Quiz 2 Flashcards
(175 cards)
1
Q
how is the PSFS implemented?
A
the patient is asked to name at least 3 activities that they are struggling with and would like to get back to and rate their ability to perform each on a scale of 0 (unable to perform) to 10 (able to perform at pre-injury level)
average score is taken out of a possible 10
2
Q
the PSFS is valid, reliable, and responsive in populations with…
A
knee dysfunction
cervical radiculopathy
acute LBP
mechanical back pain
neck dysfunction
3
Q
what is the MDC of the PSFS?
A
1.0-2.5 PSFS points
neck dysfunction, knee dysfunction, cervical radiculopathy, chronic LBP, and COPD
4
Q
what is the MCID of the PSFS?
A
spinal stenosis: 1.34
UE musculoskeletal: 1.2
5
Q
what are the goals of body mechanics?
A
protection and jt conservation
6
Q
lower COM = ____ stability
A
greater
7
Q
larger BOS = ____ stability
A
greater
8
Q
legs are _________ spine is ____________
A
source of force, means of force transfer
9
Q
is pushing or pulling easier on the lumbar spine?
A
pushing
10
Q
bending forward pushes spinal disc material _____
A
posteriorly
11
Q
bending backward pushes spinal disc material _____
A
anteriorly
12
Q
does bending forward or backward help take pressure off the foramina?
A
bending backward
13
Q
what is proper stand to sit position?
A
legs touch chair
descend by leading w/ buttocks and lowering legs
sit toward front to middle of chair (don’t aim for back)
slide back
use arm to assist
14
Q
what is proper sit to stand mechanics?
A
slide forward in chair
feet under thighs
use arms to push is able
lead with head
don’t flex neck
maintain lumbar lordosis
push up with legs
15
Q
what are proper body mechanics when going down to lift something?
A
position body close to object
wide BOS
knee flexion and move hips posteriorly w/straight spine
16
Q
what are proper body mechanics when coming up to lift something?
A
keep object close to body
engage core
don’t hold breath
lead with head
push up with legs
legs are source of force, spine is means of force transfer
17
Q
when pushing and pulling use ____ leg/arm(s)
A
both
18
Q
what is ergonomics?
A
the science and practice of sitting and designing jobs and workplaces to match the capabilities and limitations of the human body
19
Q
what is the purpose of ergonomics?
A
to help prevent injury
reduce fatigue and discomfort
increase productivity
improve quality of work
improve job satisfaction
20
Q
what is a work site analysis?
A
assessing for job demands and correcting ergonomics
21
Q
what items are on the ergonomics checklist?
A
posture
force
repetitions
vibration
temperatures
22
Q
repetitive reach items on a desk should be within how many inches?
A
13-18 inches
23
Q
occasionally reach items on a desk should be within how many inches?
A
21-26 inches
24
Q
at what level should the computer monitor be?
A
at eye level
25
arms should be positioned ____ to the floor when seated
parallel
26
how should feet be positioned when seated?
flat on the floor
27
what are the postural requirements?
must be energy efficient
must minimalize stress to the musculoskeletal system
must focus on function
28
what is static posture?
erect, bipedal stance in humans
29
what is the basis for understanding dynamic posture?
static posture
30
when are you susceptible to muscle fatigue, altered blood flow, and perturbations?
in static posture
31
what type of posture requires low energy and minimal muscle activity?
static posture
32
what is BOS?
the area from the heels to toes and foot to foot
33
where is the COM/COG located in static posture?
anterior to S2
34
how many degree is postural sway in the sagittal plane?
12 deg (6 front, 6 back)
35
how many degrees is postural sway in the frontal plane?
16 deg (8 to each side)
36
posture is a ____ not a ____
activity, position
37
what is posture?
a dynamic and complex interaction between a variety of body systems
38
what is postural control?
the ability to maintain stability of the body and body segments in response to forces that threaten to disturb the body's structural equilibrium
39
t/f: postural control requires precise function from a variety of body systems
true!
40
what is COG/COM?
the point on a structure from which gravity exerts its force
41
what is LOG?
vector that runs vertically from COG and determines the location of gravitational forces acting on the body
42
is the LOG within or outside the BOS in standing?
within
43
is the LOG within or outside the BOS in motion?
outside
44
what is center of pressure (COP)? where is it located?
center of distributed forces
b/w the feet in bipedal stance and within foot in single leg stance
45
what is the point at which the ground rxn forces are acting?
COP
46
in erect standing the GRF ___LOG
=
47
the horizontal distance b/w ___ and ___ determines the need for additional support
LOG, GRF
48
ideal posture is determined by ___
LOG
49
where is the LOG in relation to the ankle?
4-6 cm anterior
50
where is the LOG in relation to the knee
anterior
51
where is the LOG in relation to the hip?
posterior
52
what is normal pelvic tilt (ASIS-PSIS angle)?
12 deg
53
what is normal sacral inclination?
30-40 degrees
54
what is normal lumbar lordosis?
20-70 deg
55
where is the apex of the lumbar lordosis?
L3/L4
56
what is normal thoracic kyphosis?
20-50 deg
57
what is normal cervical lordosis?
20-30 deg
58
where does the LOG fall in relation to the ear?
along the tragus of the ear
59
what are common postural deviations?
weakened thoracic extensors
increased thoracic kyphosis
possible reduced lumbar lordosis
tightened pecs
60
what is flat back posture?
mild thoracic kyphosis and forward head
LOG posterior to the hips
post hip tilt
flexed lumbar spine
weakened thoracic muscles
tight pecs
potentially weakened hip flexors
61
what is the kypho-lordotic posture?
axis for knees and ankles is too anterior
anterior pelvic tilt
increased lumbar lordosis and thoracic kyphosis
forward neck flexion in cervical spine
weak glutes and back extensors
62
what is swayback posture?
very forward head
posterior pelvic tilt
decreased lumbar lordosis
63
what is scoliosis?
frontal plane alignment deviation
64
scoliosis creates an abnormal ____ curve of the spine
lateral
65
what is a common cause of scoliosis?
leg length discrepansy
66
what is structural scoliosis?
changes in the skeletal system
67
what is functional scoliosis?
curve caused by a changeable reason
68
what is compensated scoliosis?
C7 and S1/2 are lined up w/curve in b/w
69
what is uncompensated scoliosis?
C7 and S1/2 aren't lined up
70
what do you look at/for in a scoliosis check?
rib hump, arm spaces, pelvic angle, spinal curve, and scap heights
71
what are the causes of upper and lower crossed syndromes?
poor postural habits
muscles imbalances (like tight or lengthened muscles)
72
what is upper crossed syndrome?
tight upper trap, levator scap, and pecs
lengthened deep cervical muscles, serratus anterior, rhomboids, and mid and lower traps
rounded shoulders and protracted scap
forward head posture
increased cervical lordosis and thoracic kyphosis
73
what is lower crossed syndrome?
tight hip flexors and back extensors
lengthened abdominals and glutes
knee hyperextension
biceps fem lengthening
increased lumbar lordosis
protruding abdomen
anterior pelvic tilt
74
lower crossed syndrome can result in ____ movement of the COG
anterior
75
what is genu recurvatum?
hyperextended knees
76
patients with genu recurvatum may also have what deformity at the ankle?
aquinas deformity where the ankle can't dorsiflex and get out of plantar flexion
77
genu recurvatum puts excessive stress on what structure?
the posterior knee
78
what is genu valgus?
knock knees
increased valgus angle/medial angle
decreased lateral angle
79
what is genu varum?
increased lateral angle
decreased valgus angle/medial angle
bowlegged
80
what is the normal foot arch?
a straight line b/w the med mal, navicular, and head of 1st metatarsal (Feiss line)
81
what is pes planus ?
overpronated foot
dropped navicular
flat foot
82
what is hallux abductus valgus?
usually a biomechanical issue
big toe curves out
may see calluses and/or bone growth
83
what are torsions?
twist in a bone
84
what is toe in position?
medial rotation
pigeon toed
85
what is rectus position?
straight AP alignment of the feet
86
what is toe out position?
lateral rotation
87
what is pes cavus?
high arches
navicular is higher up
88
what is normal BMI?
18.5-24.9
89
what is the ectomorph body type?
skinny, hard to gain weight, slender frame, narrow chest and abdomen, smaller body structure, fast metabolism, narrow shoulders and hips
90
what is the mesomorph body type?
medium build, rectangular/wedge body, wider/broader shoulders, fairly lean, can gain muscles easily, usually strong, more muscles of arms and legs
91
what is the endomorph body type?
short in stature, difficult time losing body fat,bulky physique, rounder body, gain fat and muscles easily, wide shoulders and hips
92
what is hypomobility?
decrease in quantity of motion
93
what is hypermobility/instability?
increase in quantity of motion
more likely to dislocate or sublux
94
what is a painful arc?
pain in a portion of the ROM
95
what are the characteristics of abnormal motion?
hypomobility
hypermobility
aprehension to movement
painful arc
presence of crepitus/jt sounds/vibrations
pain during/at end of range
abnormal end feel
AROM not similar to PROM
compensation/aberrent motion (unusual way to get through motion)
96
reduction in motion may result from factors of _____ or _____ origin
musculoskeletal, non-musculoskeletal
97
t/f: hypomobility may be normal in advanced age
true
98
how do we determine if hypomobility is normal?
see if it's bilateral
dif-abnormal
similar-normal
99
what type of abnormal motion is this:
results from laxity in capsuloligamentous complex (CLC) and changes in jt surfaces, trauma, or genetic connective tissue disorders
hypermobility
100
what is capsular pattern?
restricted CLC resulting in loss of motion specific to that jt
101
what is an example of a classic capsular pattern that exists in joints?
osteoarthritis
102
what is noncapsular pattern?
loss of motion doesn't follow a characteritic patterns and may be related to isolated capsular restrictions or some other cause
103
what are the components that make up quality of movement?
coordination, neuromuscular performance, motor control, and motor performance
104
to assess normalcy we must assess what 2 characteristics of motion?
quantity and quality of motion
105
what is the quantity of motion?
defines the degree to which a jt moves through a given ROM
106
what is the quality of motion?
defines the manner in which a jt moves
107
what is muscle length?
functional excursion of a muscle from its fully lengthened position to its fully shortened position
108
what is muscle play?
ability of a muscle to move transversely relative to underlying tissue
109
one jt muscles are often measured through _____ ROM
passive
110
the expectation is that one jt muscles should allow max ____
PROM
111
what is passive insufficiency?
multi jt muscles lengthened across both jts and cannot lengthen anymore
112
what is active insufficiency?
multi jt muscles that are so contracted, they can't create any more actin/myosin overlap
113
t/f: to assess the length of a multi-joint muscles, the joint is held statically while the other is moved through its full ROM
true!
114
measurement of the ____ joint moved provides quantification of muscles length
last
115
what is classic motion?
osteokinematic motion
116
how is osteokinematic motion quantified?
using goniometry
117
what are accessory/component movements?
arthrokinematics
118
which is more challenging to evaluate osteokinematics or arthrokinematics?
arthrokinematics
119
what is rolling motion in arthrokinematics?
angular movement
approximation of new points of one jt surface w/new points on another surface
120
direction of the roll is always in the same direction as what?
the segment being displaced
121
what is gliding motion in arthrokinematics?
when jt surfaces are congruent and a single point on one jt surface is repeatedly contacting new points on the other jt surface
122
when the convex is moving on the concave, the roll and glide are in ____ direction
opposite
123
when the concave is moving on the convex, the roll and glide are in ____ direction
same
124
what is the exception to the convex-concave principle?
external rotation where there is a posterior glide
125
what ROM provides info regarding the following?
willingness to move, coordination, muscles function, jt ROM, quality of motion
screening technique to direct other aspects of care
symptoms/limitations that may be assocated with the stretch/contraction of the tissues
AROM
126
what ROM is a reflection of true jt ROM?
PROM
127
is PROM or AROM normally greater?
PROM
128
should PROM testing come before or after MMT?
before
129
what is CPP?
position of a jt in which least deg of mobility b/w articular surfaces is available
130
what is OPP?
position of max mobility
131
t/f: jt surfaces are generally incongruous, except in one specific position
true!
132
what 2 criteria should be considered for CPP/OPP?
jt congruency and CLC extensibility
133
determining OPP/CPP can be best accomplished through what?
jt play
134
normalcy of end feels is determined by what 3 factors?
1. does the end feel match that which is expected for the jt being tested?
2. does the end feel match that which is expected based on the direction of the motion?
3. does the end feel occur at the proper place w/in the ROM?
135
what is the starting position for all motions?
anatomical position
136
motion begins at __ deg and proceeds to __ deg
0-180
137
where is 0 deg in the transverse plane motion?
midway through the motion
138
when positioning for goniometry, what segment is stabilized?
the proximal segment
139
starting position for goniometry is __ deg
0
140
t/f: you should reduce the effects of periarticular tissues in goniometry
true!
141
if the measurement is not taken in a standard position, what should you do?
document the position measured in
142
what is the body of the goniometer?
the circular portion with the degree marks
143
what is the stationary arm of the goniometer?
the arm typically alignment with the proximally stabilized segment of the jt or the body
144
what is the moveable arm of the goniometer?
the arm typically aligned with the mobile segment of the jt
145
the stationary arm is aligned with the _____ axis of the ____ segment of the jt
longitudinal, proximal
146
the moveable arm is aligned with the _____ axis of the ______ segment of the jt
longitudinal, distal
147
how should you view the goniometer?
at eye level
148
how could these measurements be documented?
5 degrees of hyperextension
115 degrees of flexion
5-0-115
149
how could the following measurement be documented?
elbow flexion of 140 deg
0-140 deg
150
what do negative #s often denote what about pt's ROM?
motion which is unable to achieve neutral
151
what is the purpose of goniometry?
to measure the angle created at a jt by adjacent bones
152
decreased measurement error=_____ reliability
increased
153
in goniometry, is the intra or inter-rater reliability greater?
intrarater reliability is greater
154
why do we provide passive overstretch in goniometry?
to feel the end range and look for reproduction of symptoms
155
what is the SPADI test?
self-administered measure of the patient’s perception of
their shoulder pain and disability in an outpatient setting.
156
what are the SPADI subscales?
pain and disability
157
what is the standard error of measure of the SPADI?
8.9 for pain
7.2 for functional
6.2 overall
158
what is MDC of the SPADI?
shoulder arthroplasty: 18
adhesive capsulitis: 17
shoulder disability: 21.5
159
what is the MCID of the SPADI?
8-13
160
what is the test-retest reliability of the SPADI?
0.64-0.66
lacks strong reliability
strongest in AROM which ranged from 0.56-0.8
161
what is the DASH?
measures patient's disability in doing everyday tasks
162
what is the test-retest reliability of the DASH?
ICC of 0.96
163
what is the predictive validity of the DASH?
>0.69
164
what is the MDC of the DASH?
1.96 for proximal humeral fractures
12.2 for adults with musculoskeletal UE problems
10 for intercollegiate athletes
165
what is the MCID for the DASH?
10.2 for adults with UE musculoskeletal complaints undergoing surgery
166
what is the LEFS?
20 questions on patient reported LE function
167
are there any subscales for the LEFS?
no
168
what is the scale of the LEFS?
each item has a max score of 4 with 4 being no difficulty and 0 being extreme difficulty
169
is a higher LEFS good or bad?
good bc its a FUNCTIONAL scale not a DISABILITY scale
170
what is the standard measure of error for the LEFS?
ACL Reconstruction → 3.7 points
various LE Injuries → 3.9 points
TKA & THA → 3.7 points
orthopaedic Rehab Ward → 4 points
171
what is the MDC of the LEFS?
ACL Reconstruction → 8.7 points
various LE Injuries → 9 points
hip Impairment → 7 points
TKA & THA → 9 points
172
what is the MCID of the LEFS?
ACL reconstruction: 9 points
various LE injuries: 9 points
hip impairments: 6 points
TKA & THA: 9 points
173
what is the test-retest reliability of the LEFS?
various LE injuries: excellent (r = 0.86)
TKA & THA: excellent (r = 0.85)
TKA & THA due to OA: excellent (r = 0.86)
hip impairments: excellent (r = 0.86)
174
do you want a higher or lower score on a disability scale?
lower
175
do you want a higher or lower score on a functional scale?
higher
