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mariamandrussow
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How should ROM & Strength be evaluated for person with RA or OA?
- ROM: limit measurement to the primary areas of concern
- Strength: apply pressure at the pain free end range, NOT the true end range
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Joint Protection Principles
- Avoid staying in one position!
- Avoid positions of deformity
- Use strongest joints available for the job
- Ensure correct patters of movement
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OTs and Joint Protection techniques
- APE
- Activity Demands-tools required
- Performance Patters-conserve energy, breaks
- Environment-where
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What do you do if pain is present during the inflammatory process?
What do you do if pain is present during chronic phase?
- -decrease activity
- -avoid aggravating posture
-if pain is produced during activity, esp for more than 1-2 hours, you've gone too far!
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WHY occupatoin?
use the inherent properties of an occupation to address strength, ROM, and endurance
Exercise: Warm UP
Occupation: enhance carryover (of the strength gained in the exercise)
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Maintain muscle strength by balancing strength AROUND the unstable joints to reduce further injury
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Maintain joint ROM for RA
During acute joint inflammation:
When joint inflammation has subsided:
- -maintain ROM, do one complete ROM exercise a day
- -Increase ROM with gentle, controlled stretching to regain the loss during inflammation
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Tx to increase ROM is indicated if:
- -You need ROM to function independently in your occupations
- -ROM will not cause deformity
- -Deformity is flexible
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Goal: to increase end ROM
Tight muscles can be stretched more vigorously than tight joints.
Change is only created when tissue is stretched to the point of maximal stetch.
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PROM is used when:
- Weakness
- Inflammation
- Preparatory for engagement in occupations
- WIP
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AROM is used when:
- Patient is afraid of PROM
- weakness or pain doesn't preclude it
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STRENGTHENING: modifiable parameters to increase strength:
- Assistance level: plane (horizontal vs. sagittal) & force applied
- Type of Contraction: Isometric, Ecc, Concentric
- Duration: of contraction
- Frequency: of exercises
- Purposeful activity vs. exercise: .
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Positioning is essential to avoid development of the following:
- Deformities
- Edema
- Contractures
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