[11.08] The Role of Rehab in MSK Conditions V2.pdf

musculoskeletal disorders

What term describes any condition affecting the bones, joints, muscles, and connective tissue?

pain and loss of function

What are the two primary results of musculoskeletal disorders?

costly and disabling

How are musculoskeletal disorders characterized in the United States?

traumatic musculoskeletal injuries

What are tissue injuries that occur more or less suddenly?

return the patient to their previous levels

What is the primary role of rehabilitation in MSK injuries?

fractures

What is a traumatic break of the bone?

dislocation

What is the partial or complete displacement of the bony parts?

sprains

What term refers to an acute distraction injury of ligaments or joint capsule?

strains

What term refers to an acute distraction injury of muscle and tendons?

intertrochanteric fracture of the right femur

What is a common fracture in the elderly due to decreased bone mineral density?

anteroinferior glenohumeral dislocation

What is a common shoulder dislocation in sports?

knee dislocation

What is a common dislocation in motor vehicular accidents?

sprain

How is an ACL complete thickness tear classified regardless of the degree?

bone to bone

What structures are connected by a ligament or joint capsule in a sprain?

grade 1

What is the grading for a mild sprain?

grade 2

What is the grading for a partial tear sprain?

grade 3

What is the grading for a complete thickness tear sprain?

multiligamentous injuries

What are injuries involving two or more of the four knee ligaments?

ACL, PCL, MCL, and LCL

What are the four ligaments of the knee?

inflammatory phase

Which healing phase involves subsequent inflammation, edema, and pain?

less than 72 hours

What is the typical duration of the inflammatory phase?

fibroblasts and neutrophils

Which two cells are characteristic of the inflammatory phase?

reparative or proliferative phase

Which phase involves cell proliferation, granulation tissue, and neovascularization?

6 to 8 weeks

What is the duration of the reparative phase?

macrophages and platelets

Which two cells are present during the reparative phase?

remodeling phase

Which phase involves tissue maturation and realignment?

6 months to 1 year

What is the timeline for the remodeling phase?

erythrocytes and keratinocytes

Which two cells are present during the remodeling phase?

Problem, Goal, Intervention

What is the sequence of the rehab principle?

International Classification of Functioning, Disability and Health

What does the ICF Model stand for?

framework for making a problem list

What is the role of the ICF model in rehabilitation?

health condition

In the ICF model, what refers to the diagnosis, disorder, or disease?

body function and structure

Which ICF component refers to physiologic function and body parts?

impairments

What are problems in body function or structure such as significant deviation or loss?

activities

What is the execution of a task or action by an individual in the ICF model?

limitation

What refers to physical limitations to performing activities?

participation

What is the involvement in a life situation within one's social sphere?

restriction

What term describes problems with participation and inability to perform purpose?

environmental and personal factors

What two modifiers are accounted for in the ICF model?

pain, swelling, and soft tissue injury

Give three examples of impairments for an ankle sprain.

unable to walk properly or play football

Give two examples of activity limitations.

cannot participate in school events or life roles

Give an example of a participation restriction.

motivation and financials

What are two examples of personal factors influencing recovery?

physical barriers like stairs or lack of elevators

What is an example of an environmental factor in rehab?

Specific, Measurable, Achievable, Relevant, Time-based

What does the SMART acronym stand for?

with the patients

How are rehab goals developed?

physical agent modalities, therapeutic exercise, orthoses, and assistive devices

What are the four main types of rehab interventions?

decrease pain and inflammation and promote tissue healing

What are the two main purposes of physical agent modalities?

cryotherapy

What is treatment by lowering of local tissue temperature?

cold spray and icing

What are two examples of cryotherapy?

muscle relaxation and vasoconstriction

What two physiologic effects are promoted by cryotherapy?

decreases nerve conduction velocity

How does cryotherapy create a local analgesic effect?

thermotherapy

What are heating modalities used to increase tissue temperature?

superficial heat

Which heat type increases local blood flow and removes metabolites to reduce inflammation?

deep heat

Which heat type deposits energy through conversion on deep tissue like ligaments and tendons?

conversion

What process allows deep heat to deposit energy specifically to deep tissues?

avoids excessive heat in skin and subcutaneous fat

What is a major advantage of deep heat?

therapeutic ultrasound

What is a common example of a deep heating modality?

electrotherapy

What modality provides segmental inhibition of pain signals to the brain?

dorsal horn of the spinal cord

Besides the brain, where does electrotherapy inhibit pain signals?

endogenous opioids

What natural substances are released through electrotherapy to manage pain?

serotonin, noradrenaline, and acetylcholine

Name three neurotransmitters besides GABA released during electrotherapy.

transcutaneous electrical nerve stimulation

What does TENS stand for?

mild electrical sensation

What does a patient feel during TENS instead of pain?

shockwave therapy

Which modality destroys sensory unmyelinated nerve fibers and elicits neovascularization?

bone remodeling

What process can shockwave therapy stimulate for fractured non-unions?

extracorporeal shockwave therapy

What does ESWT stand for?

plantar fasciitis and lateral epicondylitis

ESWT has Level 1A evidence for recalcitrant cases of which two conditions?

light amplification of stimulated emissions of radiation

What does LASER stand for?

collagen metabolism and wound healing

What does laser therapy stimulate besides decreasing inflammation?

low level laser therapy

What is a common example of laser therapy?

improving function

What is the primary goal of therapeutic exercise?

muscle performance

Which physical function aspect involves strength, power, and endurance training?

cardiopulmonary endurance

Which aspect involves aerobic conditioning and reconditioning?

mobility and flexibility

Which aspect involves stretching and joint mobilization?

neuromuscular control and coordination

Which aspect involves posture awareness and facilitation techniques?

stability

Which aspect involves body mechanics and stabilization exercises?

balance and postural equilibrium

Which aspect involves agility training?

breathing exercises and ventilatory muscle training

What exercise type is used for cardiopulmonary function?

task specific functional training

What exercise type addresses specific functional needs?

orthoses

What are externally applied devices used to modify structural and functional characteristics?

protection, correction, and assistance with function

What are the three functions of an orthosis?

protection

Which orthosis function is most relevant after an MSK trauma?

stabilize unstable bony components

What is one goal of a protective orthotic device?

Sarmiento brace

What is the specific name for a humeral fracture brace?

non-surgical

A Sarmiento brace is often used for humeral injuries deemed as what?

not as restrictive as casting

What is an advantage of a Sarmiento brace compared to a cast?

hinged elbow orthosis with stops

What device is used to limit extremes of motion during fracture rehab?

ulnar collateral ligament injuries

Hinged elbow orthoses are common for baseball players with what injury?

valgus stress

What type of stress on the elbow causes UCL injuries during hard pitching?

joint contractures and subluxations

What can corrective orthotic devices help correct?

swan neck and boutonniere

What are two deformities in Rheumatoid Arthritis addressed by orthoses?

compensate for muscle weakness or increased muscle tone

How do orthoses assist with function?

assistive devices

What increase the area of support during standing and ambulation for safety?

widen the base of support

What is the primary mechanism by which assistive devices enhance balance?

canes, crutches, walkers, and wheelchairs

What are four examples of assistive devices?

canes

Which device is for mild balance impairment and 20-25 percent weight bearing reduction?

osteoarthritis

Canes are commonly used by elderly patients with which joint condition?

crutches

Which device is for those requiring complete off-loading of a limb?

knee mobilizer

What device is often used with crutches for the first few weeks of an ACL injury?