Week 1 Soft Tissue Injury, Repair, And Management

Front 1

Severity of Tissue Injury: Mild pain at the time of injury or within the first 24 hours.

Back 1

Grade 1

Front 2

Severity of Tissue Injury: Moderate pain that requires stopping the activity

Back 2

Grade 2

Front 3

Severity of Tissue Injury: Near-complete or complete tear or avulsion of the tissue with severe pain.

Back 3

Grade 3

Front 4

Severity of Tissue Injury: Has mild swelling, local tenderness, and pain when the tissue is stressed

Back 4

Grade 1

Front 5

Severity of Tissue Injury: There is increase in pain when the tissue is stressed or palpated. If it is a ligament injury, there is increase in joint mobility due to torn fibers

Back 5

Grade 2

Front 6

Severity of Tissue Injury: No pain when the tissue is stressed or palpated

Back 6

Grade 3

Front 7

Three stages of Tissue Healing

Back 7

Acute

Subacute

Chronic

Front 8

Signs of inflammation

Back 8

Rubor (Redness)

Tumor (Swelling)

Calor (Heat)

Dolor (Pain)

Functio laesa (loss of function)

Front 9

How many days does the acute stage last?

Back 9

4-6 days

Front 10

Patient Education of Acute Stage

Back 10

Inform the pt of the expected duration and symptoms

Give the precautions and contraindications

What to expect when symptoms lessen

Front 11

This is necessary during the first 24 to 48 hours and given to the part affected by the inflammation

Back 11

Protection [of injured tissue]

Front 12

To minimize MSK pain and promote healing, protection is provided via?

Back 12

Rest (Orthosis, tape, cast)

Cold (Ice)

Compression

Elevation

Front 13

T/F Complete or continuous immobilization is recommended during the first phase to weaken the connective tissue and changes in articular cartilage

Back 13

False, it is not recommended

Front 14

These movements should be directed to the structure involved to prevent abnormal adherence of the developing fibrils to surrounding tissue

Back 14

Tissue-specific movement

Front 15

The dosage of movement should be gentle enough so fibrils are not detached from sit of healing

Back 15

Intensity of movement

Front 16

Specific interventions during the acute stage

Back 16

PROM

Low-dosage joint mobilization/manipulation techniques

Muscle setting

Massage

Front 17

For muscle damage or injury, setting is done with the mm in (shortened/lengthened) position

Back 17

shortened

Front 18

For joint injury, the joint must be in _____ when using setting tehcniques

Back 18

resting position

Front 19

When massaging a muscle lesion, the mm is kept in (shortened/lengthened) position

Back 19

shortened

Front 20

When massaging a tendinous lesion, they are treated with a gentle dosage applied ______ to the fibers

Back 20

transverse

Front 21

Interventions for Associated Areas during Acute Stage

Back 21

ROM

Resistance exercises (not directly related to the affected tissue)

Functional activities

Front 22

Precautions for Acute Stage

Back 22

The proper dosage of rest and movement must be used. (keyword is rest and movement)

Front 23

Contraindications for Acute Stage

Back 23

Stretching and resistance exercises directly to the affected tissues

Front 24

In the lower extremities, these should be done to prevent vascular stasis

Back 24

ankle and toe AROM

Front 25

In this stage, the signs of inflammation progressivelt decrease and eventually are absent

Back 25

Subacute Stage

Front 26

How long does the subacute stage usually last?

Back 26

10-17 days (14-21 days after onset of injury) but can last to 6 wks

Front 27

This is present in tremendous numbers by the FOURTH day after injury and will continue until day 21

Back 27

Fibroblasts

Front 28

This begins during day 5, in which the scar shrinks

Back 28

Myofibroblastic activity

Front 29

Terms to describe the immature connective tissue produced during the subacute stage

Back 29

thin and unorganized (very fragile)

Front 30

Patient Education during subacute stage

Back 30

- Encourage the pt to return to normal activities which will not exacerbate symptoms

- Teach them a HEP and help them adapt to work and recreational activities

Front 31

Criteria for initiating active exercises and stretching during early subacute stage

Back 31

Decreased swelling

Pain no longer constant

Pain not exacerbated by motion in available range

Front 32

If signs of inflammation (increase/decrease), the intensity of the exercise and activity must decrease

Back 32

increase

Front 33

If ROM progressively (increases/decreases), the intensity of the exercise and activity must decrease.

Back 33

Decreases

Front 34

These kind of exercises are used during the early subacute stage to initiate control and strengthening of the muscles in a nonstressful manner

Back 34

Multiple-angle, submaximal isometric exercises

Front 35

To initiate isometric exercise in an injured, healing muscle, place it in the (shortened/lengthened) position

Back 35

shortened

Front 36

To initiate isometric exercises where there is joint pathology, it must be placed in ______ position

Back 36

resting

Front 37

T/F During the early subacute stage, the AROM exercises will use isolated, single plane motions

Back 37

True

Front 38

T/F use patterns of motion which are dominated by stronger muscles when exercising during the subacute stage

Back 38

False, dapat isolated or combined motions para matarget affected muscles

Front 39

Muscle fibers first to atrophy when there is joint swelling, trauma, or immobilization

Back 39

Slow-twitch muscle fibers

Front 40

During subacute stage, exercises for muscle endurance is added, including, (high/low) intensity with (high/low) repetitions with (heavy/low) resistance used

Back 40

low, high, low

Front 41

These type of exercises may stimulate stabilizing co-contractions in the mm during the subacute stage

Back 41

Protected WB or PWB exercises

Front 42

To increase the mobility of the scar during the subacute stage, these techniques are used

Back 42

Warm the tissues

Muscle relaxation techniques

Joint mobilization/manipulation

Stretching techniques

Massage

Use of new range

Front 43

Precautions for Subacute stage

Back 43

Since the signs of inflammations decreases early in this stage, discomfort felt by the pt should not last longer than a couple of hours. Signs of too much motion are resting pain, fatigue, weakness, and spasms lasting beyond 24 hrs

Front 44

How many days does it take for a wound to close in muscles?

Back 44

5-8 days

Front 45

How many days does it take for a wound to close in tendons and ligaments?

Back 45

3-6 weeks

Front 46

Scar retraction from activity of the myofibroblasts is usually complete by what day?

Back 46

21

Front 47

T/F On day 21, the scar continues to grow in size

Back 47

False, it stops growing

Front 48

From day 21-60, there is a predominance of what structres that are easily remodeled?

Back 48

fibroblasts

Front 49

If the scar is not properly stressed, the fibers will adhere to the surrounding tissue and form a restricting scar. At which week will the scar tissue become unresponsive to remodeling?

Back 49

14th week

Front 50

T/F During the chronic stage, the pt experiences no pain

Back 50

False, pain is experienced when restrictive contractures are stressed or when there is soreness due to exercise

Front 51

Patient Education in Chronic Stage

Back 51

Instruct the patient in biomechanically safe progressions of resistance and self-stretching and how to self-monitor detrimental effects.

Front 52

When the pt is not using some of the muscles do to inhibition, what should the PT do?

Back 52

Isolate the desired muscle

Progress exercises by using unidirectional simple movements to multidirectional complex movements

Front 53

This is often overlooked in preventing injury associated with fatigue

Back 53

Muscular endurance in prime mover and stabilizing mm

Cardiopulmonary endurance

Front 54

For chronic inflammation, the treatment begins by

Back 54

controlling the inflammation and treating it as an acute condition

Front 55

What should be the muscle grade in lower extremities before discontinuing the use of assistive devices?

Back 55

4 or 5