Rehabilitation Phases in Tissue Healing book resource

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Questions and Answers

What is a primary characteristic of the subacute stage during healing?

Very fragile, easily injured tissue (correct)

Maturation of connective tissue

Absence of inflammation

Contracture of scar tissue

Which of the following describes a goal of Phase II of rehabilitation?

Control pain, edema, and spasm

Prevent deleterious effects of rest (correct)

Maintain maximum protection

Develop functional independence

Which of the following tissue responses is NOT associated with the chronic stage?

Decreasing inflammation

Contracture of scar tissue

Granulation tissue (correct)

Collagen aligns to stress

In the context of physical therapy, what does 'pain synchronous with tissue resistance' indicate?

Subacute stage of healing Signup and view all the answers

What is the first step in the plan of care for managing acute stage impairments?

Educate the patient Signup and view all the answers

Which of the following best describes the expected physiological changes during the chronic stage?

Maturation and remodeling of scar tissue Signup and view all the answers

What characteristic is indicative of the acute stage of healing?

Clot formation Signup and view all the answers

What is a potential consequence of excessive abnormal stress on a healing injury?

Increased chance of re-injury Signup and view all the answers

Which of the following is NOT listed as an impairment of body structure and function in the chronic stage?

Increased joint flexibility Signup and view all the answers

Which phase in physical therapy rehabilitation specifically aims to increase tensile quality of the scar?

Phase III Signup and view all the answers

Which intervention focuses on managing tight tissues by specific techniques?

Joint mobilization/manipulation Signup and view all the answers

What is a key focus during the progression of exercises after the initial 3 weeks post-injury?

Maintaining controlled proximal stability Signup and view all the answers

When is it appropriate to continue using supportive and/or assistive devices?

Until adequate joint play and strength in muscles are achieved Signup and view all the answers

What should be monitored closely during patient education in the chronic stage?

Patient understanding and compliance with the plan Signup and view all the answers

Which of the following statements about progressing activities after 3 weeks is accurate?

Progression encompasses both protected and unprotected activities Signup and view all the answers

What is indicated about discomfort during increased activity levels in the chronic stage?

A little discomfort is expected but should resolve quickly Signup and view all the answers

What is the primary benefit of performing passive range of motion (PROM) within the limit of pain?

Maintaining mobility and improving fluid dynamics Signup and view all the answers

Which intervention is recommended to protect healing tissues during the subacute stage?

Use of assistive devices and orthoses Signup and view all the answers

What should an appropriate progression of exercises look like after three weeks post-injury?

From passive to active-assistive to active within pain limits Signup and view all the answers

What type of joint mobilization techniques are recommended for improving fluid dynamics in joints?

Grade I or II distraction and glide techniques Signup and view all the answers

What is a primary goal of the plan of care during the subacute stage?

Restoration of soft tissue, muscle, and joint mobility Signup and view all the answers

Which of the following impairments may still be present as the patient progresses through the subacute stage?

Joint effusion Signup and view all the answers

What type of exercises should be introduced initially to address muscle weakness in the subacute stage?

Multiple-angle isometric exercises within tolerance Signup and view all the answers

What should be the approach if a patient's pain or inflammation increases during exercise progression?

Decrease the intensity of exercises Signup and view all the answers

Which of the following signs indicates that activities are progressing too quickly?

Joint swelling Signup and view all the answers

What is an example of an impairment of body structure and function related to chronic inflammation?

Decreased use of the region Signup and view all the answers

Which intervention aims to counsel a patient on the need to avoid stressing the inflamed part?

Ergonomic counseling Signup and view all the answers

What is a primary goal of the 'Plan of Care' in managing chronic inflammation?

Develop strong, mobile scar Signup and view all the answers

Which of the following is NOT a method of intervention during chronic inflammation?

High-intensity resistance training Signup and view all the answers

Which muscle-related issue is commonly associated with chronic inflammation?

Imbalance in length and strength Signup and view all the answers

What is a critical component of the 'Controlled Motion and Return to Function Phases'?

Instruction on signs of too much stress Signup and view all the answers

Which condition might limit normal range of motion (ROM) due to chronic inflammation?

Soft tissue contractures Signup and view all the answers

What is a primary consideration when applying progressive strengthening and stabilizing exercises?

Monitoring the effects on the primary lesion Signup and view all the answers

What symptom indicates that too much motion or activity has occurred during recovery?

Resting pain and fatigue lasting beyond 24 hours Signup and view all the answers

What is the appropriate action when introducing new exercises during the early subacute stage?

Monitor the patient's response to the exercises Signup and view all the answers

During the chronic stage, what should be emphasized to prevent chronic or recurring pain?

Stretching contractures and breaking up adhesions Signup and view all the answers

How does the maximum strength of collagen develop during the remodeling phase?

In response to the stresses placed upon it Signup and view all the answers

What should be avoided to prevent injury to newly developing tissue?

Early initiation of high-intensity exercises Signup and view all the answers

What is likely to occur in a patient due to the restricted use of an injured region?

Muscle weakness even without pathology Signup and view all the answers

Which condition indicates that pain is due to stress placed on restrictive contractures or adhesions?

Pain only when engaging in resistive exercise Signup and view all the answers

Study Notes

Subacute Stage: Proliferation, Repair, and Healing

Noxious stimuli is removed
Capillary beds grow into the area
Collagen formation occurs
Granulation tissue is formed, which is very fragile and easily injured
Inflammation decreases
Pain is synchronous with tissue resistance

Chronic Stage: Maturation and Remodeling

Connective tissue matures
Scar tissue contracts
Scar remodeling
Collagen aligns to stress
No inflammation

Management during phases of rehabilitation

Phase I: Maximum Protection
- Control the effects of inflammation
- Prevent deleterious effects of rest by using non-destructive movement
Phase II: Moderate Protection/Controlled Motion
- Develop a mobile scar
- Promote healing
Phase III: Minimum to No Protection/Return to Function
- Increase tensile quality of scar
- Develop functional independence

Acute Stage: Maximum Protection - Impairments of Body Structure and Function

Inflammation, pain, edema, muscle spasm
Impaired movement
Joint effusion
Restricted use of associated areas

Acute Stage: Maximum Protection - Plan of Care

Educate the patient
Control pain, edema, and spasm
PROM is valuable for maintaining mobility and improving fluid dynamics
Low-dosage joint mobilization/manipulation techniques can improve fluid dynamics in the joint

Subacute Stage: Controlled Motion - Impairments of Body Structure and Function

Pain at the end of available ROM
Edema
Joint effusion
Soft tissue, muscle, and/or joint contractures
Muscle weakness
Restricted ADLs and IADLs

Subacute Stage: Controlled Motion - Plan of Care

Educate the patient
Promote healing
Restore soft tissue, muscle, and/or joint mobility
Develop neuromuscular control, muscle endurance, and strength
Maintain integrity and function of associated areas

Chronic Stage: Return to Function - Impairments of Body Structure and Function

Soft tissue and/or joint contractures and adhesions that limit normal ROM or joint play
Decreased muscle performance-weakness, poor endurance, poor neuromuscular control
Decreased usage of the involved part
Inability to participate normally in an expected activity

Chronic Stage: Return to Function - Plan of Care

Educate the patient
Increase soft tissue, muscle, and/or joint mobility
Improve neuromuscular control, strength, and muscle endurance
Improve cardiopulmonary endurance
Progress activities and participation in life situations

Chronic Inflammation / Cumulative Trauma Syndromes - Impairments of Body Structure and Function

Pain in the involved tissue of varying degrees
Soft tissue, muscle, and/or joint contractures or adhesions that limit normal ROM or joint play
Connective tissue weakness in painful region
Muscle weakness and poor muscular endurance in postural or stabilizing muscles
Imbalance in length and strength between antagonistic muscles; biomechanical dysfunction
Faulty position or movement pattern perpetuating the impairment
Decreased use of the region for activities

Chronic Inflammation / Cumulative Trauma Syndromes - Plan of Care

Educate the patient
Promote healing; decrease pain and inflammation
Maintain integrity and mobility of involved tissue
Develop support in related regions

Chronic Inflammation / Cumulative Trauma Syndromes - Interventions during chronic inflammation

Counsel on the cause of chronic irritation
Adapt the environment to decrease tissue stress
Implement a home exercise program
Cold, compression, massage Rest to the part
Nonstressful passive movement, massage, and muscle setting within limits of pain
Posture training Stabilization exercises

Chronic Inflammation / Cumulative Trauma Syndromes - Interventions – Controlled Motion and Return to Function Phases

Ergonomic counseling to prevent recurrence
Home instruction in safe progression of stretching and strengthening exercises
Friction massage Soft tissue mobilization
Correct cause of faulty muscle and joint mechanics
Posture training Stabilization exercises

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Description

This quiz explores the different stages of rehabilitation in tissue healing, including the subacute, chronic, and acute phases. It focuses on key concepts such as inflammation management, collagen formation, and the transition from protection to functional independence. Test your knowledge on how to effectively rehabilitate and promote healing during these critical stages.