Questions and Answers
What is the primary reason for the patient's hip movement limitations?
Which of the following post-surgery precautions is NOT recommended?
What does WBAT stand for in the context of mobilizing after surgery?
In the sit-to-stand transfer, what is the recommended approach to avoid spinal twisting?
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What kind of assistance does the patient require during bed mobility?
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How should a patient safely get out of bed post-surgery?
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What is the purpose of providing pain education for patients exhibiting fear avoidance behaviors?
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What is one common challenge that patients face related to remembering post-surgery activity steps?
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What is the recommended timeframe before returning to play after an ACL reconstruction?
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Which exercise involves pushing down into a towel under the knee?
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What should be thought of as 'magnetic' to the operated leg?
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What is the primary characteristic of the regression exercise listed for knee slides?
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Which phrase best describes the progression of the quad contraction exercise?
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What happens to bone bruising after surgery?
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What is the main goal for a patient post ACL reconstruction by the start of the season?
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Which exercise is suggested as the easiest and basic form of rehabilitation for the operated leg?
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What is the primary purpose of ankle pumps in the initial exercises post-surgery?
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Which of the following exercises is designed to target the gluteus medius?
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What should a patient avoid doing with their legs during the first day post-surgery?
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What is recommended to reduce postoperative pain and swelling for an ACL surgery patient?
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Which procedure is essential for regaining knee function after ACL surgery?
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In the rehabilitation process post-rotator cuff repair surgery, what is the main restriction during the first six weeks?
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Which exercise should be avoided in the early recovery period post-surgery for a full thickness RCT?
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What should be the immediate goal for knee flexion after ACL surgery?
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Which of the following actions is critical to perform while getting dressed post-shoulder surgery?
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What is the recommended progression for glute squeezes post-surgery?
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What is a crucial post-operative instruction for patients with an anterior approach to hip surgery?
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Which exercise is not typically included in the first four weeks post-rotator cuff surgery?
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What is the benefit of using SMART Goals in rehabilitation?
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Study Notes
Case Study 1: LSF
- 70-year-old patient admitted for L1-L3 lumbar spine fusion (LSF).
- L1-L2 compression fracture with 20% canal compromise due to retro pulsed fragment and chronic degeneration observed.
- Previously independent, stair navigation at home required crutch instruction.
- Hip flexion and abduction range of motion (ROM) restricted by severe pain.
- Muscle weakness observed in all hip movements, primarily limited by pain, affecting walking and transfers.
Anatomy of Surgery
- Surgical procedure involves fusion of L1 to L3 vertebrae.
Day 1 Post-Surgery Precautions
- Weight restrictions: no lifting over 2 kgs.
- Avoid upper body twisting and excessive back extension or flexion.
- Ensure sitting is limited to 30 minutes, with instructions to log roll out of bed.
- Mandatory usage of non-slip shoes.
Bed Mobility Techniques
- Requires moderate assistance with log roll and sit to edge of bed.
- Pain reported at 4/10 during mobility tasks.
Weight Bearing as Tolerated (WBAT)
- WBAT allows control over weight distribution through lower limbs based on comfort.
- FASF (functional assistive support framework) provides upper limb support during mobility.
Sit to Stand & Chair Transfer
- Patient requires moderate assistance to transition from bed to chair.
- Emphasize large sweeping motions for transfers to avoid spinal twisting.
Pain and Fear Avoidance Education
- Emphasize the importance of gentle movement for recovery to reduce blood clots and discomfort.
- Use visual aids and demonstrations to support understanding of movements.
Exercises
- Focus on hip flexion and abduction, targeting pain-limited muscle strength.
- Introduce active resistance and ROM exercises including ankle pumps and knee bends.
Week 1 Post-Op Exercises
- Standing knee raises and hip abduction exercises focus on improving strength and mobility post-surgery.
Case Study 2: THR
- Patient remains independent with daily activities but slightly underweight.
- Weight-bearing as tolerated (WBAT) with moderate resting pain (5/10).
- Right hip movements affected by pain, extending to flexion and extension strength limitations.
Anatomy of Surgery
- Intracapsular neck of femur fracture corrected via posterior surgical approach, affecting surrounding musculature.
Day 1 Post-Surgery Precautions
- Maintain hips at a 90-degree angle, avoiding crossing legs.
- Limit internal and external hip rotations.
Bed Mobility Techniques
- Requires minimal assistance to sit up from lying position.
Weight Bearing as Tolerated (WBAT)
- Patient can progressively bear weight based on comfort.
Sit to Stand & Chair Transfer
- Moderate assistance provided during transfers.
Bed Exercises
- Glute squeezes to support circulation post-surgical intervention.
Week 1 Post-Op Exercises
- Emphasis on standing knee raises and hip extension exercises to facilitate recovery.
Case Study 3: RCR
- Injury acquired through a FOOSH mechanism (fall on outstretched hand), resulting in 4 months of work absence.
- Retraction of the supraspinatus muscle to the glenoid rim identified.
Anatomy of Surgery
- Full thickness rotator cuff tear repaired via open surgery, with a medium incision through the deltoid.
Post-Surgery Precautions
- Sling usage required 24/7 for 6 weeks, including specific motions to avoid.
- Maintain cleanliness and dryness of the surgical site.
Sling Information
- Use an abduction sling for 6 weeks, allowing for limited arm movement.
Rehabilitation Exercises
- Initial focus on pendulum swings and scapular depression exercises for strength and mobility.
Progression Timeline for Exercises
- Gradual introduction of active assisted range of motion (AAROM) exercises from weeks 5-8, advancing to more challenging movements by weeks 12-16.
Case Study 4: ACL Reconstruction
- 17-year-old patient undergoing rehabilitation post-ACL reconstruction, with a planned return to AFL in 8 months.
Anatomy of Surgery
- Utilization of a patella tendon graft; meniscectomy performed for horizontal tear repair.
Day 1 Post-Surgery Precautions
- Focus on keeping incisions clean and transitioning mobility to regain knee flexion and extension.
- Pain management with cryotherapy recommended.
Bed Mobility Techniques
- Moderate assistance required for transitioning from lying to sitting.
Sit to Stand & Weight Bearing
- Weight-bearing as tolerated (WBAT) to be managed with specific crutch movements.
Bed Exercises
- Initial exercises include quadriceps contractions and knee slides progressing to resisted flexion.
Week 1 Post-Op Exercises
- Strength program targeting knee recovery, ensuring proper joint mobility.
Return to AFL Advice
- Reinforce the importance of following recovery timelines for safe return to sports activities.
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Description
This quiz focuses on a case study involving a 70-year-old patient with lumbar spine fractures and resultant complications. Participants will analyze the patient's condition, mobility challenges, and treatment strategies. Understanding hip movements and rehabilitation techniques is key.