Week 4 Flashcards Preview

Management of complex patients > Week 4 > Flashcards

Flashcards in Week 4 Deck (114)
Loading flashcards...
1

It is common for patients with lupus to be referred to PT for what?

Referral/seek treatment for:
• Arthritis
• Weakness/fatigue
• Pain reduction

2

What is the role of PT in the education of patients with lupus?

• Skin Care, prevention of breakdown
• Limit sunlight exposure
• Energy conservation techniques: avoid excessive bed rest, because it makes the fatigue worse and ultimately leads to osteoporosis

3

What is the role of PT in the infection control of patients with lupus/RA?

Many of the medication that patients on lupus are on can weaken their immune system, and make them more susceptible to sustaining or acquiring infections

4

What are the types of ADs that we consider for patients especially those with RA?

Consider ADs for skeletal deformities that they may have, especially in the hand

5

Why may ROM or MMT be contraindicated in patients with RA or lupus?

Due to acute inflammation of the joints

6

In the RA population, atlanto-axial instability is common. What are some problems that patients will present with that will require immediate contact of the MD?

• Neuro signs
• Progressive neck pain
• Paraplegia
• Spasticity
• Hyperreflexia
• Ataxic gait

7

What are some interventions that may be contraindicated in patients with RA or lupus?

Vigorous mobilization or manipulation

8

What are the parameters for exercise recommendation for patients with RA or lupus?

• Exercise in short, frequent sessions throughout the
day versus one long session
• To avoid fatigue, alternate activities
• Stop activity when fatigue and pain begin
• Decrease the level of activity or remove the activity from
the program if pain lasts for more than 1-2 hours after the
end of the activity

9

What something really important to keep in mind for exercise in patients with lupus or RA?

Balance of rest and activity in order to avoid muscular and total body fatigue. It is also important to balance stretching and mobilization with protection

10

What are the things that we want to do during flare ups in patients with lupus/RA?

During flare ups, we want to make sure to increase rest, because the enflamed joints can be easily damaged, and have them resume exercise after the flare up subsides

11

What are some recommendations that we give to patients with lupus/RA?

• Change positions every 20-30 minutes throughout the
day to avoid static positioning
• Avoid high-impact sports and contact sports
• During inflammation flare ups, avoid excessive
bending and stooping

12

What are the benefits of aerobic exercise in patients with lupus?

• Reduce fatigue
• Increase QOL
• Improved functional testing scores
• No aggravation of symptoms

13

What were the exercise parameters that were given to patients with lupus in the RCT that was done in brazil?

3 x per week, 12 weeks
• Cardio 65-75% HRR
• Resistance 65-75% 1 rep max for 8 exercises

14

What were the outcome tools of the exercise parameters that were given to patients with lupus in the RCT that was done in brazil?

• SF-36, Beck Depression Inventory, SLE Disease Activity Index, 12 minute walk test

15

What were the results of the exercise parameters that were given to patients with lupus in the RCT that was done in brazil?

• Better than no exercise for improved QoL and physical function
• Cardio better than resistance for improved QoL
• Neither exercise group demonstrated a change in disease activity after 12 weeks of training

16

When comparing aquatic exercise and land exercise in patients with RA, what were the results of the study?

• Aquatics: 87% “much better or very much better”
• No significant differences in 10 m walk, functional scores, Qol, or pain scores

17

What were the results of the study that was done on patients with RA in order to use aerobic exercise and muscle strength training to improve pain and physical function?

• Short and long term land-based aerobic and strength training on aerobic capacity and muscle strength
• Limited evidence for + effect of short term water-based aerobic training

18

What were the results of the study that was done to look at the Effects of Person-Centered Physical Therapy on Fatigue Related Variables in Persons With Rheumatoid Arthritis?

Self care plan development with focus on balance of
physical and life activities resulted in:
• Reduced general fatigue
• Less anxiety

19

What are the common signs and symptoms around chronic pain syndromes: myofascial pain syndrome (MPS aka chronic myofascial pain, [CMP]), Fibromyalgia (FMS), and chronic fatigue syndrome (CFS)?

• Chronic, widespread pain
• Often accompanied by fatigue, sleep, memory, and mood disturbances
• May represent a central pain syndrome
- Does not r/o peripheral nociceptive input or neuropathic contributions
- Makes id of pain source less clear & thus leads to treatment difficulties

20

Chronic pain syndrome diagnoses often overlap and are associated with ____

Chronic pain syndrome diagnoses often overlap and are associated with *anxiety and depression*

21

What is nociceptive pain?

Pain related to damage of somatic or visceral tissue, due to trauma or inflammation

22

What type of pain presentation is considered to be nociceptive pain?

Acute pain

23

What is neuropathic pain?

Pain related to damage of peripheral or central nerves

24

What is centralized pain?

Pain without identifiable nerve or tissue damage, thought to result from persistent neuronal dysregulation

25

What are the key characteristics of acute pain?

It is a 1st time event

26

What are the key characteristics of recurrent pain?

- Relapsing/remitting
- Episodic vs constant

27

What are the key characteristics of chronic pain?

- Neural adaptation
- Sympathetic alterations
- Biopsychosocial consequences

28

What kind of pain is myofascial pain syndrome?

Recurrent pain

29

What kind of pain is fibromyalgia and chronic pain syndrome?

Chronic pain

30

What is hyperalgesia?

Increased pain response to a normally painful stimulus, which results from damaged peripheral pain fibers