Lab guide 4

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Questions and Answers

What is the most appropriate intervention for Edna, considering her osteoarthritis and the time since her arthroscopy?

Strengthening exercises focusing on quadriceps and hamstrings

Passive range of motion exercises to maintain joint mobility (correct)

High-impact aerobic exercises to improve conditioning

Strict bed rest to prevent further joint damage

What position should Bart be in to maximize the efficacy of his rehabilitation for his ankle stiffness?

Sitting with his leg dangling down

In a prone position to alleviate pressure on the ankle

Supine with his ankle on a pillow (correct)

Standing while holding onto a stationary object

Which type of range of motion would be recommended for Bart to help alleviate his stiffness post-cast removal?

Passive range of motion to prevent muscle atrophy

Self-assisted range of motion to develop independence

Active-assisted range of motion to facilitate movement (correct)

Active range of motion without assistance to increase strength

What is the main goal of implementing a knee rehabilitation protocol for a patient like Edna?

To reduce pain and swelling while restoring function Signup and view all the answers

What is the most crucial plane of motion for Bart to achieve a normal walking pattern?

Sagittal plane movement for forward propulsion Signup and view all the answers

In Homer’s situation, which range of motion technique would be most appropriate due to his condition?

Passive range of motion to maintain joint integrity Signup and view all the answers

What intervention technique should be avoided in the early postoperative care of a patient undergoing knee arthroscopy?

Resistive strengthening exercises Signup and view all the answers

How important is patient education regarding functional outcomes in Kaiser’s rehabilitation process?

Very important, to enhance motivation and adherence to therapy Signup and view all the answers

What is the recommended dosage for Active Assisted Range of Motion (AAROM) exercises?

20-30 repetitions, 2-5 times a day Signup and view all the answers

In which scenario is Constant Passive Motion (CPM) most warranted?

When a specific clinical reasoning justifies its use Signup and view all the answers

What are the key considerations during Active Range of Motion (AROM) exercises?

Observing pain, fatigue, and vital signs changes Signup and view all the answers

What should be done for a patient with less than 3/5 strength during AROM activities?

Assist them in movement against gravity Signup and view all the answers

What is the primary objective of passive range of motion (PROM) during the inflammatory phase of recovery?

To maintain joint mobility without stressing the tissues Signup and view all the answers

What is a key benefit of the manual techniques for knee rehabilitation?

They allow for more accurate physiological feedback Signup and view all the answers

Which therapeutic exercise is most suitable for a patient transitioning from passive to active range of motion (AROM) after knee surgery?

Assisted active knee flexion using a strap Signup and view all the answers

What should be prioritized when selecting a positioning technique for a patient undergoing rehabilitation for knee injury?

Facilitating optimal alignment and support for the knee Signup and view all the answers

Which of the following best describes what D1 Flexion entails?

Extension - Abduction - IR to Flexion - Adduction - ER Signup and view all the answers

When should you modify a patient's position to control for the effects of gravity during range of motion exercises?

When transitioning from PROM to AAROM to AROM Signup and view all the answers

What is an expected outcome of using mechanical therapy for knee rehabilitation compared to manual therapy?

Greater consistency in achieving specific ROM goals Signup and view all the answers

When is it appropriate to progress to active assisted range of motion (AAROM) in a rehabilitation plan?

Once the pain-free range of motion is established Signup and view all the answers

In pain management during postoperative care, what vital signs should be closely monitored for potential pain indicators?

Blood pressure and respiratory rate Signup and view all the answers

How does pain management in postoperative care influence the rehabilitation process for knee injuries?

It affects patient participation and compliance in the rehabilitation program. Signup and view all the answers

What is a critical consideration when progressing strength training for a patient after prolonged immobilization of the knee?

Gradually increasing resistance based on pain and tolerance Signup and view all the answers

Which technique is most appropriate for minimizing the effects of immobility in a patient with limited active range of motion following knee surgery?

Incorporating self-assisted range of motion with therapist guidance Signup and view all the answers

Study Notes

Case Study #1 - Marge

Marge is experiencing pain after reaching behind to give her kids a toy
The pain is sudden onset
Initial stage of tissue healing - inflammatory stage
Management goals should focus on protecting and resting the injured tissue, reducing pain and inflammation
Interventions should include modalities such as ice, elevation and gentle passive range of motion exercises

Case Study #1 - Marge - One Month After Injury

Marge's pain is ongoing, indicating that she is still in the inflammation stage
The plan of care needs to be adjusted to focus on moving into the subacute stage of healing
Interventions should aim to reduce inflammation, control pain, and promote healing
Modalities may include: light heat, gentle active range of motion, and pain management techniques

Case Study #1 - Marge - Limited Motions

Shoulder abduction and external rotation are likely to be the most limited motions based on her symptoms

Case Study #1 - Marge - Positioning

Positioning for intervention should be comfortable and supportive
Examples include: supine, side-lying, or sitting with proper support

Case Study #2 - Edna

Edna is 65 years old with osteoarthritis in her knees
She has undergone arthroscopy to clear out debris in the knee joint
Two weeks post-surgery - Edna is in the subacute stage of healing

Case Study #2 - Edna - Limited Motions

Stair climbing is a complex activity requiring hip flexion, knee extension, and ankle dorsiflexion
The most limited motions in this scenario are likely knee flexion and ankle dorsiflexion, as they are essential for negotiating stairs

Case Study #2 - Edna - Positioning

Positioning for Edna should prioritize comfort and support for her knee
Examples include: supine, side-lying, or sitting with proper support

Case Study #2 - Edna - Range of Motion

Active-assisted range of motion (AAROM) is an appropriate choice considering Edna's age and osteoarthritis
AAROM allows for gentle movement while reducing the strain on the joint and muscles
Passive range of motion (PROM) can also be incorporated, but active movement is crucial for promoting healing and regaining function

Case Study #3 - Bart

Bart is a 16 year old who sustained an ankle fracture requiring a cast for 6 weeks
He has difficulty walking after the cast was removed, reporting stiffness as his main complaint

Case Study #3 - Bart - Ankle Motions for Walking

Ankle dorsiflexion and plantarflexion are crucial for a normal walking pattern
Inversion and eversion also play a role in heel to toe progression

Case Study #3 - Bart - Plane of Motion

The sagittal plane is most important for Bart's goal of walking
It allows for the necessary ankle dorsiflexion and plantarflexion for propulsion and foot clearance

Case Study #3 - Bart - Range of Motion

Active range of motion (AROM) is the most beneficial exercise for Bart at this time
It promotes active engagement of muscles and helps regain full ankle mobility
Light resistance exercises can also be incorporated progressively as tolerance and strength increase

Case Study #4 - Homer

Homer is a 36-year-old male who sustained a traumatic brain injury in a motor vehicle accident and is currently in an induced coma in the ICU.

Case Study #4 - Homer - Range of Motion Exercises

Passive range of motion (PROM) can be performed
Rationale: Since Homer cannot actively participate due to his condition, PROM helps prevent joint stiffness and maintain muscle length.

Case Study #4 - Homer - Education

The patient's family, staff and loved ones can be educated on the benefits of promoting ROM
Key points: Explain the purpose of PROM and how it contributes to overall recovery.
Communication with healthcare professionals is paramount to ensure the safety and appropriateness of any intervention, particularly in a high-risk situation like Homer's.

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Description

This quiz explores the physical therapy management of a patient named Marge, who is dealing with pain and inflammation after an injury. It covers the initial and follow-up stages of her recovery, focusing on appropriate interventions and modalities for healing. Understand the transitions in care as her condition evolves and how to address limited motions effectively.