Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
87 Cards in this Set
- Front
- Back
Name 6 assessments of coordination/dexterity
|
1. Perdue pegboard2. Minnesota manual dexterity test3.O'connor tweezer test4. crawford small parts dexterity test5. nine hole peg test6. Jebson hand function test
|
|
Why is perdue pegboard preferred over nine-hole peg test?
|
perdue peg board can be both unilateral and bilateralit is more reliable
|
|
What UE assessment tool includes 7 subtests in various areas of occupation
|
Jebsen hand Function TestIncludes writing, page turning, picking up common objects, feeding, stacking, picking up large light objects, picking up large heavy objects
|
|
what 2 UE assessment tools look at finger dexterity
|
purdue pegboardnine hole peg test
|
|
what assessment tool looks at eye hand coordination in the context of fine motor?
|
o'connor tweezer test
|
|
what UE assessment tool looks at gross hand and arm movements?
|
Minnesota Manual Dexterity Test
|
|
what are the 2 components of the perdue peg board?
|
manual dexterity (30 sec)assembly job simulation (1 min)
|
|
What are the 2 components of the Minnesota Manual dexterity test?
|
placing test (1 hand)turning test (2 hands)
|
|
How do you increase ROM?
|
1. PROM and passive stretchused when there is contracture, or PROM = AROM2. AROMuse when PROM is greater than AROM3. cannot increase ROM if there is arthrodesis, ankylosis, long-standing contracture, or joint destructionIncorporate into occupation
|
|
How do you know what type of passive exercise is appropriate?
|
Review MD orders
|
|
How do passive stretch and PROM differ?
|
passive stretch includes over-pressure
|
|
how do you apply passive stretch
|
manual stretch within person's tolerance-hold for 15-30 seconds-pain should go away immediately when pressure released (otherwise too much pressure)-adding weight increases stretch. Be careful what objects you are using when doing this in the context of occupation
|
|
What exercises are often prescribes s/p shoulder surgery
|
codman's exercises (a type ofPROM)
|
|
What are some additional methods of PROM
|
dynamic and serial splintingequipment such as continuous passive movement and pulleys
|
|
When is it appropriate to use AROM to improve range of motion?
|
when PROM > AROM
|
|
what are some methods to improve ROM via AROM?
|
differential tendon glides (increase tendon excursion in case of adhesions)blocking exercises (isolate joint motion)encourage functional use/occ based activitiespreparatory interventions: wall walking, cane exercises, AROM
|
|
Precautions when increasing ROM
|
overstretch can create myositis ossificans (a type of heterotopic ossification)
|
|
How do you increase ROM?
|
1. PROM and passive stretchused when there is contracture, or PROM = AROM2. AROMuse when PROM is greater than AROM3. cannot increase ROM if there is arthrodesis, ankylosis, long-standing contracture, or joint destructionIncorporate into occupation
|
|
How do you know what type of passive exercise is appropriate?
|
Review MD orders
|
|
How do passive stretch and PROM differ?
|
passive stretch includes over-pressure
|
|
how do you apply passive stretch
|
manual stretch within person's tolerance-hold for 15-30 seconds-pain should go away immediately when pressure released (otherwise too much pressure)-adding weight increases stretch. Be careful what objects you are using when doing this in the context of occupation
|
|
What exercises are often prescribes s/p shoulder surgery
|
codman's exercises (a type ofPROM)
|
|
What are some additional methods of PROM
|
dynamic and serial splintingequipment such as continuous passive movement and pulleys
|
|
When is it appropriate to use AROM to improve range of motion?
|
when PROM > AROM
|
|
what are some methods to improve ROM via AROM?
|
differential tendon glides (increase tendon excursion in case of adhesions)blocking exercises (isolate joint motion)encourage functional use/occ based activitiespreparatory interventions: wall walking, cane exercises, AROM
|
|
Precautions when increasing ROM
|
overstretch can create myositis ossificans (a type of heterotopic ossification)
|
|
How do you increase strength? what type of contraction is most efficient?
|
high resistance, low reps increases strengthisometrics can produce more powerful contractions
|
|
When strengthening, what type of contraction may be contraindicated? With what populations?
|
Isometrics are contraindicated with cardiovascular conditions and HTN because they increase HR & BP
|
|
What are the 3 types of muscle contractions
|
-isometrics = contract without movement2 types of isotonics:-eccentric = muscle lengthens -concentric = muscle shortens
|
|
How do you increase endurance?
|
Work at 50% of max resistance or less-increase reps and duration, but not resistance-use energy cons methods
|
|
What do you increase in order to improve endurance
|
increase number of reps, and duration of activitydo not increase resistance
|
|
What are 5 methods of reducing edema?
|
1. Elevate above heart2.Retrograde massage3. compression garments4. cold packs5. contrast bath
|
|
You patient has poor circulation and an edematous UE. What should you NOT do?
|
you should not use elevation to reduce edema if a patient has poor circulation
|
|
principles of retrograde massage
|
stroke distal to proximalstroke in centripetal directionperform with extremity elevated
|
|
when is it appropriate to use a compression garment?
|
to prevent re-accumulation of edema following retrograde massage
|
|
Examples of compression garments
|
isotoner glove for handtubigrip for UE (elastic stockinet)ace wrapscoban wrap (for digits)(can exercise and use hand for ADL while wearing coban)
|
|
What should be done when a cold pack is applied to manage edema?
|
cold packs are most effective with elevationmonitor vascular status (vasoconstriction)
|
|
What is a contrast bath?
|
method of reducing edemathere is conflicting evidence regarding effectiveness for hand edemaemerse hand in warm water then cold water
|
|
What are the contraindications for managing edema?
|
-avoid heatdo not use edema management techniques if: infections, grafts, wounds, vascular damage, unstable fractures, CHF
|
|
When is it appropriate to use heat if there is edema
|
may be used in cases of mild edema when application of heat is necessary, but must be closely monitored
|
|
6 principles of scar management
|
1. ROM - early mobilization is most effective2. massage (circular and friction)3. compression garments (coban, isotoner glove, tubigrip)4. Scar pads with compression5. splinting to prevent contractures6. edema control (particularly in acute phase)
|
|
What are 3 interventions for sensory training
|
1. desensitization for hypersensitivity2. sensory re-education3. compensation
|
|
Types of desensitization interventions
|
-if s/p surgery, begin in periphery of scar and work over as tolerated1. massage2. textures3. vibration4. 3 phase desensitization kit5. fluidotherapy
|
|
Types of sensory re-education interventions
|
1. massage2. textures3. vibration4. 3-phase desensitization kit
|
|
compensatory strategies for sensory re-training
|
avoid using hands with vision occludedobserve safety precautions
|
|
principles of improving coordination
|
1. begin with slow gross movements, gradually progress to fast percise movements2. focus on accuracy and speed
|
|
what are the 2 main types of splints?
|
static (immobilizes)dynamic (increases PROM or augments AROM)
|
|
5 purposes of splinting
|
1. rest2. prevent deformities/contractures3. increase joint ROM4. protect bone, joint, and soft tissue5. increase functional use
|
|
2 main principles of designing splints
|
maintain arches of the hand(proximal and distal transverse arches, longitudinal arches)Don't impinge on creases(distal and proximal palmar creases, distal and proximal wrist creases, thenar crease)
|
|
4 Mechanical principles of splinting
|
1. decrease pressure with a long wide base and round edges2. slings should be positioned at 90* angle of pull3. use low load to increase duration4. maintain 3 points of pressure v. circumference
|
|
What is the position of deformity?
|
avoid in splintingwrist flexionMCP hyperextensionIPs flexedthumbs adducted
|
|
what is the safe splinting position?
|
wrist = 20-30* extensionMCP = 50-70* flexionIP extensionthumb abducted and extended
|
|
Resting splinting position
|
wrist = 10-20* extensionMCP = 30-45* flexionIP = 0-20* flexionthumbs abducted
|
|
What is an important precaution for splinting
|
check skin before and after weareducate patient to check skin
|
|
what patient education should be completed for splinting?
|
-skin inspection-splint care-provide wear and care form-teach to don/doff-make sure they understand purpose, functions, and limitations-teach use during role activities
|
|
What can a COTA do in terms of splinting?
|
help determine splint typeexperienced COTAs can make static splints and help with dynamic splints
|
|
what splint is used for brachial plexus injury?
|
flail arm splint
|
|
What splint is used for radial nerve palsy?
|
dynamic wrist, finger, thumb extension splint(lose extensors)
|
|
What splint is used for median nerve injury?
|
opponens splint, c-bar or thumb post splint(lose opposition)
|
|
What splint is used for ulnar nerve injury?
|
dynamic or static MP flexion splint(lose intrinsics-- lumbricals 4 & 5 and interossei)
|
|
what splint is used for combined median-ulnar nerve injury
|
figure of 8 or dynamic MCP flexion splint
|
|
when is a tenodesis splint used?
|
C6-C7 SCI(C6 has wrist extension and use of bicepsC7 has wrist/finger extensors and use of triceps)C8 does not need this splint because they have wrist/finger flexors
|
|
what splint is used for carpal tunnel
|
wrist splint in neutral
|
|
what splint is used for cubital tunnel
|
elbow splint in 30* flexion
|
|
what splint is used for DeQuervains?
|
forearm based thumb splint (includes wrist) with IP free
|
|
What splint is used for skier's thumb?
|
Ruptured ulnar collateral ligament Hand based thumb splint (thumb spica)
|
|
What splint is used for CMC arthritis
|
hand based thumb splint(thumb spica)
|
|
What splint is used for ulnar drift?
|
ulnar drift splint
|
|
What splint is used for flexor tendon injury?
|
dorsal block (protection) splint
|
|
what splints are used for swan neck deformity?
|
silver ring splint or buttonhole splint
|
|
what splints are used for boutonniere deformity?
|
silver ring splint or PIP extension splint
|
|
what splints are used for arthritis?
|
functional splint or safe splint depending on the stage
|
|
what splint is used for flaccidity
|
resting hand splint
|
|
what splint is used for spasticity
|
spasticity splint or cone splint
|
|
What splints are used for muscle weakness?
|
For ALS, SCI, Guillan Barre-balanced forearm orthosis-deltoid sling-suspension sling
|
|
How are balanced forearm orthoses, deltoid slings, and suspension slings used?What movement is needed?
|
mount to wheelchairneed shoulder or trunk movement to use
|
|
splinting for hand burns
|
wrist = 15-30* extensionMCP = 50-70* flexionIPs = full extension
|
|
When is it appropriate to use PAMs?
|
PAMs can only be used if they precede, support, or enable engagement in occupation.-a PREPARATORY method
|
|
What are 8 types of PAMs?
|
1. paraffin baths2. hot packs3. cold packs4. fluidotherapy5. whirlpool6. contrast baths7.ultra sound8. electrical stimulation units
|
|
what are 3 types of Estim?
|
1. functional electrical stim (FES)2. Neuromuscular electrical stim (NMES)3. trancutaneous electrical nerve stimulator (TENS)
|
|
Benefits of superficial heat
|
1. relieves pain2. increases tissue extensibility (for increasing range of motion)3. assists with wound healing
|
|
benefits of cryotherapy
|
1. relieves pain2. controls edema3. decreases abnormal tone4. facilitates muscle tone
|
|
benefits of whirlpool
|
1. cleans and debrides an open infected woundcannot be used as a heat modality--it is not hot enough
|
|
benefits of electrical stimulation
|
1. relieves pain2. decreases swelling3. stimulates and strengthens muscles4. stimulates denervated muscle
|
|
benefits of ultrasound
|
1. relieves pain2. decreases inflammation3. increases tissue extensibility4. decreases adhesions
|
|
benefits of contrast baths
|
reduces edema
|
|
6 general contraindications for PAMs
|
1. cancer2. pacemaker3. pregnancy4. cognitive impairment5. sensory impairment6. vascular impairmentalways consider age and diagnosis (ex. ultrasound cant be used over a growth plate)
|