Knee Intervention Flashcards Preview

PT 515 Musculo > Knee Intervention > Flashcards

Flashcards in Knee Intervention Deck (18):
1

Capsular restriction

Grade III and IV non-thrust manipulation
3-5 sets 3-5 minutes
Static stretching with creep or stress relaxation

2

Flexibility

3-5 sets, 30-60 seconds each
Closer to 60 seconds is better for elderly patients

3

Muscle performance and functional control

Consider co-contraction of quads and hamstrings
Goals:
-stability
-Improved biomechanics
-Coordination
-Endurance
-Motor Control
-Limit reflexive inhibition

4

Exercise progression guidelines based on soreness

-If no soreness present from previous day, change one variable
-If soreness present from previous day goes away with warm up, stay at same level
-If soreness present from previous day doesnt go away regress to previous level

5

Open Chain Exercises

Quad sets
Straight leg raises in 4 positions
Short arc quads
Full arc extensions
Hamstring curls

6

Closed Chain exercises

Isometrics:
-Seated co-contractions
-Standing pertebations at the pelvis
Dynamic
-Unilateral knee extensions
-Standing SLR x 4
-Mini squats/squats
-Step ups/downs
-LE balance and Reach
-Wall slides
-Weight shift/Lunges
-Chair scooting

7

Quad Weakness

Direct functional consequences
-Decreased knee excursion during stance phase
-Increases risk of fall in elderly
NMES shown effective to produce strength gains faster than volitional excercise alone when deficit >20%

8

Eccentric Training

Greater changes in neural activation and muscle hypertrophy
-Good for tendonosis
-3 sets/ 15 reps, twice a week
-Significant improvements in strength and function in 12
weeks

9

Balance and Reach testing

Named based off of direction in relation to the standing foot

10

Closed chain excercises

Proprioception
-balance on firm surfaces
-EO/EC
-Perturbations
-Dynamic surface
Plyometrics
-Drills
-Sports/activity specific

11

Motor Control

Training includes different platforms/surfaces, perturbations, amplitude, speed, multi-direction changes
-Start with focused challenge, progress to unexpected situations

12

PFPS

Conservative management focus
-VMO strength
-Biofeedback
-LE flexibility
-Patellar taping
-Orthotics
Or look at the hip

13

Important rehab considerations PFPS

Must work in pain free range
Mix of WB and NWB positions
-Quad sets
-SLRs
-Leg press/Total Gym
-Progress to function
-Improve core and hip strength and endurance
Local factors
-Pain can be caused by multiple tissues
Abnormal foot mechanics

14

CPR for orthotics

If 3/4 factors present, 86% success rate
->25 y/o
-Height >5'5"
-VAS < 5.3
-Midfoot with difference WB to NWB >10.96mm

15

Surgical considerations for PFPS

-Synovectomy
-Lateral retinacular release
-Distal realignment of tibial tubercle
-VMO imbrication (move it to more central/distal location
-MPFL repair

16

PFPS pediatric considerations

Bipartite Patella
-two separate pieces of patella
-asymptomatic until direct trauma

Osgood Schlatter disease

Sinding-Larsen-Johnson syndrome
-Apophysitis and inferior pole of patella

17

OA

Cyclic loading
-Bycicle; therapy ball; total gym
Strength training
-Quads; hamstrings; glutes
Flexibility
-Quads; hamstrings; hip flexors; hip rotators

18

CPR hip mobilization for reduction in knee pain

2 or more present is 97% success rate
-Pain with ipsilateral hip distraction
-Ipsilateral knee flexion PROM <17
-Pain or paresthesia in ipsilateral hip or groin
-Ipsilateral anterior thigh pain