Musculoskeletal Impairments

Question 1

prosthesis wearing schedule

Answer 1

• initial time should be 15-30 min
• remove and examine stump for reddened areas
• if no reddened areas apparent after 20 min, the wearing time is increased in 15-30 min. increments until the client wears for full day
• any reddened areas that do not disappears after approx. 20 min should be reported to the prosthestist so it can be adjusted

Question 2

prosthesis control training

Answer 2

operation of each component of the upper limb prosthesis

Question 3

prosthesis use training

Answer 3

integration of prosthesis comments for efficient assist during functional use

Question 4

prepositioning training

Answer 4

identification of the optimal position of each positioning unit (e.g. wrist, elbow) to perform an activity or grasp an object

Question 5

prehension training

Answer 5

TD control during grasp activities

Question 6

functional training

Answer 6

control and use of the prosthesis during functional activities

• incorporation of the TD as a functional assist
• focus on a problem-solving approach

Question 7

anti deformity (safe position) burn splint

Answer 7

wrist 20 degrees extension, MCP joints 90 degrees flexion, PIP and DIP joints 0 degrees extension

Question 8

elbow or knee extension splint

Answer 8

positions in as much extension as possible

Question 9

wrist extension splint

Answer 9

to prevent wrist drop

functional splint with 45 degrees of wrist ext. worn during day

Question 10

thumb abd. splint

Answer 10

to prevent them add. contracture

splint forms a C bar between the dumb and index web space

Question 11

lumbrical bar splints

Answer 11

to reduce MCP hyperextension and IP flexion contractors

MCPs are splinted to block hyperextension

Question 12

resting hand, ball, and cone anti spasticity splints

Answer 12

to decrease tone in the hand and UE

Question 13

soft neoprene splints

Answer 13

to position thumb and forearm

commonly used with client with RA or CP to increase functional use of the hand

Question 14

splint to prevent foot drop

Answer 14

below the knee to keep ankles at 0 degrees for possible future amb.

Question 15

serial casting

Answer 15

use of fiberglass or plaster of paris materials to position clients with increfsedtone and over time stretch out soft tissue contractures

Question 16

dynamic splinting

Answer 16

may involve metal and loop components

angle of pull needs to be 90 degrees for most effective outcome.

Question 17

posterolateral approach

Answer 17

no hip flexion greater than 90 degrees, no IR, no add.

Question 18

anterolateral approach

Answer 18

no ER, no /, no add.

Question 19

bouchards nodes

Answer 19

bone spurs on PIP joints

Question 20

heberdens nodes

Answer 20

bone spurs in the DIP joints

Question 21

TKR precautions

Answer 21

not putting pillow under knee while in bed
resting foot on the floor when sitting to increase ROM
wearing an immobilizer as instructed
avoiding kneeling, equating, or twisting the knee

Question 22

OA intervention

Answer 22

AROM exercises, PROM only if AROM is preluded
isometric or isotonic strengthening exercises to be performed to tolerance.
low impact aerobic condition exercises
pinching exercises may be CONTRAINDICATED with CMC joint instability b/ of stresses on the joint

spica splint

Question 23

Osteoporosis

Answer 23

low bone mass or density and deterioration leading to bone fragility and pathological fractures, particularly WB bones.

Question 24

osteopenia

Answer 24

precursor to osteoporosis. weakening of the bone

Question 25

Osteoporosis intervention

Answer 25

occupation-based retraining with adaptations or mods to accommodate or compensate for pain, stiffness, decreased ROM and instability

low impact WB activities such as walking
encourage good positioning and posture during physical activity.

environmental mods to improve access and reduce fall risk.

body mechanics, energy conservation, and joint protection.

Question 26

boutonniere deformity

Answer 26

flexion of the PIP joint and hyperextension of the DIP joint

Question 27

swan neck deformity

Answer 27

hyperextension of the PIP joint and flexion of the DIP joint

Question 28

mallet finger

Answer 28

flexion of the DIP joint

Question 29

ulnar drift

Answer 29

radial deviation of the wrist and ulnar deviation of the MCP joints

Question 30

mutilans deformity

Answer 30

characterized by floppy joints with shortened bones and redundant skin. most common in MCP ,PIP, radoiocarpal and radioulnar joints

Question 31

acute RA

Answer 31

pain and tenderness at rest that increased with movement, limited ROM, overall stiffness, weakness, tingling or numbness, hot, red joints, cold, sweaty hands, low endurance, weight loss or decreased appetite, fever.

Question 32

subacute RA

Answer 32

reduced pain and tenderness, morning stiffness, limits movement, tingling or numbness, pink warm joints, low endurance, weakness, weight loss or decreased appetite, mild fever

Question 33

chronic active RA

Answer 33

low grade inflation, decreased ROM, less tingling, pain and tenderness primarily with movement, low endurance

Question 34

chronic inactive RA

Answer 34

no signs of inflation, low endurance, pain from stiffness and weakened joints, morning stiffness primarily related to disuse, limited ROM, weakness and muscle atrophy, contractures.

Question 35

RA intervention

Answer 35

limit activities during acute flareups.
assistive devices
physical agent modalities, superficial heat and cold can be used to control symptoms

AROM can be used through full pain free range
PROM may be more appropriate during acute flare ups to prevent stress on inflamed joints

isometrics exercises within pain free exertions are appropriate during acute flare ups.

isotonic progressive resistive exercise can be performed as tolerated when the client is in remission.

aerobic exercises

resting hand splint.