Podcast
Questions and Answers
What is the most likely presentation for a patient with rheumatoid arthritis affecting the hands?
What is the most likely presentation for a patient with rheumatoid arthritis affecting the hands?
- Osteophytes
- Radial drift of the metacarpophalangeal joints
- Bilateral symmetrical deformities (correct)
- Stiffness of the fingers of short duration
What should the PTA do for a patient recently discharged after an ORIF for a pathological fracture?
What should the PTA do for a patient recently discharged after an ORIF for a pathological fracture?
- Modify the treatment to avoid walking
- Continue with treatment as tolerated and attribute the pain to increased use during treatment
- Recommend that the patient see the physician as soon as possible (correct)
- Suggest the use of heat and monitor response at the next visit
How can the PTA best meet the plan of care for a patient with multiple conditions including RA and a hip fracture?
How can the PTA best meet the plan of care for a patient with multiple conditions including RA and a hip fracture?
- Walk as tolerated with a standard walker and perform passive stretch to bilateral hamstrings
- Participate in contract/relax exercise to stretch bilateral hamstrings and walk on a treadmill
- Use an UE ergometer set at moderate resistance and prone-lying passive stretch of the hamstrings
- Use a recumbent bike and perform contract/relax stretching to bilateral hamstrings (correct)
What should initial physical therapy treatment include for a patient with RA in bilateral elbows?
What should initial physical therapy treatment include for a patient with RA in bilateral elbows?
What should the plan of care include for a patient immediately following a cesarean delivery?
What should the plan of care include for a patient immediately following a cesarean delivery?
Which massage technique is most appropriate for releasing soft tissue adhesions of the calcaneal tendon before stretching?
Which massage technique is most appropriate for releasing soft tissue adhesions of the calcaneal tendon before stretching?
Which exercise should a PTA instruct a participant with spinal stenosis to replace during a water exercise class?
Which exercise should a PTA instruct a participant with spinal stenosis to replace during a water exercise class?
What should a PTA do upon noting increased shortness of breath and a physician's order for a ventilation perfusion scan?
What should a PTA do upon noting increased shortness of breath and a physician's order for a ventilation perfusion scan?
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Study Notes
Rheumatoid Arthritis and Treatment Expectations
- Patients with Rheumatoid Arthritis (RA) often present with bilateral symmetrical deformities in the hands, notably at the metacarpophalangeal joints.
Management of Pain Post-Operative Care
- For patients post-ORIF with a history of metastatic carcinoma, surgical pain should be evaluated urgently; recommending immediate consultation with a physician is crucial when sharp pain is reported, especially if it's affecting sleep.
Rehabilitation Following Multiple Health Issues
- In patients resuming activity post-bedrest with multiple medical challenges, using a recumbent bike for contract/relax stretches of hamstrings is preferable for meeting physical therapy goals.
RA Treatment for Desk Job Challenges
- Initial physical therapy for RA in the elbows should focus on heat modalities combined with joint protection strategies to improve comfort and function during long work hours.
Post-Cesarean Delivery Rehabilitation
- Patients recovering from cesarean deliveries are recommended to start with pelvic floor exercises to aid in recovery and enhance core stability.
Deep Partial-Thickness Burns Management
- When addressing plantar flexion contractures post-burns, cross-friction massage is most suitable to alleviate soft tissue adhesions before joint stretching.
Cardiac Rehabilitation and Exercise Adjustments
- In water exercise classes for cardiac rehabilitation, adjustments should be made based on individual diagnosis; those with spinal stenosis should refrain from performing the crawl stroke.
Monitoring Respiratory Conditions During Treatment
- If a patient shows signs of increased shortness of breath prior to gait training and has a pending ventilation-perfusion scan, treatment should be withheld until the supervising therapist is consulted for further instructions.
Observations of Edema and Skin Changes
- Increased lower extremity aching, alleviated through elevation, along with signs of edema and skin pigmentation changes, requires prompt reporting to the supervising therapist for potential further evaluation.
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