Term
| ____physical therapy and exercise used to extend the spine can help "centralize" the patient’s pain by moving it away from the extremities (leg or arm) to the back. Back pain is usually better tolerated than leg pain or arm pain, and the theory of the approach is that centralizing the pain allows the source of the pain to be treated rather than the symptoms. |
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Definition
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Term
| ____self-healing and self-treatment are important for the patient’s pain relief and rehabilitation. |
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Definition
| Central tenant of the mckenzie approach |
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Term
| passive modalities of the mckenzie method are |
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Definition
| NONE—such as heat, cold, ultrasound, medicine or needles—are used in the treatment. |
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Term
| What is the long term goal of the McKenzie method |
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Definition
| teach patients suffering from neck pain and/or back pain how to treat themselves and manage their own pain for life using exercise and other strategies. |
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Term
| The McKenzie method's goal is to ___ the patients visit |
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Definition
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Term
| In order for the McKenzie method to work with its design to help patients you need the pain to |
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Definition
|
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Term
| What are some patients where pain would not centralize |
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Definition
| lumbar spinal stenosis, facet joint osteoarthritis, extending the spine may actually increase their pain |
|
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Term
| What is the highest clinical categories of back pain |
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Definition
|
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Term
| What is the second highest category of back pain |
|
Definition
| nerve root pathology (<10%) |
|
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Term
| Serious spinal pathology incidence is in about ___% |
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Definition
|
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Term
| What are the 3 syndromes in the mckenzie method |
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Definition
| postural, dysfunction, derangement |
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Term
| ____characterized by intermittent pain brought on only by prolonged static loading of normal tissues. |
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Definition
|
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Term
| What is essential in a postural syndrome? |
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Definition
| time is causative component in prolonged loading |
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Term
| Patients with postural syndrome experience how much pain and movement with activity |
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Definition
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Term
| To provoke pain in what syndrome is slumped sitting which results in prolonged end-range positioning of the joint capsules or adjacent supportive ligaments? |
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Definition
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Term
| In this syndrome Pain is never constant and appears only as the affected structures are mechanically loaded. Pain will stop almost immediately on cessation of loading. |
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Definition
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Term
| In dysfunction syndrome where is the pain caused from? |
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Definition
| mechanical deformation of structurally impaired tissues from either previous trauma or inflammatory degeneration process |
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Term
| Previous trauma or inflammatory degenerative processes will result in what deformation of tissue |
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Definition
| contraction, scarring, adherance, adaptive shortening, or imperfect repair (pain felt when loaded) |
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Term
| In dysfunction syndrome end range stress of ___ shortened structures |
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Definition
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Term
| In dysfunction syndromeMechanical deformation ___ produces pain at end of range |
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Definition
|
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Term
| In dysfunction syndrome what 5 areas could be the cause |
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Definition
| discogenic, zygopophyseal, ligamentous, muscular, apenurosis |
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Term
| This is the most common mechanical syndrome. Signs and symptoms may include back pain only, back and leg pain, or leg pain only. |
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Definition
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Term
| ___causes a disturbance in the normal resting position of the affected joint surfaces. |
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Definition
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Term
| Internal displacement of articular tissue of whatever origin will cause pain to remain constant until |
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Definition
| the displacement is reduced |
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Term
| What tissue obstructs movement in derangement syndrome |
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Definition
| displacement of articular tissue |
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Term
| ___derangement is the model used to explain the dramatic and long-lasting detrimental or beneficial responses to movement and positioning. |
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Definition
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Term
| ___ is no loading strategies decrease, abolish or centratise symptoms |
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Definition
| derangement syndrome irreducible |
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Term
| ___ is loading strategies decrease, abolish, or centralize symptoms |
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Definition
|
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Term
| ___Pain only at limited end range |
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Definition
| dysfunction adherent nerve root |
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Term
| ___ is pain only on static loading, physical exam normal |
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Definition
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Term
| If a person fails to meet a spinal mechanical classification then consider |
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Definition
| stenosis, hip, SIJ, mechanical inconclusive, spondylo, chronic pain state |
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Term
| Derrangement and dysfunction use what three principles |
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Definition
| extension, flexion, and lateral |
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Term
| Postural uses what principle |
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Definition
| postural (skips by extension, flexion and lateral) |
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Term
| ___phenomenon in which limb pain emanating from the spine is progressively abolished in a distal to proximal direction in response to therapeutic loading strategies….. indicates a good prognosis. |
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Definition
|
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Term
| occurs when distal symptoms are produced and remain or distal symptoms are made more severe by loading strategies without centralisation…. the prognosis is poor. |
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Definition
|
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Term
| What are the 4 principles of managment of derangement syndrome |
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Definition
| achive reduction, maintain reduction, recover function, train the patient in prophylaxis |
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Term
| ___ is achieved when the pain is centralized, the obstruction to motion is removed, and the condition remains better |
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Definition
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Term
| What syndrome is the intention of the treatment procedures is to produce the symptoms at end range in order to initiate a remodeling effect upon the adaptively shortened, scarred and/or fibrosed tissues. This is the “no pain, no gain” group. |
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Definition
|
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Term
| what is the emphasis of treatment of dysfunction syndrome |
|
Definition
| to regain lost function due to the loss of tissue extensibility, and ultimately prophylactic training is emphasized |
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Term
| What is the intent of treatment of postural syndromes |
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Definition
| to educate the patient in the mechanism of pain production, and train the patient to correct the postural habits at fault. This includes correct postures when sitting, standing, and lying. |
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Term
| What are 6 prerequisites to doing a good orthopedic evaluation? |
|
Definition
1. Take a good history
2. Understand the neuro/orho overlaps
3.Knowledge of the musculoskeletal system
4. Knowledge of Imaging studies and how to order them
5. Good clinical lab test in differential diagnosis
6. Understand ortho eval and its relation to diagnosis/treatment |
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Term
| What are the parts to an ortho evaluation? |
|
Definition
Inspection/Observation
Soft Tissue Palpation
Bony Palpation
Neurological Exam
ROM Studies
Orthopedic Testing
Examination of Related Areas
Diagnostic Imaging
Clinical Laboratory
Establishing Base Line to Measure Progress |
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Term
| if a doctors goal is to promote anatomical rest, diminish muscular spasm, reduce inflammation, and alleviate pain they are in the ___ intervention stage of passive care |
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Definition
|
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Term
| The __ stage of treatment is to increase pain free ROM, and minimize deconditioning |
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Definition
| remobilization active care |
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Term
| The __ stage of treatment is to restore strength and endurance and to increase physical work capacity |
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Definition
| rehabilitation active care |
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Term
| The ___ stage is to modify social and recreational activities, diminish risk factors, and to adapt psychological factors |
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Definition
| Life style adaptions active care |
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Term
| Pain will decrease after ___ weeks |
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Definition
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Term
| Tissue healing will be almost complete after ___ weeks |
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Definition
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Term
| If a patient has a NMS condition that has pain through a portion of its ROM, what types of exercise can a provider do that will provide 15 degrees of strength overflow to each side of the exercised which will add 30 degrees of improvement |
|
Definition
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Term
| If a patient has a one sided extremity disorder that the provider can treat/exercise the opposite side and gain 15 degrees of ROM and improvement in proprioception |
|
Definition
|
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Term
| what describes these syndromes: tendonitis, impingement syndrome, rotator cuff, epicondylitis, dequervains, and trigger finger |
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Definition
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Term
| What are 4 modalities a provider can use to treat overuse syndromes |
|
Definition
| ice, interferential current, iontophoresis, and micro current |
|
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Term
| What are 4 short term DME/Supports one can use to treat over use injuries |
|
Definition
| kinesio taping, shoulder sling, epicondyle support, and wrist/hand support |
|
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Term
| How long at most would someone use supports or DME |
|
Definition
|
|
Term
| What types of nutritional supports would be helpful with patients with overuse syndromes |
|
Definition
proteolytic enzymes
Antiox + Anti inflammatory
Nerve support (neuro ease)
Magnesium Salicylate (Ultra cal-M)
White Willow Bark + Bromelain (Salizan) (aspirin) |
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Term
| Do not give a patient white willow bark or salicylate if they are already on ___ |
|
Definition
coumadin or other blood thinners
have history of peptic ulcers |
|
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Term
| What types of proproceptive training could you do with a person with overuse syndromes? |
|
Definition
cross crawl
exercise balls
Body Blade
PNF |
|
|
Term
| What types of manipulation techniques would be indicated for people with overuse injuries |
|
Definition
soft tissue (gua sha, graston, cross friction massage)
osseous adjustments |
|
|
Term
| What types of exercise would be utilized for people with overuse injuries |
|
Definition
| stretching, isometric, isokinetic(bands tubing), and small free weights |
|
|
Term
| What instructions would you give a patient with overuse syndrome |
|
Definition
| avoidance and/or alteration of precipitating factors |
|
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Term
| What modalities would be utilized for bursitis? |
|
Definition
| heat, ultrasound, iontophoresis |
|
|
Term
| What DME/supports would you use for bursitis |
|
Definition
|
|
Term
| What nutritional support would be used for bursitis? |
|
Definition
B6 (B6 plus B complex)
Glucosamine + anti inflammatory (joint support) |
|
|
Term
| What type of proprioception would be used for NMR or sensory for bursitis patients |
|
Definition
ROM into pain and limitations
exercise balls
body blade
PNF |
|
|
Term
| What types of manipulation would be used for bursitis patients? |
|
Definition
soft tissue (gua sha, graston, cross friction massage)
osseous with light mobilization |
|
|
Term
| What types of exercise would be used for bursitis? |
|
Definition
| isometric, stretching, isokinetic(bands and tubing, small free weights (codman's) |
|
|
Term
| What instructions do you give bursitis patients? |
|
Definition
keep moving (no pain no gain)
Slow to response time |
|
|
Term
| If trying to treat a bursitis patient and they get worse with treatment rather than getting better than change diagnosis to ___ |
|
Definition
|
|
Term
| What are the modalities for compression neuropathies? |
|
Definition
|
|
Term
| When do you use DME/Supports for compression neuropathies |
|
Definition
|
|
Term
| What nutritional support do you use for compression neuropathies |
|
Definition
botanical/nerve (neuro ease)
B complex (tri-B-plex) |
|
|
Term
| What type of proprioceptive training would be use for NMR or sensory support of compression neuropathies |
|
Definition
pnf
exercise ball
body blade |
|
|
Term
| What type of manipulation procedures would you use for a compression neuropathy |
|
Definition
soft tissue (graston, gua sha, spray stretch)
osseous decompress entrapment |
|
|
Term
| What modalities are used for the treatment of traumatic injuries |
|
Definition
| ice, interferential current, micro current |
|
|
Term
| When do you use DME/Supports in a traumatic injury |
|
Definition
| during the passive phase only |
|
|
Term
| What nutritional support do you use in a traumatic injury |
|
Definition
proteolytic enzymes (zyamin)
Formula (joint support) |
|
|
Term
| In a traumatic injury what type of proprioceptive training would be necessary |
|
Definition
PNF
Exercise ball
body blade |
|
|
Term
| What type of manipulation would be necessary in a traumatic injury |
|
Definition
soft tissue (prevent chronic residuals)
Osseous (mild in acute stages) |
|
|
Term
| What type of exercise is used in traumatic injuries |
|
Definition
isometric (acute)
ROM stretch
Isokinetic (band and tubing)
Free weights |
|
|
Term
| What type of instructions do you give to a traumatic injury patient |
|
Definition
| complete full rehab program to prevent reoccurance and or early DJD |
|
|
Term
| What modalities would you use in the treatment of DJD |
|
Definition
| heat, ultrasound, diathermy, paraffin bath |
|
|
Term
| what supports/DME would you use in DJD patients |
|
Definition
| only during stressful activities and avoid if possible |
|
|
Term
| What nutritional support could be given for patients with DJD |
|
Definition
glucosamine/MSM (anabolic)
Calcium/Osteoporosis (bone support)
Multi vitamin (aved multi) |
|
|
Term
| What type of proprioceptive training would be helpful in DJD patients |
|
Definition
cross crawl
exercise ball
body blade
pnf |
|
|
Term
| What type of manipulation would be helpful in DJD patients |
|
Definition
soft tissue (stretch, massage)
ossseous (mobilizing) |
|
|
Term
| What type of exercise would be helpful for DJD patients |
|
Definition
| isometric, isokinetic, light free weights, water aerobics |
|
|
Term
| What instructions would you give to a DJD patient |
|
Definition
avoid stressful actives and if so use DME
Keep moving |
|
|
Term
| if there is a nerve injury then you need to __ |
|
Definition
|
|
Term
| if the nerve is dying then you will have ___ weeks of care |
|
Definition
|
|
Term
| if there is nerve death you will have __ weeks of care |
|
Definition
| only maintenance care (can't ever help its dead) |
|
|
Term
| if a person can not sleep on an extremity then think towards what condition |
|
Definition
|
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