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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
Q

Total Hip Arthroplasty - Activities

A

Dec bed and transfer mobility
Dec gait
Dec ability to sit

26
Q

Total Hip Participation

A

Changes in roles for recreation and work

27
Q

Acute (days 1-3) - Hip Joint Arthroplasty - Movement and Alignment Interventions

A

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
Q

Acute (days 1-3) - Hip Joint Arthroplasty - Extrinsic Interventions

A

Edema and pain control - ice and elevation

29
Q

Acute (days 1-3) - Hip Joint Arthroplasty - Psychosocial

A

Pre-operative education

Discharge instruction

30
Q

Acute (days 1-3) - Hip Joint Arthroplasty - Physiological Interventions

A

Awareness of the influence on healing and progression of activity
Medications, age, systemic pathology, obesity/diet, health habits

31
Q

Hip Fracture Impairments

A

Pain
Limited ROM
limited strength throughout

32
Q

Hip Fracture Activities

A

Dec ablity to ambulate (WB)
Dec bed mobility and transfers
Dec ability to dress, bath, toilet

33
Q

Hip Fracture Participation

A

More dependence in self care

Loss of ability to maintain independent living

34
Q

Hip Fracture - Actue in Hospital

A

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
Q

Hip Fracture - Subacute - Home or skilled nursing facility

A

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
Q

Hip Fracture - Chronic/Return to FUnction Phase -

A

Will continue with strengthening and progress to WB
Goal - independent ambulation without assistvive device
Balance training

37
Q

Labral Tears - conservative tx -

A

Tx what you find on examination and focus on
Muscle imbalances
ROM limitations
Postural imbalances

38
Q

Labral tears - avoid

A

Provocation positions

Crossed legs, sitting hyperflexed, sitting knees lower than hips, pivoting motions`

39
Q

Restrictions with labral tear

A 
Flexion = 90 degrees
Rotation = no medial or lateral rotation 
WB = ToeTouchWB for 4 to 6 weeks
40
Q

Interventions for hip labral repair

A

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
Q

Tendonitis/Bursitis/Mm strain

Acute - inflammatory - Goal

A

Speed inflammatory process and promote movement

42
Q

Tendonitis/Bursitis/Mm strain

Acute - inflammatory - Impairments

A

Pain

mm weakness

43
Q

Tendonitis/Bursitis/Mm strain

Acute - inflammatory - Treatment

A 
painfree ex
physical agents
Manual therapy  (Grade 1,2 mobs, STM, taping)
Gentle stretching
Isometric progressing to isotonics
Stregnthening to surrounging mm
44
Q

Tendonitis/Bursitis/Mm strain - Subacute Tissue Formation Goal

A

Promote healing and normal fibroblastic tissue response

45
Q

Tendonitis/Bursitis/Mm strain - Subacute Tissue Formation Impairments

A

Mm weakness
Poor endurance
Unable to tolerate high stress to the tissues without pain
Possible mm imbalance

46
Q

Tendonitis/Bursitis/Mm strain - Subacute Tissue Formation Treatment

A 
Painfree ex
More aggressive exercises
Cardio
Balance/ proprio
FUnctional activiites - fix causative factor
47
Q

Tendonitis/Bursitis/Mm strain - Chronic/Return to function/Remodeling Goal

A

Return to previous functional level given tissue status and comorbidities

48
Q

Tendonitis/Bursitis/Mm strain - Chronic/Return to function/Remodeling Impairments/Activities

A

Should be minimal impairment problems

Function and Endurance for activity should be focus

49
Q

Tendonitis/Bursitis/Mm strain - Chronic/Return to function/Remodeling - Treatment

A 
Vigorous strengthenign (eccentric)
Plyometric
Endurance and function
Return to protected functional abilities
50
Q

Hip Adductor Strain - Acute - Movement and alignment interventions

A

AROM through pain free range
Stretching - ACTIVE stretching of adductors and hamstring
Strengthening - lower abs, iliopsoas, glut med
Movement pattern correction - gait
Posture

51
Q

Hip Adductor Strain - Acute - Extrinsic Interventions

A

RICE, Estim for acture pain, pulsed US for tissue healing
Manual therapy - massage
Alternative forms of cardio exer like arm ergometer

52
Q

Hip Adductr Strain - Acute - Psychosocial interventions

A

Education in tissue healing phases and plan of care

53
Q

Hip Adductor Strain - Acute - Physiological Interventions

A

Awareness of effect of medications, age, systemic pathology, diet and health habits on healing

54
Q

Hip Adductor Strain - Subacute - Movement and Alignment Interventions

A

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
Q

Hip Adductr Strain - Subacute - Extrinsic Intervention

A

ice post exercise, continuous US for tissue healing

56
Q

Hip Adductor Strain - Subacute - Psychosocial Interventions

A

Education in continuing to be conservatibe with activities btu can start greater activity without pain

57
Q

Hip Adductor Strain - Subacue - Physiological Interventions

A

Adjust level of activity based on awareness of effect meds, age, systemic pathology, and obestiy have on healing

58
Q

Hip Adductor Strain - Chronic Remodeling - Movement and Alignment Interventions

A 
Concentric and Eccentric strengthening
Stretching 
Movement patter correction 
Proper standing posture
Advance balance and proprio
Advance functional
59
Q

Hip adductor Strain - chronic and remodeling stage - Extrinsic Intervention

A

Ice if necessary

60
Q

Hip adductor Strain - chronic and remodeling stage - Psychosocial

A

Returning to activity graduall

61
Q

Hip adductor Strain - chronic and remodeling stage - Physiological

A

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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