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Arthrogryposis multiplex congenita - S/S & Tx - 5
- Rigid joints of extremities (usually symmetrical)
- “Sausage-like" appearance of limbs
- Weak or non-functioning mms
- Results in - hip dislocations/contractures (ABD/ER/Flex); sh contracture (ADD/IR); club feet
- Tx - PROM is indicated bc main problem is contracture
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Osteogenesis imperfecta - S/S & Tx
- Inherited disorder w/ABNORMAL COLLAGEN SYNTHESIS - FRAGILE BONES
- Fx & deformity of WB bones
- Tx - CONTRAINDICATION - NO PROM or traction
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Osteochondritis dissecans - definition
- SEPARATION OF ARTICULAR CARTILAGE FROM UNDERLYING BONE
- @ Medial femoral condyLe near intercondylar notch
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Osteomalacia - 5
- Softening of bones due to VITAMIN D DEFICIENCY
- Severe pain
- Fractures
- Weakness
- Deformities
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Paget’s disease - 4
- Slowly progressive metabolic bone disease - abnormal osteoclastic activity
- Legs - bow-legged, enlarged, misshapen bones
- Spine - results in stenosis, facet orthography, possible spinal fx
- Test - INC level of alkaline phosphate
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Sprains - 1, 2, 3
- 1 - jt stable
- 2 - jt stability intact
- 3 - jt - unstable - WB not desirable
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Heberden's nodes vs Bouchard’s node
- Heberden's - DIP (OA)
- Bouchard’s - PIP (RA)
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Osteoporosis
- Best therex + 2 examples
- Therex not so great + why?
- Avoid what movement for spine? - 2
- Best - WB extensor stabilization exercises
- Ex: standing partail squats; standing holding against resistance
- Therex not so great - jumping; running; weight - less stimulus to bone + risk of mm injury
- Spine - Avoid - Trunk flexion; Trunk flexion + rotation
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Esophageal cancer - S/S - 4
- Pain radiating to back
- Pain w/swallowing
- Dysphagia
- Weight loss
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How to do ankle clonus
Position leg in slight knee flexion & rapidly DF ankle
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Strain vs. sprain - tear of what?
- Strain = Muscle
- Sprain = Ligament
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Resisted MM testing - strong, painful - 1
Minor structural lesion of mm /tendon
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Resisted MM testing - weak, painless - 2
- Complete rupture of mm/tendon
- Neuro
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Resisted MM testing - weak, painful - 2
- Partial disruption of mm/tendon unit
- Pain d/t SERIOUS PATHOLOGY or concurrent near deficit
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Describe contractile pain
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Describe Ligamentous pain
Dull leading to sharp
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Describe Neurogenic pain
Burning
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Resistance to stretch w/contractile dysfunction
MM spasm
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Resistance to stretch w/ligamentous dysfunction
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Resistance to stretch w/neurogenic dysfunction
Soft tissue stretch
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Phantom limb pain - describe
Cramped & twisting pain
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Scale for accessory mobility - Range
- 0 - Ankylosed jt
- 1 - Considerable limitation
- 2 - Slight limitation
- 3 - Normal
- 4 - Slight hypermobility
- 5 - Considerable hypermobility
- 6 - Pathologically unstable
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Irritated tissue - Neural tissue mobilization - use what grade? should be non-painful
II
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Non-irritated tissue - Neural tissue mobilization - use what grade? to engage barrier but remain non-painful
III
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Chronically inflamed mm - what type of exercise is best?
Eccentrics
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To improve lower abdominal control, therapy ball would have to move in what direction? Causing what type of tilting at pelvis?
- Forward
- Posterior tilting of pelvis
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Sjogren’s Syndrome - Tx -
- Sipping fluids throughout day
- Chewing sugarless gum
- Mouthwash for mouth dryness
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Strength/Hypertrophy training - 4
- Reps - 8-12
- Sets - 1-6
- Rest - 30-120 sec
- 1% RPM - 70-80%
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Endurance training - 4
- Reps - 12-20
- Sets - 1-3
- Rest - 20-30 sec
- 1% RPM - <70%
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Max strength - 4
- Reps - 1-8
- Sets - 1-5+
- Rest - 2-5 min
- 1% RPM - 80-100%
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DOMS - when do they begin? When do they peak?
- Begin - 12-24 hrs
- Peak 24-48 hrs
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When are DOMS greater, after concentric or eccentric exercises?
ECCENTRIC
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Hypertrophy from resistance training can be observed after how long?
At least 6-8 weeks of training
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Acclimatization to heat takes how long?
10 days
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To improve fast-twitch (type IIa) fiber function - intensity; contraction speed; duration
- High intensity
- Fast contraction speeds for Short duration (<20 reps)
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To improve slow-twitch (type I) fiber function - intensity; contraction speed; duration
- Low intensity
- Slow contraction speeds for Short duration
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What type of training improves strength and power more than endurance?
Interval training
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Sprains - After what time is strengthening allowed?
2-3 weeks
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Sprains - 3rd degree - Strength & mobility postop
Up to 5-6 months
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Tendonosis - Initial tx emphasizes what?
ECCENTRIC EXERCISES
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Contraindications for contract-relax stretching - 7
- Acute mm spasm
- Joint instability or hyper mobility
- Acute mm strain or joint sprain
- Inflammation or joint effusion
- Unhealed fx
- Osteoporosis
- Excessive pain
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Hydrostatic P - depth of immersion INC —-> INC hydrostatic P - expected to do what? - 3
- DEC effusion
- Assist venous return
- Can induce bradycardia
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Myositis ossificans - common locations - 3
- Quadriceps
- Brachialis
- Biceps brachii
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