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ORTHO MOBILIZATION GRADES:
Terms in this set (78)
a small oscillation or small amplitude motion that occurs only at the beginning of the available ROM
a small oscillation or amplitude of motion that occurs at the very end range of the available joint
what grade(s) used to treat pain
grade I and II
I and IV
a large amplitude motion that occurs from midrange of motion to the end of the available range.
T or F mobilizations applied for 10-30 seconds 4 or 5 times per session
Applied for 20 to 60 seconds only four or five times/session
a larger amplitude motion occurring from the beginning of the ROM to near midrange
T or F
grade I- is a piccolo with neutral pressure
Someone underwent surgery can you do a joint moblization
yes- procede with extreme caution
Betty has RA, Osteoporosis, neurologic symptoms
can you do a joint mobilization
no- absolute contraindication
(neuro include- cauda equina, nerve root involvement, SCI)
What components is needed for diabetic shoes?
custom-made arch supports to correct the position of the foot and assist with a better gait pattern-Diabetic shoes are as seamless as possible and have extra depth to accommodate custom arch supports and custom AFOs.
ankle foot "
knee ankle foot ""
hip knee ankle foot ""
elbow wrist hip "
basic sleeve is used for what purpose
What would you use for minimal knee instability and provide proprioception, and mild OA
patella tracking orthosis
hinged knee orthosis
What kind of ankle orthosis would you use for a fracture?
foot drop would require what orthosis?
afo at 90 degrees- limiting inv, ev
what kind of orthosis can be indicated for the following diagnosis:
spina bifida, paraplegia, muscular dystrophy, and osteogenesis imperfecta
These are contraindications for what orthosis
severe contractures, spasticity or other involuntary movements, obesity, and poor upper extremity strength
pt. has symptoms of knee pain in front exacerbated during squatting and climbing steps. What kind of orthosis would you recommend?
patellar tracking orthosis- (symptoms of patellofemoral syndrome, patellar dislocations, patellar trakcing problems)
Which is false about non-surgical knee braces:
helps ant. post compartment
unload compressed side
Postoperative knee orthoses Adjustable ROM settings
false: ant and post compartment
helps medial or lateral compartment
What diagnosis benefit from arch support? (name a few)
diabetes, plantar fasciitis, heel spurs, pronation, ulcerations
What AFO is most cost effective and simplest?
How do we pick the orthosis and components for a pt?
the functional goals of the patient are key to making the most appropriate selection of componentry. -Weight, age, activity level, and potential to regain independence and agility are the factors used to determine which type of orthoses or material to choose.
what drug inhibits cyclo-oxygenase?
What drug is used to decrease pain, not inflammation, in rheumatic disorders?
_____ refers to the degree to which a test is consistent and stable in measuring what it is intended to measure. Most simply put, a test is reliable if it is consistent within itself and across time (produces similar results over time)
in ankle strategy, external pertubations (causing loss of balance in forward direction) cause muscles to activate.
These muscles activate____ to_____. put the muscles in order:
hamstrings, gastroc nemius, paraspinals
distal to proximal
gastroc nemius, hamstrings, paraspinals
in response to falling in backwards direction where does muscle activity begin? (muscles)
tibialis ant., quadriceps, abdominals (still distal to proximal recruitment)
What's an advantage of SLS to BS?
comparing bilaterally (compare both sides)
How would you progress a balance exercise of sitting with eyes closed?
How could you further progress a SLS balance exercise with postural stress?
next, apply postural stress. e.g., tap them on one shoulder and see if they recover.
Change the surface or add a foam pad.
Which test i(nvovles a balance and gait component) involving a 360 degree turn and gait analysis
Which strengthening method involves working at 50%, 75%, 100% of 10RM?
Which involves 100%, 75%, 50% of 10RM?
gradually developing tension for 2 seconds, maintaining a maximal contraction for 6, and decreasing tension for 2 is what type of exercise protocol?
Pre-determined, organized sequence of exercise. one or two exercises for each part of the body. 30-60 second rest period is what type of exercise protocol? (general body conditioning)
What type of training involves intense power-generating exercises for sport specific functional training: jumping, skipping, hopping
What is an advantage of CKC exercise (distal segment is weight bearing or fixed)?
concentric and eccentric muscle contractions
We would expect a ligamentous laxity or hyper-mobile joint to have what end feel?
A torn meniscus would expect what kind of end feel?
internal derangement (springy)
What is the LP & CP position for talocrural joint?
subtalocrural joint? capsualr pattern?
type of joint
talo- 10 deg PF (midway bewteen inv and EV)
talo CP- max DF
capsular: PF > DF
subtalo- midway between extreme ROM (joint mob.)
subtaloCP- max supination
capsular: Various limitations (supination > pronation)
hinged synovial joint
If you want to increase ankle PF what mobilization would you do?
talocrural anterior glide
talocrural posterior glide
if someone has hurt their ATF ligament- what motion do we want to avoid?
what special test would we use?
what ligament (sole action) limits inversion, injured in INV. and DF, and whats its special test?
anterior drawer, or medial talar tilt- avoid PF, INV
calcaneofibular (CFL), medial talar test
In a first degree lateral ankle sprain what ligaments are torn?
ATF, CFL, PTF
(first degree- atf, second degree- atf cfl, , third degree ptf)
What ligament is located medially, rare, prevents excessive eversion?
for a partial tear what is treatment:
for complete what is treatment: and how long
complete- surgery and NWB- 6 wks, then PWB-
which ligament is most commonly injured in ankle?
Match the treatments with their phase of protection: lateral ankle sprain
max, min, mod
A.concentric/eccentric, proprioception, stationary bike
B.WBAT, AROM, isometrics, taping
C proprioception & general fitness , isotonic, plyometrics
max- B- WBAT, AROM, isometrics, taping
mod- A-concentric/eccentric, prop, stationary bike
min- C prop, general fitness, isotonic, plyo
T or F
a partial tear can be managed non-operatively with PT
complete ruptures occur with fractures and require surgical repair
name the injury:
testing with ER and squeeze test
intervention: immobilization, limit WB, surgery
high ankle sprain
chronic instability in ankle. what occurs?
______- subjective feeling of giving way without affecting ligament laxity, proprioception, dec. strength
______- laxity of ligaments, reconstructive surgical procedures to help stabilize the lateral ligaments, ankle arthroscopy to treat lesions
functional and mechanical instability
standard sprain- which grade is slight stretching and microscopic tearing of the ligament fibers
-Chronic inflammation of plantar aponeurosis
-inflammation of plantar fascia
-shortening of gastroc, stress/pull
-symptoms- pain along medial border of calcaneus on plantar surface
what stage of gait would be affected by plantar fasciitis
Achilles non-conservative repair vs conservative
is there a greater loss of power in conservative or non-conservative?
which will have the slower progression?
greater loss in conservative- non surgical treatment
What structures are involved in an achilles rupture?
gastroc, soleus, calcaneus?
an overuse injury resulting from repetitive stress. localized pain at mid-portion, distal third and insertion at calcaneus
aka a "shin" splint.
Tenderness over the distal posteromedial tibia caused by inflammation, periosteal inflammation, injury to the tibia bone, muscles
medial tibial stres syndrome
What is the LP position for patellofemoral joint?
type of joint
patella- full ext. (plane joint)
tibio- 25 degrees of felxion (synovial hinge joint)
By testing the lachman, anterior drawer and lateral pivot what am I testing for?
What does the ACL do and prevent
how is it injured
-prevent ant. translation of tibia on femur.
secondary- control hyperextension and rotational movement, and varus/valgus stress of the knee
-injured- foot planted with rotational movement
match the times table to their approach
non-surgical- 2-4 (shorter process)
surgical 0-8 longer process
In what phase of protection for surgical ACL repair would we want to avoid ambulation without brace locked at 0 degrees.
maximum protection phase
What are the ROM requirements for max, to mod to min , to return to sport phases of ACL repair?
min- return to sport- greater or equal to limb symmetry or isokinetic testing.- physcian clearance
what does a derotation device do
negates any rotation- designed for rotary instabilities secondary to cruciate injuries and deficiencies
what ligament restricts posterior tibial translation, MVA, hyperextension injuries. We test it with posterior drawer, posterior sag, quadriceps active test
What percentages of vascularity goes to the medial and lateral meniscus?
what are the zones? I, II, III
lateral- 10-25% (rich)
I- red on red (vascular on both side)
II- red-on-white (vascular on one side)
III-white-on white (no vascular side)
osteotomy is the removal of a wedge of bone on ______ ________.
what does it repair?
can realign the knee to take pressure off the damaged side by wedging open the upper portion of the tibia to reconfigure the knee joint.
What is the WB status for articular lesion repairs:
Non-weight bearing for 2 to 8 weeks- Full weight bearing in 8 to 10 weeks and relatively limp free- Normal gait, full ROM in 2 to 6 months
PFPS (patellofemoral pain syndrome)- chronic and difficult to define. inlcudes: anterior knee pain, fat pat syndrome, patellofemoral arth, chondromalacia.
what causes it?
bony malalignment, muscular imbalances, poor proprioception, overloading joint
common finding- pain around patella
What exercises might not help at all or irritate it?
anterior knee pain with prolonged sitting, stair ambulation, squatting motions
TKA- what is it?
surgical procedure where one or two surfaces of the tibiofemoral joint is replaced.
name the fracture that goes with the following pairs:
-distal femur or patella/ avulsion of inferior superior pole of patella WBAT, crutches
- distal femur (supracondylar)- TTWB to WBAT, crutches
- metaphysis of tibia and articular surface- non-operative-PWB-FWB, Operative-NWB-FWB
distal femur, patella- patellar fracture
supra-condylar-distal femur (supracondylar)- TTWB to WBAT, crutches
tibial- metaphysis of tibia and articular surface- non-operative-PWB-FWB, Operative-NWB-FWB
Genu Varum VS. genu valgum
bowlegged, compressive medial condyle, medial tibia plateau, LCL stretched
knock-kneed, compressive on lateral condyle and lateral tibia plateau of knee, MCL stretched
valgum- knock-kneed, compressive on lateral condyle and lateral tibia plateau of knee, MCL stretched
varum- bowlegged, compressive medial condyle, medial tibia plateau, LCL stretched
type of joint
Loose packed Position: 30 flex. 30 abd, slight ER
Closed packed position: Full extension, IR
joint type: ball and socket, synovial
THR- total hip arthroplasty
ORIF- open reduction internal fixation. secures fragments with internal devices
ORIF VS THR-
irritated and inflamed form excessive compression and repeated friction
bursitis/ trochanteric bursitis
characterized by pain and bony erosion of the symphysis pubis
The bony erosion is often a much later finding and can complicate early diagnosis.
pain pubic area that radiates laterally across the anterior hip, which is usually aggravated by striding, kicking, or pivoting
sudden forceful contraction or over-stretching of the muscles - affects hip and pelvis and subcutaneous tissues
femoral head becomes flattened at the weight-bearing surface, disrupts blood supply.
Long term complication- incongruous joint surface and advanced DJD.
Legg calve Perthes
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