Final Part 2 Flashcards

Question

Lumbar Stabilization | Maintain neutral zone (isometrics)

Answer 1

Isometric contraction: contract on exhalation of diaphragmatic breath take a deep inhale belly rises now squeeze the air out and abdominals come in, my hand on medial ASIS to feel TrA Inhale belly rise, exhale naval to spine feel the contraction, breath and maintain this ---May need them to do small sips of air to maintain the contraction to start

Answer 2

WATCH THE PELVIS MAKE SURE IT IS NEUTRAL THE WHOLE TIME Inhalation belly rise, exhale belly draw in maneuver, breath continues to flow: slide your leg out and slide it back in I watch the pelvis for tilting now bring leg up and down and other leg up and down. Can do heel slide, march, lateral knee fall out and back in while maintianing the neutral pelvis ,…arm reaches...

Answer 3

1) 10 pelvic rocks to find spine neutral (can be pain modulation if do in painfree range to relax stuff, gentle mobilization, BF into area) 2) isometric Tra: maintain steady contraction with the breath cycle 10 seconds x 10 sets while breathing normally 3) increase with indurance progression: 15 seconds x 5 --> 20 seconds x 4--> 30 seconds x 2 4) different people need different positions positions: hookline, prone (pull naval off pillow), sidelie, standing, quadruped

Answer 4

1) Hookline: neutral 2) Pelvic rocks (marble on clock) 3) Stop at middle zone ½ between each rock 4) Watch for rib flare or rib depression as breath in and out and have maintain the draw in and maintain neutral spine and lift leg into air and lower it down—see if stabilizing, the pelvis will rotate so cue to anchor the opposite side to counter that so pelvis doesn’t twist –sometimes tying leg lift with exhale helps 5) Take a breath in and squeeze as raise one leg then the other then lower one then lower the other—if transverse cannot support it the rectus will come in 6) Kegals, isometrics, arms, legs

Answer 5

``` kegal isometric arms: B/L-->reciprocal-->unilateral Legs: heel slides, marches, lateral knee fallouts, up-down-up-down, toe taps Deadbugs: opposite arm to opposite leg ```

Answer 6

isometrics one arm extension one leg extension alternate arm and leg extension

Answer 7

static dynamic with abduction/adduction bridge with march

Answer 8

``` isometrics one arm reach one leg reach A/P WS bird dog ```

Answer 9

bilateral arms reciprocal arms hinge

Answer 10

``` B/L arms Reciprocal Arms WS side to side WS forward WS backwards ```

Answer 11

1) lengthen lever arms 2) progress to less stable/unstable surface 3) endurance training 4) increase speed, reps, resistance 5) move in combined axes 6) integrate into functional task

Answer 12

foam roller air disc physioball

Answer 13

• Ergo = work • Nomos = law • Definition from international ergonomics associations o Scientific discipline o “optimize human well-being” o optimize “system performance” o “fitting the physical work space to the worker”

Answer 14

work place injuries/ fatalities • 2014 index: most disabling workplace injuries in 2012 ~$60 billion in workers comp • each day btwn 12 & 13 U.S workers dies as a result of a traumatic injury on the job o big graph… o overexertion is the most expensive

Answer 15

Occupational safety and health admin --Established by Occupation and health act, 1970 ****Part of the US Department of Labor: regulates and enforces workplace safety and health initiatives **healthcare workers most injured

Answer 16

National Institute of Occupational Safety and Health --Part of CDC & Dept of Health and Human services ***Makes recommendations for preventing injuries and illnesses related to work - Conducts research - Provides education and disseminates information

Answer 17

1. overexertion involving outside source (lift, carry) 2. fall on same level 3. struck by object/equipment 4. fall to lower level 5. other exertions or body actions (basic human movements: kneeling, sitting, twisting, ..)

Answer 18

workplace stress and injury of the Neck, UE, low back report - -evidence that lifting and forceful movements related to back injuries - -full body vibration related to back injuries Positive relationship between heavy physical work and bending and twisting (defined as an akward posture) there is insufficient evidence of static posture being related to back injury

Answer 19

OUR OWN safety during transfers, lifting, prolonged standing, repetitive activities our understanding of human performance and musculoskeleetal disorders make us ideal consultants for workplace

Answer 20

Workplace o Office o factory floor -retail, show, retail, car Required work tasks/equiptment o Overhead work o Keyboarding desk, bag, desk, computer

Answer 21

Examinations o Worker o Work site and work station Evaluation o Productivity needs of the employer o Health and safety needs of the worker Recommended preventive strategies o Conduct on site training Rehab of the injured worker Assist the worker with return to work prn o Work hardening

Answer 22

Physical demand description 1. Prepare--who is involved, equipment need, schedule test 2. Observe & data collection: tasks, classify essential and nonessential tasks 3. Report: distribute for signoff

Answer 23

Designed systematically analyze the workers ability and capacity to EXECUTE their work tasks --can the worker do the tasks needed for the job Procedure 1. Take a history 2. Perform a preevaluation screening examination 3. Perform functional testing 4. Inerpret results 5. Prepare a report Indications: to order an FCE: • no plateaued progress • discrepancy btwn subjective vs. objective • difficulty returning to work • legal settlement Contraindications: not medically stable, cannot follow direction Target variables: • body mechanic • ROM • Strength • Endurance • Pace • Coordination • Balance • Safety Special consideration: • PAIN IS NOT CONTRAINDICATED for functional testing and is expected if individual has been inactive >4 weeks *note FCEs

Answer 24

• Differences Variations in # of measurements, degree of standardization, clarity of concepts and underlying theories, variety in choice of measuring instruments, adequacy of measurement for certain injury groups, controlled vs. uncontrolled Isenhager work systems -> workwell o Designed by Susan J. Isernhagen in 1998 o Duration 4-6 hrs, 1-2 days -Better to mimic what they do (how many hours they actually are working) -But so many FCEs variability, not testing the specific tasks Assessment tools o Nextgen ergonomics: software and instrumentation for ergonomics & biomechanics o Washington state department of labor & industries Lifting calculator Recommendations o Safety recommendations about resident transfers

Answer 25

Baggage handling, beverage delivery, computer stations, electrical contractors, sewing

Answer 26

Perform the FCE and Physical Demand Description and make RECOMMENDATIONS to the employer

Answer 27

A functional capacity evaluation (FCE) evaluates an individual's capacity to perform work activities related to his or her participation in employment (Soer et al., 2008). The FCE process compares the individual's health status, and body functions and structures to the demands of the job and the work environment. In essence, an FCE's primary purpose is to evaluate a person's ability to participate in work, although other instrumental activities of daily living that support work performance may also be evaluated.

Answer 28

Video display terminal & eye strain (mayo clinic & american opthamology) 1) 25 inches from computer screen 2) screen position: eyes gazing slightly downward 3) lighting: effect eyestrain • if light reflects on screen glare from screen makes u work harder--have it at a right angle: above or side • when reading a book, light should be behind you, 4) directly focused on page 5) 20-20-20 rule (every 20 minutes gaze at objet 20 feet away for 20 seconds) 6) blink post-it 7) artificial tears 8) regular breaks

Answer 29

eyes gaze down

Answer 30

o Regular rest breaks (15 min q 2-4hrs) o Switch tasks often while working, eg alternate filing with keyboard use o Frequent change in posture o Minimize contact with sharp surfaces o Rest eyes frequently, ensure adequate lighting o Minimize forces you generate o Keep hands warm

Answer 31

Adjustive seat angle (110), Good suspension, Adjust seat, steering for comfortable pedal use, Lumbar support, Tilt seat every 20-30 min to alter vibration location o Have pt set up mirrors while in good position so when they can’t see again, they self adjust

Answer 32

• Stage conditions, backstage conditions, flying harnesses, costumes, shoes

Answer 33

1) Patient education 2) Behavior modification: to stop behaviors that contribute to the back pain 3) Minimize future episodes of back pain Patient should undergo a thorough evaluation to determine areas of pathology, poor mechanics, postural deviations Back school is an adjunct to treatment

Answer 34

1) Understand their condition Lack of understanding of the mechanics of condition—explain to help them control and manage the condition and symptoms, give them power over the condition Independently manage their condition/ symptoms 2) Employ lifestyle changes: stress –if pattern of pain follows their stress pattern need to address the stress—stress management—refer them weight

Answer 35

1) Body mechanics 2) Proper lifting techniques 3) Adaptations for work and home 4) Appropriate exercise 5) How to manage frequency and intensely of exacerbations i. Teach the patient in patient education ---re-herniation rates increase chance of herniation

Answer 36

1) Anatomy models 2) Video clips followed by q and a session 3) Individualized instruction—especially in chronic LBP - Help them understand the exercises and doing them correctly 4) Reading material 5) Practice real life situations: home, work, school - See how they lift things - Encourage behavioral changes - Smoking cessation - Caffeine consumption - Balanced diet - Regular exercise - Stress management

Answer 37

1) Functional anatomy and biomechanics 2) Discuss in terms patients will understand 3) Relate to principles of health and wellbeing - -Being upbeat with the recommendations 4) Correct posture: static vs dynamic - See how the patient gets out of the chair and then how you can correct it—if they are getting a shear causing the backpain work on stabilization and a weight shift – can they WX to bring buttocks up and then back down –then correct it and tailor it for them specifically 5) Lifestyle changes”: - -Keep moving --Walking program (They are not an athlete, give them walking,) - -Appropriate rest - For the super active people need to get them to rest more - Get adequate sleep, and this is when the body restores and regenerates and get nutrition in discs - Less stressing exercises - -Pillows/mattresses/ sleeping posture - How it contributes to symptoms—is the spine neutral 6) exercise 7) body mechanics 8) Proper nutrition (avoid laxatives) 9) Weight loss 10) Smoking cessation 11) Caffeiene consumption

Answer 38

1. Expect some soreness in exercise, determine where and what kind – is it the original symptoms or is it something else 2. What can they do about the soreness-should they use ice, heat, cycling to flush out acid

Answer 39

1. Don’t bend over with knees straight 2. Don’t reach over 3. Don’t crouch over the desk 4. Don’t sit far from the work and leaning forward 5. Don’t sit asymmetrically at the chair 6. Don’t sit with back unsupported 7. Don’t work at a bench or table that is too low for you 8. Be careful not to work overhead for long periods of time with you neck bent backwards 9. Don’t thrust neck forward to read 10. Don’t twist neck to hold phone 11. Don’t jolt spine necessarily by jumping out of your truck or off a high object 12. Don’t twist your neck to look behind you

Final Part 2 Flashcards

(66 cards)