound
- foot and leg swelling
67
4 (edema scale)
- even deeper pit (>1cm); >20 seconds to rebound
- severe foot and leg swelling
68
light touch
cotton swab/cotton ball
- person responds when touched
- scoring + (intact), - (impaired), 0 (absent)
69
localization
cotton swab and person responds yes when touched and with vision points to are that was touched
- scoring +, -, 0
70
pain (protective sensation)
patient responds "sharp" or "dull"
- intact, impaired, or absent
*felt sharp when it was dull may indicate hypersensitivity)
71
temperature sensation
responds "hot" or "cold"
- scoring +, -, or 0
72
stereognosis
recognition by touch of common objects
- scoring is number of correct
73
touch/pressure test
determines light touch and deep pressure by using monofilaments
74
proprioception
position sense
- positions involved extremity; patient duplicates position with contralateral side
75
kinesthesia
movement sense
- OT moves segment; responds up or down
76
purdue pegboard
test of fingertip dexterity and assembly job simulation
77
minnesota manual dexterity test
test of gross hand and arm movements
78
O'connors tweezer test
test of eye-hand coordination using tweezers
79
crawfors small parts dexterity test
test of fine motor dexterity using small tools
80
nine hole peg test
measure finger dexterity
81
lebsin-taylor hand function
test of hanf function
82
CN V dermatome, muscle, and function
anterior facial region
mastication
ingestion
83
codman's exercise (pendulum exercise)
common form of PROM used for postsurgical shoulder patients
84
orthosis for PROM
dynamic mobilization (acute joint stiffness)
static progressive
serial casting (chronic joint stiffness)
85
when should AROM be preformed
when PROM is greater than AROM
86
blocking exercises
used to isolate individual motion
87
to increase strength you should provide
high resistance; low repetitions
88
eccentric (isotonic movement)
lengthening
89
concentric (isotonic movement)
shortening
90
how to increase endurance
increase repetitions and duration, not resistance
91
edema reduction techniques
- elevation
- AROM
- manual edema mobilization
- retrograde massage
- compression garments
- cold packs
- contrast baths
92
elevation
extremity should be placed above heart
93
avoid extreme positions of elevation for individuals with
right sided heart weakness
94
retrograde massage is contraindicated with
cardiac edema
95
scar management
- ROM
- massage
- compression
- scar pad with compression
- orthotic
- edema control
96
desensitization for hypersensitivity
- massage
- textures
- vibration
- desensitization kits
- fluidotherapy
- desensitization program
97
sensory re-education with textures
apply textures for one minute with eyes open the with eyes closed for one minute
98
mirror therapy
textures in both hands to stimulate sensory receptor-cortical reorganization
99
how to improve coordination
- begin with gross motor and grade to fine motor
- ROM is within reach yet challenging
- focus on accuracy and speed
100
static orthosis
no moving parts and immobilizes a joint or part
101
dynamic orthosis
includes a resilient component (elastic, rubber band, or spring) that the individual moves
- designed to increase PROM or augment AROM
102
serial static orthosis
static orthosis or the use of casting material that is remolded to address changes in joint motion
- designed to increase PROM
103
static progressive orthosis
includes a static adjustment part (turnbuckle or strap) that allows the person to make changes in the tension or angle to increase motion without remodeling orthosis
104
hand orthotic design standards
- maintain arches of the hand
- do not impinge upon creases of the hand
105
resting hand orthosis
used to rest structures or protect structures of the hand
- wrist 0-20 extension
- MCPs 20-30 flexion
- IPs 10-20 flexion
- thumb slight extended and abducted
106
safe position orthosis (intrinsic plus or antideformity)
used to prevent deformity position in dorsal hand burns and maintain the length of the collateral ligaments
- wrist 15-30 extension
- MCPs 50-70 flexion
- IPs full extension
- thumb palmar abduction
107
brachial plexus orthosis
flail arm orthosis
- used for positioning
108
radial nerve injury orthosis
colditz orthosis or radial nerve orthosis
- assists with partial wrist motion and finger extension
109
median nerve injury orthosis
opponens orthosis and web space orthosis
- used to hold the thumb in opposition during functional activities
110
ulnar nerve injury orthosis
anticlaw orthosis or called lumbrical bar orthosis
- prevent MCPs in flexion
- prevent clawing of 4th and 5th digit
111
combined median ulnar orthosis
figure of eight or lumbrical bar orthosis
- position MCPs in flexion for digits
- prevent hand ftom assuming intrinsic minus position
112
spinal cord (C6-7) orthosis
wrist driven wrist hand orthosis (flexor hinge orthosis; tenodesis orthosis)
- used to facilitate grasp and release
113
carpal tunnel orthosis
wrist orthosis positioned in neutral
- used to decrease carpal canal pressure
114
cubital tunnel orthosis
elbow orthosis positioned at 30 degree flexion
- prevent elbow flexion at night
- decrease ulnar nerve symptoms
115
de quervains orthosis
forearm based thumb spica (long opponens orthosis)
- includes wrist, IP joints free
116
skiers thumb orthosis
ulnar collateral ligament hand based thumb CMC orthosis (short opponens)
- protects ulnar collateral ligament of MCP joint of thumb
117
CMC arthritis orthosis
hand based thumb CMC or short opponens
- used to place the CMC joint of the thumb at rest
118
ulnar drift orthosis
ulnar drift orthosis
- used to decrease pain, provide stability, and realign MCP joints of digits
119
flexor tendon injury orthosis
dorsal blocking orthosis
- protect repair site and allow for early controlled mobilization
120
swan neck orthosis
silver rings, 3 point oval 8, digital orthosis in slight PIP flexion
- PIP joint in slight flexion to prevent further deformity
121
boutonniere orthosis
silver rings, 3 point oval 8, PIP extension orthosis
- place PIP joint in extension
122
arthritis/RA flare up orthosis
resting hand orthosis
- used to place joints at rest until inflammation decreases
123
flaccidity orthosis
resting/functional orthosis
- prevent joint contractures
124
spasticity orthosis
spasticity orthosis or cone orthosis
- prevent joint contractures
125
muscle weakness (ALS, spinal cord injury, guillan barre) orthosis
mobile arm support (MAS) or deltoid sling/suspension sling
- allow for use of distal extremity during activities
126
dorsal hand burns orthosis
wrist 15-30 extension, MCP 50-70 extension, IPs full extension
- maintain soft tissue structures
127
thermotherapy (hot)
superficial thermal agent
- paraffin
- hot packs
- fluidotherapy
- whirlpool
128
cryotherapy (cold)
superficial thermal agent
- ice packs
- ice massage
129
mechanotherapy
ultrasound
130
electrical stimulation
- neuromuscular electrical stimulation (NMES)
- transcutaneous electrical nerve stimulator (TENS)
- high voltage galvanic stimulation (HVGS)
- iontophoresis
131
conduction
direct contact of PAM and body part (hot packs and paraffin)
132
convection
circulation of air, liquid, or other medium transfers thermal energy to the body part (fluidotherapy or whirlpool)
133
conversion
mechanical energy changes to hear (ultrasound)
134
benefits of heat
- relieve pain
- increase ROM
- increase blood flow
- decrease muscle spasms
135
how many layers between hot pack and person
4 layers of a folded towel
136
how long until you check skin during heat therapy
5 minutes
137
how long do u leave heat therapy on
15-20 mins
138
how long do u leave paraffin on
15-30 min
139
fluidotherapy
decrease hypersensitivity
- adjust blowers according to person's sensitivity
140
how long for fluidotherapy
20 minutes
141
whirlpool treatment time
10-20 minutes
142
benefits of cyrotherapy
- relieves pain
- controls edema
- decrease abnormal tone
- facilitate muscle tone
- commonly used to treat acute injuries and post-surgical repairs
143
application of cryotherapy
- dry or wet towel between clients skin and cold pack
- 10-15 minutes
144
when do u check skin during cryotherapy
after 3-5 minutes
145
benefits of electrical stimulation
- controls pain
- decrease swelling
- stimulates and strengthens muscles
- muscle re-education
- stimulates denervated muscle
146
measuring sensation for persons with SCI
proximal to distal following dermatome patterns
147
measuring sensation for persons with neurological disorders
according to dermatome patterns
148
measuring sensation for persons with peripheral nerve injuries
distal to proximal following dermatome patterns
