Physical Therapy Conditions and Development

Klippel-Feil Syndrome

• Characterized by a short or absent neck due to fusion of cervical vertebrae.

Paraplegia

• T11 Paraplegic rolling from supine to prone:
  • Techniques include flexion of the trunk, crossing the ankles, and bilateral UE rocking with outstretched arms.
  • Extension of the head and neck is NOT recommended.

Infant Development

• Milestones expected by 9 months of age:
  • Creeping
  • Rolling from prone to supine
  • Sitting independently
  • Cruising

METS

• Average stair-climbing effort requires 6-8 METS.

Anterior Spinal Cord Syndrome

• Unilateral loss of temperature.
• Sacral sparing occurs.
• Pain and temperature sensations are intact.
• Proprioception and position sense are spared.

Tarsal Tunnel Syndrome

• Characterized by painful dysesthesias at the soles and toes, with weakness of the intrinsic foot muscles.

Immobilization and Cardiac Complications

• Immobilization can lead to decreased cardiac output and increased cardiac size.
• Stroke volume and heart rate may be affected.

Quadriplegia

• C7 quadriplegic patients should be able to perform independently:
  • Sitting board transfer
  • Sliding board transfer
  • Wheelchair to car transfer
  • Floor to wheelchair transfer is NOT typically expected independently.

Downhill Running

• Commonly associated with Achilles tendonitis.

Low Back Pain Contributing Factors

• Height, age, and smoking can contribute to low back pain.
• Muscle strength is NOT typically considered a contributing factor.

Posterior Cruciate Ligament Injury

• Mechanism of injury:
  • Forceful landing on anterior tibia with knee hyperflexed.

Strangulated Stump

• Characterized by a strangulated stump with distal edema.

Deep Venous Thrombosis Risk Reduction

• Elevating the leg reduces the risk of deep venous thrombosis.
• Shallow breaths, dangling the head, and immobilization do not reduce the risk.

Posterior Interosseous Nerve Compression

• Structures that can compress the posterior interosseous nerve include:
  • Ligament of Struthers
  • Arcade of Frohse
  • Pronator teres
  • Osborne's fascia

Hearing Aid Use

• A hearing aid can be given to a hearing-impaired child starting at 3 years old.

Involuntary Movements

• Chorea is an involuntary movement that does not respond to physical or occupational therapy.

Carpal Tunnel Syndrome Diagnosis

• The most objective test for diagnosing Carpal Tunnel Syndrome is EMG-NCV.

Athletic Trauma

• The most common site of athletic trauma to joints and overuse injury is the knee.

Superficial Peroneal Nerve Innervation

• Innervates the skin on the web space between the first and second toes.

Duchenne Muscular Dystrophy

• The most appropriate physical therapy goal is the prevention of contractures and determination of the best method of mobility.

Trisomy 21 and Contact Sports

• Children with Trisomy 21 should be advised NOT to engage in contact sports due to their predisposition to atlanto-axial instability.

Suction Suspension Prosthesis

• Usually indicated for children with above-knee prostheses.

Autonomic Dysreflexia

• SC1 patients at the T10-T12 level are at the highest risk for autonomic dysreflexia.

Carpal Tunnel Syndrome Orthosis

• Static wrist orthosis for Carpal Tunnel Syndrome positions the wrist at 0-18 degrees of extension.

Osteoporotic Patient Exercise

• Avoid trunk flexion exercises for patients with osteoporosis.
• Weight-bearing exercises, swimming, and bicycling are recommended.

Volkmann's Ischemic Contracture

• A complication of a fracture of the radius.

Benign Tumors

• Osteogenic sarcoma is NOT a benign tumor.
• Osteoma, osteochondroma, and chondroma are benign tumors.

Maximum Heart Rate Estimation

• Estimated by subtracting age from 220.

Froment's Test

• Tests the function of the ulnar nerve.

Neuromuscular Junction Disorders

• Myasthenia gravis is a disorder of the neuromuscular junction.

Emotional Adjustment Disability Stages

• The anger reaction stage is characterized by animosity, anger, negativism, and non-compliance with rehabilitation procedures.

AFO Anterior Stop

• Used in patients with weak calf muscles.

Pressure Ulcer Complications

• The most common complication associated with pressure ulcers is infection.

Pressure Ulcer Location

• The most common site for pressure ulcers in bed-level patients is the sacrum.

Cerebral Palsy Classification

• Spastic cerebral palsy can be secondary to Rh incompatibility or kernicterus.

Skin Grafts

• A heterograft (xenograft) is a skin graft taken from a donor of a different species.

Spinal Cord Injury and Fertility

• The ability to bear children is usually NOT affected for women with spinal cord injuries.

Prosthetic Hand Pinch

• Prosthetic hands provide a 3-jaw chuck pinch.

Object Identification

• Sensory testing with object identification should be performed in a quiet environment, ideally the patient's room.

Parkinson's Disease

• The focus of physical therapy for a patient with Parkinson's disease is to address mobility and safety concerns like falls. This includes:
  • Transfer and wheelchair training
  • Caregiver training for contact guarding during level walking and stairs
  • Locomotor training using a rolling walker

Amyotrophic Lateral Sclerosis (ALS)

• Physical therapy for early-stage ALS focuses on maintaining functional independence and addressing mobility challenges:
  • Recommend use of a commode chair for the bedroom.

Palliative Care

• The most important aspect of physical therapy in palliative care is to provide pain control and comfort for patients with late-stage conditions.

Respiratory Assessment

• Decreased breath sounds and decreased fremitus are most indicative of atelectasis.

Respiratory System

• The respiratory center is located in the pons and medulla oblongata.
• The normal volume of dead space air is approximately 150 ml.

AK Prosthesis Gait Deviations

• Swing phase deviations can include:
  • Insufficient knee flexion
  • Excessive knee flexion
  • Knee hyperextension
  • Inadequate foot clearance
  • Circumduction
  • Abduction/Adduction