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Semester 2 PM Exam 7 > Hip Intervention > Flashcards

Hip Intervention Flashcards

1
Q

The hip cannot be treated without

A

looking at waht is happening at the lumbar spine and pelvis

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2
Q

Physical Stress Theory

A

Changes in the relative level of physical stress cause a predictable adaptive response in all biological tissue

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3
Q

Stress Restriction evaluation and treatment focus

A

What factors appear to be contributing to stress on tissue

How can I modify those factors to reduce stress on tissue

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4
Q

Stress Progression evaluation and treatment focus

A

What is the activity goal
What are the current modifiable factors limiting the activity goal
How should these factors be modified to meet the activity goal

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5
Q

Physical Therapy Interventions - List

A

Movement and Alignment
Extrinsic
Psychosocial
Physiological

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6
Q

PT Interventions - Movement and Alignment includes

A

Muscle performance
Motor control
Posture and alignment
Physical activity

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7
Q

PT Interventions - Extrinsic includes

A

Assistive devices

Physical agents

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8
Q

PT iNterventions - Psychosocial includes

A

education on specific things

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9
Q

PT Interventions - Physiological includes

A

Awareness of the influence on tissues

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10
Q

Stages of Healing - Acute - Goal

A

Reduce inflammation, protect injured tissues, minimize effects of immobilization, maintain general fitness

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11
Q

Stages of Healing - Subacute Goal

A

Progression of ROM and strengthening, normalizing movement, modified functional activities

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12
Q

Stages of Healing - Chronic or Remodeling Goal

A

Increasing stress to tissues in order to effect tolerance of tissue to stress
Neuromuscular fine tuning and advancement to full functional movement and activities
Modification of movement to participate in daily activities

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13
Q

Common pathological conditions of the hip

A 
OA
THR
Fractured hip
Labral repair
Tendonitis 
Bursitis 
Muscle strain
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14
Q

OA of the hip - Impairments

A 
Pain
Decreased ROM
Dec Strength
Dec balance
Impaired joint mobility
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15
Q

OA of the hip - Activitites

A 
Dec ability to walk and do stairs
Bend over to put shoes on
Stand on one leg to dress
Sit comfortably 
Sexual activity
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16
Q

OA of the hip - participation

A

Loss of ability to perform recreational activiites
dec ability for interaction in community due to loss of mobility
Inability to job maybe
Modification in sexual activiy

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17
Q

Hip OA Movement and Alignment interventions

A 
PROM/AROM
Stretching
Joint mob
Stregntheing 
Balance and proprio
Functional ex
Movement pattern correction
Endurance ex with reduced minimal impact through joint (swimming, bike)
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18
Q

OA - ACute phase PT

A

4 stretch
Hamstring stretch
Quad sets
Adduction ex

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19
Q

OA - Subacute phase PT

A

A lot of open chain so that we dont have a lot weight on tissues
A lot of open chain in supine and then move to close chain

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20
Q

OA - Acute phase to chronic PT

A

pool is really good

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21
Q

Hip OA Extrinsic Intervention

A

Assitive device
Long handle shoe horn
Sock donner
Shock absorbing insoles

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22
Q

Hip OA Psychosocial intervention

A

Education in activity modification of daily living and self care
Could refer to arthritis website

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23
Q

Hip OA Physiological Intervention

A

Weight control

Awareness of medications, systemic pathology, obesity/diet and health habits that may influence tissues

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24
Q

Total Hip Arthroplasty Impairments

A

Limited ROM by surgeon secondary to surgical approach
Decreased strength
Pain, edema
Dec balance

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25
Total Hip Arthroplasty - Activities
Dec bed and transfer mobility Dec gait Dec ability to sit
26
Total Hip Participation
Changes in roles for recreation and work
27
Acute (days 1-3) - Hip Joint Arthroplasty - Movement and Alignment Interventions
Muscle = deep breath and cough, AROM heel slides and ankle pumps, strengthening with wuad sets, gluteal sets, hamstrings Motor control = gait training, stairs Physical activity = functional activites, bed mobility and transfer training within hip precautions
28
Acute (days 1-3) - Hip Joint Arthroplasty - Extrinsic Interventions
Edema and pain control - ice and elevation
29
Acute (days 1-3) - Hip Joint Arthroplasty - Psychosocial
Pre-operative education | Discharge instruction
30
Acute (days 1-3) - Hip Joint Arthroplasty - Physiological Interventions
Awareness of the influence on healing and progression of activity Medications, age, systemic pathology, obesity/diet, health habits
31
Hip Fracture Impairments
Pain Limited ROM limited strength throughout
32
Hip Fracture Activities
Dec ablity to ambulate (WB) Dec bed mobility and transfers Dec ability to dress, bath, toilet
33
Hip Fracture Participation
More dependence in self care | Loss of ability to maintain independent living
34
Hip Fracture - Actue in Hospital
Breathing/Coughing post surgery Gentle PROM and AAROM and AROM and strengthing hip with no movement precautions Activities for function of bed mobility and transfers Gait training with assistive device
35
Hip Fracture - Subacute - Home or skilled nursing facility
Continue to prrgress functional activities Continue to strengthen - usually open chain with WB restrictions Will continue until fracture is healed - about 8 to 12 weeks
36
Hip Fracture - Chronic/Return to FUnction Phase -
Will continue with strengthening and progress to WB Goal - independent ambulation without assistvive device Balance training
37
Labral Tears - conservative tx -
Tx what you find on examination and focus on Muscle imbalances ROM limitations Postural imbalances
38
Labral tears - avoid
Provocation positions | Crossed legs, sitting hyperflexed, sitting knees lower than hips, pivoting motions`
39
Restrictions with labral tear
``` Flexion = 90 degrees Rotation = no medial or lateral rotation WB = ToeTouchWB for 4 to 6 weeks ```
40
Interventions for hip labral repair
Avoid full hip hyperextension (walking on treadmill) avoid SLR (excessive hip flexor) Early - protection/mobility Correction of muscle imbalances Structural problems take into consideration Late - return to high level physical work or sport
41
Tendonitis/Bursitis/Mm strain | Acute - inflammatory - Goal
Speed inflammatory process and promote movement
42
Tendonitis/Bursitis/Mm strain | Acute - inflammatory - Impairments
Pain | mm weakness
43
Tendonitis/Bursitis/Mm strain | Acute - inflammatory - Treatment
``` painfree ex physical agents Manual therapy (Grade 1,2 mobs, STM, taping) Gentle stretching Isometric progressing to isotonics Stregnthening to surrounging mm ```
44
Tendonitis/Bursitis/Mm strain - Subacute Tissue Formation Goal
Promote healing and normal fibroblastic tissue response
45
Tendonitis/Bursitis/Mm strain - Subacute Tissue Formation Impairments
Mm weakness Poor endurance Unable to tolerate high stress to the tissues without pain Possible mm imbalance
46
Tendonitis/Bursitis/Mm strain - Subacute Tissue Formation Treatment
``` Painfree ex More aggressive exercises Cardio Balance/ proprio FUnctional activiites - fix causative factor ```
47
Tendonitis/Bursitis/Mm strain - Chronic/Return to function/Remodeling Goal
Return to previous functional level given tissue status and comorbidities
48
Tendonitis/Bursitis/Mm strain - Chronic/Return to function/Remodeling Impairments/Activities
Should be minimal impairment problems | Function and Endurance for activity should be focus
49
Tendonitis/Bursitis/Mm strain - Chronic/Return to function/Remodeling - Treatment
``` Vigorous strengthenign (eccentric) Plyometric Endurance and function Return to protected functional abilities ```
50
Hip Adductor Strain - Acute - Movement and alignment interventions
AROM through pain free range Stretching - ACTIVE stretching of adductors and hamstring Strengthening - lower abs, iliopsoas, glut med Movement pattern correction - gait Posture
51
Hip Adductor Strain - Acute - Extrinsic Interventions
RICE, Estim for acture pain, pulsed US for tissue healing Manual therapy - massage Alternative forms of cardio exer like arm ergometer
52
Hip Adductr Strain - Acute - Psychosocial interventions
Education in tissue healing phases and plan of care
53
Hip Adductor Strain - Acute - Physiological Interventions
Awareness of effect of medications, age, systemic pathology, diet and health habits on healing
54
Hip Adductor Strain - Subacute - Movement and Alignment Interventions
Active stretching - moderate low grade duration 30 sec 3-5x Strengthening - submax Balance and proprio Movement pattern correction - specific to muscle imabalcne Functional - sit to stand Cardio - in stress or gravty reduced environment Manual therapy - friction to tendon, deep tssue mob
55
Hip Adductr Strain - Subacute - Extrinsic Intervention
ice post exercise, continuous US for tissue healing
56
Hip Adductor Strain - Subacute - Psychosocial Interventions
Education in continuing to be conservatibe with activities btu can start greater activity without pain
57
Hip Adductor Strain - Subacue - Physiological Interventions
Adjust level of activity based on awareness of effect meds, age, systemic pathology, and obestiy have on healing
58
Hip Adductor Strain - Chronic Remodeling - Movement and Alignment Interventions
``` Concentric and Eccentric strengthening Stretching Movement patter correction Proper standing posture Advance balance and proprio Advance functional ```
59
Hip adductor Strain - chronic and remodeling stage - Extrinsic Intervention
Ice if necessary
60
Hip adductor Strain - chronic and remodeling stage - Psychosocial
Returning to activity graduall
61
Hip adductor Strain - chronic and remodeling stage - Physiological
Adjust level of activity based on awareness of effect of medications, age, systemic path, and obesity/diet and health habits have on healing and pregression of activiy

Semester 2 PM Exam 7 (8 decks)

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