PSPE MSK Problem Definitions PDF

Physiological effects of treatment Heat application \- Have relaxing the nociceptive information decrease, these are only temporary \- Increase blood flow to area, vasodilation, provide more o2 and nutrients to help healing \- Help reduce pain and stiffness +-------------+-------------+--------...

Physiological effects of treatment Heat application \- Have relaxing the nociceptive information decrease, these are only temporary \- Increase blood flow to area, vasodilation, provide more o2 and nutrients to help healing \- Help reduce pain and stiffness +-------------+-------------+-------------+-------------+-------------+ | Treatment | Physiologic | What | Principles | Contraindic | | rationale | al | structures | of | ations | | | effects | are | application | / | | | | affected? | | precautions | +=============+=============+=============+=============+=============+ | Decrease | Circulatory | Muscles, | 1) | Decreased / | | muscle | - | joints | Introduce | absent | | spasm, | vasodilatio | | | sensation | | joint | n | Areas in | 2) Explain | | | stiffness, | healing | pain, with | procedure & | Demyelinati | | oedema/swel | promotion, | spasm, | benefits | ng | | ling | metabolic | swelling | for | disease | | & pain | rate | (post | informed | | | | | 72hrs), | consent | Acute | | Increase | Neurophysio | tenosynovit | | inflammatio | | tissue | logical | is, | 3\) Check | n | | extensibili | - force | contracture | area | | | ty | generation, | s | visually | Bleeding | | | analgesic | & | and ask | disorder | | | effects | haematomas | about | | | | | | contraindic | Hemorrhage | | | Mechanical | | ations | | | | - | | | Malignancy | | | viscoelasti | | 4\) Hot & | | | | c | | cold | Communicati | | | properties | | sensation | on | | | | | test | difficultie | | | Neuropsycho | | | s | | | logical | | 5\) Wrap | | | | - fear, | | hot pack | Atrophic | | | relaxation, | | in 8 | skin | | | pain, | | layers of | | | | reassurance | | towel | Ischaemia | | | , | | | | | | locus of | | 6\) Pack | Scar tissue | | | control, | | hot pack | | | | placebo | | around | Hypertensio | | | | | area | n | | | | | | | | | | | 7\) Leave | Pregnancy | | | | | for 4-5 | | | | | | mins, | Multiple | | | | | check | sclerosis | | | | | temp \~ | | | | | | if too | Open wounds | | | | | hot take | / infection | | | | | off or | | | | | | add | Adrenal | | | | | another | suppression | | | | | layer of | / failure | | | | | towel | | | | | | | Systemic | | | | | 8\) Leave | lupus | | | | | it for | | | | | | 12-15 | Erythematos | | | | | minutes, | us | | | | | remove & | | | | | | check | | | | | | skin for | | | | | | damage | | +-------------+-------------+-------------+-------------+-------------+ Cold- Application of Ice \- Reduce pain, swelling and venous return \- Vasoconstriction limit amount of fluid in area \- Increase ROM +-------------+-------------+-------------+-------------+-------------+ | Treatment | Physiologic | What | Principles | Contraindic | | rationale | al | structures | of | ations | | | effects | are | application | / | | | | affected? | | precautions | +=============+=============+=============+=============+=============+ | Decrease | Circulatory | Muscles, | 1) | Arterioscle | | swelling, | - | joints | Introduce | rosis | | acute | vasoconstri | | | | | inflammatio | ction, | Areas where | 2) Explain | Peripheral | | n, | healing | pain, spasm | procedure & | vascular | | pain | metabolic | / | benefits | disease | | | rate damage | spasticity, | for | | | Inhibits | prevention | acute | informed | Active DVT | | spasticity | | swelling | consent | | | and spasm | Neurophysio | burns are | | Vasospasm | | | logical | present | 3\) Check | -- | | Produces | - nerve | | area | Raynaud's | | reactive | conduction | Areas where | visually | disease | | hyperemia | speed, pain | muscle | and ask | | | | relief | stimulation | about | Cryoglobina | | Stimulates | | is required | contraindic | emia | | muscle | Mechanical | | ations | | | contraction | - | Areas where | | Cold | | | spasticity, | reactive | 4\) Hot & | urticarial | | | swelling | hyperemia | cold | | | | | should be | sensation | Chronic | | | Neurophysio | induced | test | wound | | | logical | | | | | | - fear, | | 5\) Apply | Impaired | | | relaxation, | | baby oil | cognition | | | pain, | | & ensure | or | | | reassurance | | patient | communicati | | | , | | comfort | on | | | locus of | | | | | | control, | | 6\) Put | Cardiac | | | placebo | | ice in a | disease | | | | | damp | | | | | | towel & | Hypertensio | | | | | fold up | n | | | | | the ends | | | | | | | Defective | | | | | 7\) Pack | skin | | | | | around | sensation | | | | | joint, | | | | | | leave for | Skin | | | | | 12 mins, | hypersensit | | | | | check | ivity | | | | | skin | | | | | | redness | Adverse | | | | | every few | psychologic | | | | | minutes | al | | | | | | factors | | | | | 8\) Remove | | | | | | after 12 | Damaged or | | | | | and check | at risk | | | | | for | skin | | | | | damage | | | | | | | | | | | | 9\) Dry | | | | | | area | | | | | | | | | | | | 10) Advise | | | | | | on how to | | | | | | do safely @ | | | | | | home - | | | | | | don't put | | | | | | limb on ice | | | | | | pack | | +-------------+-------------+-------------+-------------+-------------+ TENS +-------------+-------------+-------------+-------------+-------------+ | Treatment | Physiologic | What | Principles | Contraindic | | rationale | al | structures | of | ations | | | effects | are | application | / | | | | affected? | | precautions | +=============+=============+=============+=============+=============+ | Introduces | Pain relief | Sensory | 1) | Do not use | | a new | | receptors | Introduce | TENS on | | sensation | High TENS= | in area of | | people who | | that | | application | 2) Explain | have the | | travels | High | | procedure & | following: | | faster than | frequency, | | benefits | | | pain | low | | for | Pacemakers | | signals - | intensity, | | informed | | | pain nerve | lots of | | consent | Heart | | fibres are | short | | | disease or | | slower than | stimuli | | 3\) Check | dysrhythmia | | sensory | block pain | | area | s | | | signals | | visually | | | Faster | | | and ask | Undiagnosed | | light touch | Low TENS= | | about | pain | | sensations | | | contraindic | | | from TENS | Low | | ations | Epilepsy | | blocks pain | frequency, | | | | | signals | High pulse | | 4) Perform | In the | | | width & | | a pin prick | first three | | Masking | intensity, | | test. | months of | | pain may | stabbing | | | pregnancy | | allow | sensation | | 5\) Place | | | patients to | acts as a | | electrode | Do not use | | temporarily | noxious | | either | on the | | regain | stimulus so | | side of | following | | movement | body | | the area | area: | | | releases | | to be | | | | pain | | treated. | The mouth | | | relieving | | | | | | chemicals | | 6\) Attach | The carotid | | | | | the leads | sinus | | | | | to the | | | | | | machine. | Broken skin | | | | | | | | | | | 7\) Set | Anaesthetic | | | | | the | skin | | | | | desired | | | | | | frequency | The abdomen | | | | | and pulse | during | | | | | rate. | pregnancy | | | | | | | | | | | 8\) Turn | Near the | | | | | up the | eyes | | | | | intensity | | | | | | as much | | | | | | as the | | | | | | patient | | | | | | can | | | | | | comfortably | | | | | | tolerate. | | | | | | | | | | | | 9\) Start | | | | | | the | | | | | | timer. | | | | | | | | | | | | 10\) At | | | | | | the end | | | | | | of time | | | | | | turn the | | | | | | machine | | | | | | off | | | | | | | | | | | | and remove | | | | | | the | | | | | | electrodes, | | | | | | checking | | | | | | the skin | | | | | | for any | | | | | | signs of | | | | | | | | | | | | Adverse | | | | | | reactions. | | | | | | | | | | | | 11) Patient | | | | | | may have to | | | | | | be taught | | | | | | how to | | | | | | | | | | | | apply and | | | | | | use the | | | | | | machine as | | | | | | TENS is | | | | | | | | | | | | frequently | | | | | | given for | | | | | | home use. | | | | | | | | | | | | High TENS: | | | | | | | | | | | | FQ= 150hz | | | | | | | | | | | | Pulse w= | | | | | | 50-80us | | | | | | | | | | | | Duration = | | | | | | up to 8hrs | | | | | | | | | | | | Intensity = | | | | | | pins & | | | | | | needles | | | | | | | | | | | | Low TENS: | | | | | | | | | | | | FQ= 1-4hz | | | | | | | | | | | | Pulse w= | | | | | | 200us | | | | | | | | | | | | Duration = | | | | | | up to | | | | | | 30-40mins | | | | | | | | | | | | Intensity = | | | | | | very strong | | +-------------+-------------+-------------+-------------+-------------+ Hydrotherapy Stretching \- Help reduce pain \- Improve ROM \- Increase blood flow to muscle, increase muscles length \- Increase ROM - Prevent contractures - Decrease risk of injury \- Increase muscle length by stretching sarcomere +-----------+-----------+-----------+-----------+-----------+-----------+ | | Treatment | Physiolog | What | Principle | Contraind | | | rationale | ical | structure | s | ications | | | | effects | s | of | / | | | | | are | applicati | precautio | | | | | affected? | on | ns | +===========+===========+===========+===========+===========+===========+ | Static | Increase | A regular | Muscle | Inc. ROM: | Bony | | | ROM | force | | 20 - 30 | limit to | | | | over a | | secs x 3 | movement | | | Cool down | long time | | - 5 reps | | | | | period: | | | Recent | | | Maintenan | | | 1 - 3 per | fracture | | | ce | Increases | | day | | | | | the | | | Acute | | | | ability | | 5 days | inflammat | | | | to | | /week, | ion/ | | | | tolerate | | for | | | | | discomfor | | | tissue | | | | t | | 6/52 | trauma | | | | | | | | | | | Increase | | Cool | Acute | | | | tissue's | | down: 20 | pain with | | | | ability | | - 30 secs | | | | | to | | x 3 -- 5 | movement | | | | tolerate | | reps | | | | | load | | | Non-compl | | | | | | Post | iant | | | | Stretchin | | activity | patient | | | | g | | | | | | | using | | Maintenan | or unable | | | | regular | | ce: | to give | | | | low-level | | | consent | | | | force | | 15-30 | | | | | results | | secs x 4 | Shortened | | | | in | | - 5 reps | tissues | | | | Stronger: | | | are | | | | | | At least | | | | | Fibre | | x 3 a | compensat | | | | orientati | | week | ory | | | | on | | | | | | | | | | | | | | Increased | | | | | | | thickness | | | | | | | | | | | | | | Improved | | | | | | | cross-bri | | | | | | | dging | | | | +-----------+-----------+-----------+-----------+-----------+-----------+ | Active | Increases | "" | Muscle | 10- 15 | "" | | | active | | | secs | | | | | | | | | | | flexibili | | | 2 - 6 | | | | ty. | | | reps | | | | Strengthe | | | | | | | ns | | | 5 days | | | | | | | per week, | | | | the | | | for | | | | agonistic | | | | | | | muscles | | | 6/52/3-4 | | | | | | | times a | | | | | | | | | | | | | | week (for | | | | | | | strength) | | +-----------+-----------+-----------+-----------+-----------+-----------+ | Dynamic | Improves | "" | Muscle | 8 - 12 | "" | | | dynamic | | | reps | | | | | | | | | | | flexibili | | | As | | | | ty | | | required | | | | | | | | | | | As part | | | | | | | of | | | | | | | warm-up | | | | | +-----------+-----------+-----------+-----------+-----------+-----------+ Active Assisted Exercise +-------------+-------------+-------------+-------------+-------------+ | Treatment | Physiologic | What | Principles | Contraindic | | rationale | al | structures | of | ations | | | effects | are | application | / | | | | affected? | | precautions | +=============+=============+=============+=============+=============+ | Exercises | maintain | Synovial | 1) | Early | | performed | ROM, | joints, | Introduce | unstable | | by patient | | muscle, | | fracture | | with | joint | ligaments | 2) Explain | | | assistance | integrity, | | procedure & | Intolerable | | from | | | benefits | pain | | outside | decrease | | for | | | force | pain | | informed | Immediately | | | | | consent | post injury | | Used if | increase | | | | | patient not | circulation | | 3\) Check | Incomplete | | strong | propriocept | | area | muscle or | | enough to | ion | | visually | ligament | | perform | | | and ask | tear | | full ROM - | Increase | | about | | | enforced | muscle | | contraindic | Compromised | | rest, pain, | activity | | ations | circulation | | weakness, | | | | | | fear | Neuroplasti | | 4\) choose | Subluexed | | avoidance | c | | appropriate | shoulder | | | change | | of active | | | | | | assisted | | | | | | - | | | | | | | | | | | | Auto | | | | | | (patient | | | | | | assists | | | | | | themselves) | | | | | | , | | | | | | Manual | | | | | | (another | | | | | | person | | | | | | assists) or | | | | | | mechanical | | | | | | (piece of | | | | | | equipment | | | | | | assists) | | | | | | | | | | | | 5) | | +-------------+-------------+-------------+-------------+-------------+ Manual Strengthening Help reduce pain \- Help maintain bone and muscle mass \- Increase blood flow to muscle providing more 02 and nutrients \- Increase ROM \- Prevent contractures \- Decrease risk of injury \- Increase muscle activity by increase of recruitment \- Increase muscle fibres +-------------+-------------+-------------+-------------+-------------+ | Treatment | Physiologic | What | Principles | Contraindic | | rationale | al | structures | of | ations | | | effects | are | application | / | | | | affected? | | precautions | +=============+=============+=============+=============+=============+ | To reduce | Increase | Muscle & | 1) | Inflammator | | weakness - | type II | connective | Introduce | y | | Loss of | fibre size | tissue | | conditions | | muscle mass | | | 2) Explain | of the | | | Increased | | procedure & | muscle or | | Neuromuscul | movement | | benefits | joint | | ar | efficiency | | for | | | | | | informed | Pain | | | Decrease | | consent | | | | capillary | | | CV | | | density | | 3\) Check | precautions | | | | | area | | | | Increase | | visually | Valsalva | | | anaerobic | | and ask | manoeuvre | | | processes | | about | | | | | | contraindic | Fatigue | | | Increase | | ations | | | | type I | | | Overwork / | | | fibre size | | 4\) teach | Overtrainin | | | | | resistance | g | | | Increased | | exercises | | | | movement | | that work | Osteoporosi | | | efficiency | | specific | s | | | | | muscle | | | | Increased | | | Substitute | | | capillary | | 5\) advise | movement | | | Density | | 2-6 sets | | | | | | of 6 | DOMS | | | Increase | | repetitions | | | | aerobic | | | | | | processes | | 6\) check | | | | | | for | | | | | | adverse | | | | | | affects | | +-------------+-------------+-------------+-------------+-------------+ Mechanical Strengthening Help reduce pain \- Help maintain bone and muscle mass \- Increase blood flow to muscle providing more 02 and nutrients \- Increase ROM \- Prevent contractures \- Decrease risk of injury \- Increase muscle activity by increase of recruitment \- Increase muscle fibres +-------------+-------------+-------------+-------------+-------------+ | Treatment | Physiologic | What | Principles | Contraindic | | rationale | al | structures | of | ations | | | effects | are | application | / | | | | affected? | | precautions | +=============+=============+=============+=============+=============+ | To reduce | Increase | Muscle | 1) | Inflammator | | weakness - | type II | | Introduce | y | | Loss of | fibre size | | | conditions | | muscle mass | | | 2) Explain | of the | | | Increased | | procedure & | muscle or | | Neuromuscul | movement | | benefits | joint | | ar | efficiency | | for | | | | | | informed | Pain | | Use | Decrease | | consent | | | equipment: | capillary | | | CV | | Free | density | | 3\) Check | precautions | | weights, | | | area | | | Therabands, | Increase | | visually | Valsalva | | | anaerobic | | and ask | manoeuvre | | Weights | processes | | about | | | machines | | | contraindic | Fatigue | | | Increase | | ations | | | Tin of | type I | | | Overwork / | | beans, | fibre size | | 4\) teach | Overtrainin | | socks and a | | | exercises | g | | walking | Increased | | that work | | | stick | movement | | specific | Osteoporosi | | | efficiency | | muscle, | s | | | | | use | | | | Increased | | weight | Substitute | | | capillary | | that is | movement | | | Density | | over 85% | | | | | | of one | DOM | | | Increase | | rep max | | | | aerobic | | | | | | processes | | 5\) advise | | | | | | 2-6 sets | | | | | | of 6 | | | | | | repetitions | | | | | | | | | | | | 6\) check | | | | | | for | | | | | | adverse | | | | | | affects | | +-------------+-------------+-------------+-------------+-------------+ Neural flushers - - - - -