L13 Mechanical Therapy

Question 1

Types of mechanical motion

Answer 1

continuous passive motion
static progressive stretching
traction
intermittent pneumatic compression

Question 2

Continuous passive motion

Answer 2

device provides uninterrupted motion through controlled ROM
typically applied 1-4 hours/session for 1-3x day
best applied 2-21 days post injury

most helpful in acute phase when nothing else helps

Question 3

Proposed effects of CPM

Answer 3

accelerate interarticular cartilage healing
decrease edema/effusion
minimize contractures
increases ROM
decease post op pain
increase lubrication
improve circulation
prevent adhesions

Question 4

Precautions of CPM

Answer 4

significant bleeding
sensory impairments
skin irritation
increasing pain

Question 5

Contraindications of CPM

Answer 5

unstable fracture
uncontrolled infection
spastic paralysis
DVT
poor pt compliance

Question 6

All of the following parameters of Continuous Passive Motion are modifiable before it is applied to the patient

Answer 6

speed of motion
length of proximal and distal supportive arms
ROM the limb will be taken through

pulse duration of biphasic waveform can be modified during

Question 7

Most common conditions for CPM

Answer 7

TKA
back surgery
shoulder surgery
frozen shouldeer

Question 8

CPM alternatives

Answer 8

drop and dangle
sling
supine gymball roles
wall slides

Question 9

Static progressive stretch devices

Answer 9

shoulder, knee, elbow, jaw, wrist, fingers, toe, ankle

helps with excessive tone, alignment of joints/bones, maintaining vascular integrity, diabetes, neuropathy, edema, osteoporosis

Question 10

Dosage of static progressive devices

Answer 10

5 min on, 1 min off for 30 min, 3x a day

Question 11

Ultimate conclusion of static progressive devices

Answer 11

first line of treatment should not be this
evidence is conflicting
patient compliance is an issue
not very comfortable, causes skin breakdown

Question 12

Goals of traction

Answer 12

distracting joints, stretching soft tissue, reducing disc herniation, reducing pain, muscle relaxation

Question 13

Cervical traction

Answer 13

Supine, 15-20 degrees. Increase up to 30 degrees if it is lower down the neck. Joint = 20 to 30 lbs, Disc = 10-15 lbs. Acute = 5-10 min, chronic = 15-30 min. Can do static (disc/motion aggravated pain) or intermittent (disc/joint distraction)

Question 14

Lumbar traction

Answer 14

acute = 30 to 40 lbs
disc, spasm, soft tissue = 25% BW
joint = 50 lbs

duration is 5-10 min for disc, 10-30 min for other

not a stand alone treatment, mostly helpful for pain. can use auto traction, inversion, gymballs

Question 15

Constant compression

Answer 15

increase hydrostatic pressure on the interstitial space

changes in lymph/venous, trauma, or amputation can cause this.

ace wraps, compression socks, TED hose help

Question 16

Intermittent compression

Answer 16

typicall 7-8 minutes of treatment

forces fluids into lymph and venous systems to reduce edema

still should use compression socks afterwards

does appear to be helpful reducing risk of DVT and exercise recovery

Question 17

IPC precautions

Answer 17

impaired sensation
malignancy
uncontrolled hypertension
numbness, tingling, pulse, pain during treatment

Question 18

IPC contraindications

Answer 18

acute trauma
acute DVT
obstructed fluid return
arterial disease
very old or very young pts

Question 19

After setting up a patient with acute lumbar radiculopathy on supine intermittent mechanical lumbar traction, you check in on them and they report feeling less pain in the involved lower extremity when the traction force is applied and worse when the traction is off. Which of the following parameters would be BEST to modify to improve their response?

Answer 19

Changing from intermittent to static traction duty cycle

Question 20

When setting up traction for a 125 lb patient with acute C6/7 radiculopathy, which of the following parameters would be BEST to start with?

Answer 20

5-10 minutes of traction 3x/day

Question 21

cervical traction documentation

Answer 21

(Position) cervical traction applied at (weight) for (length & cycle). Applied at (beginning, end, middle) of session for (purpose). Patient response.