OTS 450 comp 2 - PAMs

What PAMs are appropriate for the following client with rotator cuff repair?

C.R. is a 44-year-old male who works in manufacturing for a car assembly plant. He was injured at work and recently underwent a R shoulder rotator cuff repair surgery for a medium tear of the supraspinatus muscle. His goal is to return to work and driving as soon as possible. Focus on interventions through post-op week 5.

• Cryotherapy - 15 minutes

• Ice massage

• Cold packs - 15 minutes

What PAMs are appropriate for the following client with below the elbow amputation?

This client is a 23 year old male who suffered a below elbow amputation of his dominant right arm during his work in the Air Force. He is an airplane mechanic and would like to stay in the air force but may need to be retrained for a different occupation. He is overwhelmed psychologically regarding coming to terms with his amputation and complains of phantom sensations.

• TENS - pain management

• Fluidotherapy - desensitization

• Cold packs - if client can tolerate cold

• Cryotherapy - periodically throughout the day for 10-15 minutes

What PAMs are appropriate for the following client with Reverse total shoulder arthroplasty?

D.B. is a 58-year-old male who has rheumatoid arthritis. His right deltoid was intact, but he had damage to his rotator cuff muscles. He works at an animal shelter and wants to return to work as soon as he is able. He is being seen in the OT clinic 7 days after the surgery.

• cryotherapy - post exercise for 5 minutes

• ice pack - 10-20 minutes with 4-6 towels

• ice massage

What PAMs would be appropriate for the following client with Carpal Tunnel Syndrome?

The client is a 28-year-old pregnant female who is carrying twins. She has been referred to OT to evaluate and treat her for CTS. She c/o of numbness and tingling in both hands, especially at night. She is a 4^th grade teacher and needs to finish out the last six weeks of the school year before taking off for the summer.

Contrast bath - bilateral hands in warm bath for 3 minute, followed by 1 minute in cold for 20-30 minutes total (ending in cold for edema)

cold pack - reduce inflammation and limit pain

heat - prior to ROM with caution

kinesiotaping - edema and swelling

What PAMs would be appropriate for the following client with lateral epicondylitis?

The client is a 55-year-old male who currently paints houses for a living. His elbow has been painful for about 4 weeks, and it is not getting any better. The condition is with his nondominant arm, and he wonders if he can keep painting houses while he is being treated for his condition.

• cold pack - reduce inflammation and swelling/numbing pain

• ice massage - cool muscle and numb pain

What PAMs would be appropriate for the following client with radial nerve repair?

The client is a 24-year-old male who was in a MVA where he fractured his right humerus. The humeral fracture has healed, but the injury affected his radial nerve. He received a radial nerve repair 1 week ago. He is a student at the local community college and has a job as a cashier at a home improvement store.

• scar massage and desensitization techniques 2-3x daily, 5 minutes (10-14 days post-op)

• avoid PAMs due to sensory loss

What PAMs would be appropriate for the following client with CMC OA?

The client is a 53-year-old female who is postmenopausal. She has been referred to OT by an orthopedic surgeon to evaluate and treat her OA, specifically the CMC of the thumb on the Right hand. She works as a florist and complains of pain when picking up and moving flower vases. She also has pain when driving, using scissors to cut flowers, and other work activities that involve thumb use of the right dominant hand.

• paraffin wax - before functional activities to increase circulation, improve tissue extensibility, and reduce pain/stiffness for 10-20 minutes

• fluidotherapy - pain management, stiffness, limited ROM, gentle AROM

• cold pack - 10-15 minutes after activity

• ice massage

What PAMs would be appropriate for the following client with cubital tunnel syndrome?

The client is a 28-year-old female dentist who complains of ulnar nerve symptoms in her right upper extremity. She has been referred to OT to evaluate and treat her condition.  She is also going through a divorce where she spends hours on her cell phone with her girlfriends and mom and she wonders if this could be aggravating her symptoms.

• moist heat - increase blood flow, reduce muscle guarding, prep tissue for stretching and nerve gliding

• cold pack - for flare ups

• ice massage - for flare ups

What PAMs would be appropriate for the following client with carpal tunnel release?

The client is a 34-year-old female who is a hairdresser. She underwent a carpal tunnel release 1of her right dominant hand 10 days ago. She also has symptoms of CTS in her left non-dominant hand. She has been referred to OT for evaluation and treatment after her surgery.

• cold pack - immediately following post-op to reduce pain and welling

• ice massage - based on client tolerance

What PAMs would be appropriate for the following client with distal radius fracture?

The client is a 75-year-old female who slipped and fell on an outstretched hand (FOOSH). It has been six weeks, and her cast has been removed. She has been referred to OT for evaluation and treatment. She enjoys taking continuing education courses at the local college and likes to cook for her extended family.

• contrast bath - 3-4 minutes arm, 1 minute cold (repeat for 15-20 minutes_

• hot pack - 15-20 minutes prior to exercise, increase tissue elasticity, reduce stiffness, and prepare wrist for AAROM

What PAMs would be appropriate for the following client with De Quervains Tenosynovitis?

The client is a 32-year-old new mother who complains of pain on the dorsal surface of her right hand on the thumb side. It is especially painful for her to pick up her infant and when she is breastfeeding. She is off work for 6 weeks and will return to her job as a certified nursing assistant at the end of the 6 weeks.

• cryotherapy - reduce pain and inflammation

• contrast bath - reduce edema or stiffness, manage pain (3 minutes warm, 1 minute cold for 15-20 minutes)

What PAMs would be appropriate for the following client with Hand burns - post grafting?

Your client is a 28-year-old male who works as a roofer. He accidently spilled tar on the dorsal surface of his forearm and hand. He received 3rd degree burns. He is on the burn unit and received grafts 7 days ago. OT is seeing him post-surgery for rehabilitation of the forearm and hand.

• moist heat when wound is closed prior to ROM exercises (3-4 weeks post-op)