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30 Cards in this Set

  • Front
  • Back
Chronic systemic auto-immune disorder; long lasting which involves multiple body systems
RA Etiology
2-3 X more frequent in women than in men
Onset usually 30-40 yr olds can be hereditary
RA Pathology
May be abrupt w/simultaneous inflammation
Characterized by remissions and exacerbations
RA Signs and Symptoms
-inflammation of joints
-morning stiffness
-limited movement
-sudden onset
RA Eval
RA Interventions
-Joint protection
-Joint immobilization (splinting)
-Activity modification
-Maintain or incr strength and function
-Energy conservation
Give examples of assistive devices used in DECREASED ROM
-Long handled shoe horns
-Extended mop handle
-Revolving space savers
-Peg boards
Give examples of assistive devices used in IMPAIRED GRASP
-Built up soft handles
-Lg pens
-Universal cuffs
Give examples of assistive devices used in INSTABILITY
-Nonskid mats, grab bars, suction brushes
Give examples of assistive devices used in POTENTIAL FOR JNT DEFORMITIES
These AD are to help prevent static or prolonged holding and to increase leverage:
-extended faucet handles
-adapted key holder
-vegetable peeler at MPs
-book stand, bowl holder
Give examples of assistive devices used in DECREASED STRENGTH
Example of AD to modify work heights, raise height of beds & chairs to make standing easier:
- Raised toilet seats
Treatment Methods for RA
-REST: to reduce inflammation and not aggrevate pain. Localized rest may include wearing a splint; psychological rest by focusing on enjoyable things vs work.
-POSITIONING: Maintain good alignments while sitting, standing, even sleeping. Don't use big pillows, pillows under knees
-PAMs: Heat, TENS, COLD (if tolerated).
-THERAPEUTIC ACTIVITY AND EX: Used to promote joint func, MS strength, endurance
-SPLINTING:To reduce inflamm, support joint for func
-ADL TRAINING: Modified methods and use of adaptive equip
Name the 4 stages of RA and some symptoms
1. Acute: Red/Hot joints, pain w/any movement, stiffness
2. Subacute: Pink/Warm joints, pain but unlike that of the acute stage
3. Chronic-Active: Inflammation may be gone, pain tenderness reduced, can tolerate movement, low endurance.
4. Chronic-Inactive: No inflammation, pain due to stiffness from disuse; decrease func from disuse;limited ROM, MS atrophy, or contractures
What exercises are recommended the ACUTE stage
Active-assistive with gravity eliminated and perform with tolerance of pain; choose an appropriate time for pt in reg to pain
-Gentle passive & active ROM to point of pain, but DON'T stretch 2 X a day do 1-2 reps of complete ROM to maintain
-Isometric ex w/out resistence to maint strength 1-3 reps per MS group/day
What exercises are recommended the SUBACUTE stage
Active & Passive ROM w/stretch (not to end point)can be started; Resistive isotonic and graded isometric w/minimal stress to joints
What exercises are recommended the CHRONIC-ACTIVE and CHRONIC-INACTIVE
Stretch at the end of the range may be included during ROM; RESISTIVE ISOTONIC AND ISOMETRIC ex w/out overstressing joints
Why do we splint RA joints:
-prevent further deformities
-In some cases restore deformities
Body joints usually affected in RA?
Synovial Joints
Most affected body parts are: the hands: CMC joint
PIP joint
MCP joint
What is Ulnar Drift
Ulnar drift: radial deviation- the hand moves toward thumb and tendons pull fingers toward little finger.
Using fingers toward radial deviation help prevent further ulnar drift
What is swan-neck deformity
Inflammation of the MCP joint causes intrinsic MS to become tight. The MS pull on the finger causing the DIP joint to flex and the PIP joint to hyperextend
What is boutonniere deformity
The inflammation of the PIP joint. The damaged ligaments stop the joint from straigthening. The pull created causes the DIP joint to extend (go backward).
Thumb deformities
inflammation of the DIP joint and/or MCP joint of the thumb
Joint Protection: Give the 6 examples
1. Respect pain
2. Maintain MS strength and ROM
3. Avoid positions that put stress on involved joints
4. Avoid staying in one position for a long time
5. use the strongest joints and MS avail.
6.Distribute the work load over several joints.
How can Joint Protection be accomplished in principle "Respect Pain"
-Don't tough it out. Pain will lead to more pain!
-If pain last more than 1 hr after the activity, chg, break it down into steps, use less effort
-Or avoid the activity that is straining an already strained joint
How can Joint Protection be accomplished in principle "Maintain muscle strength & ROM"
-Try to use FULL ROM & strength daily by:
using long, flowing strokes when sweeping, mopping, vacuuming; straightening and bending the arms when ironing, reaching for objects
How can Joint Protection be accomplished in principle "Avoid positions that put stress on involved joints"
-normal way of doing things may need to be changed. Examples:hold knife like dagger, use pizza cutter instead; push up from chairs w/palms not fingers; dusting mitt encourages extended fingers; learn to open jars by radial deviation
How can Joint Protection be accomplished in principle "Avoid staying in one position for a long time"
eliminate staying in one postion: don't hold things for long time use bood stand; don't hold bowl while stirring, instead set in a partially opened drawer
How can Joint Protection be accomplished in principle "Use the strongest joints and MS available
use of larger joints reduce the stress on smaller ones. Ex. carry purse on shoulder instead of hand; push open door w/side of arm instead of hand; add cloth loops to drawers to pull w/forearm
How can Joint Protection be accomplished in principle "Distribute the work load over several joints"
Use palms of both hands to lift and hold cups, plates, pots; carry heavy loads close to body w/arms; slide object along counter; may reduce stress by wearing a wrist splint
Treatment Precautions for arthritic patients
-avoid fatigue
-respect pain
-avoid static, stressful, resistive activities
-Limit the applicatoin of heat to 20 min
-Use resisive ex w/caution and never with unstable joints
-be aware of sensory impairments