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Irene Gold: PT Section Questions And
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Massage: indications & contraindications - ANSWER✔✔ Indications: subacute sprains, strains, bruises, tendinitis, bursitis contraindications: vascular problems type of massage used to break adhesions - ANSWER✔✔ friction massage trigger point therapy: indications - ANSWER✔✔ myofascial pain used to elongate contracted bands of muscle fibers performed no longer than 10 seconds traction: indications/contraindications - ANSWER✔✔ indications: disc syndromes, IVF encroachment, chronic mm spasm contraindications: bone weak, inhibiting conditions, ligament instability, acute injury cryotherapy: indications/contraindications - ANSWER✔✔ indications: ACUTE conditions (<72 hours)
- spasticity with CNS disorders, local swelling, mm spasms, neuralgia contraindications: raynauds, circulatory compromise, cold hypersensitive, frostbite, cold allergy, open dermal wounds used 20-30 mins Sensing Cold progression: CBAN - ANSWER✔✔ cold burning aching numb local effects of cryotherapy - ANSWER✔✔ vasoconstriction analgesia (greatest effect) anesthesia blocked histamine hardened CT systemic effects of cryotherapy - ANSWER✔✔ decreased mm fatigue reduced lymph/venous drain shivering/increased mm tone posterior hypothalamus cooled increased BP decreased resp rate/HR
Ultrasound ind/contra - ANSWER✔✔ ind: MSK conditions, contractures, adhesions. Pulsed- acute continuous- subacute/chronic contra: epiphyseal centers, bony prominences, fractures effects: thermal (continuous only), mechanical, chemical, neural US settings - ANSWER✔✔ Acute: Pulsed 0.5-1.0 w/cm2 (thin) 1 - 1.5 w/cm2 (thick skin) chronic: Continuous 1 - 1.5 w/cm 1.5-2.0 w/cm low volt galvanic - ANSWER✔✔ exhibits polar effects used for iontophoresis, denervated mm high volt galvanic - ANSWER✔✔ used for pain control, to reduce mm spasm and edema, and to exercise muscle
TENS used for _________ only - ANSWER✔✔ pain control Faradic/Sine wave - ANSWER✔✔ used for mm contraction, stretch fibrotic tissue, increase lymph flow Interferential Current (IFC) - ANSWER✔✔ Used for pain control, edema reduction, break mm spasm, exercise mm same basic effects as high volt but has deeper penetration by use of crossing 2 sine waves trochanteric belt AKA sacroiliac girdle - ANSWER✔✔ used for SI hypermobility (sit/stand test) 3 types of mm contraction - ANSWER✔✔ 1. isometric
- isotonic
- isokinetic isometric contraction - ANSWER✔✔ tension is developed but the mm does NOT change in length, NO JOINT MVMT
- initial treatment of injury ex: jendrassik maneuver, plank
McKenzie extension exercises - ANSWER✔✔ extension type exercises used for LBP. Can be used during acute phase codmans exercises (aka Pendular exercises) - ANSWER✔✔ finger tip wall walking and pendular exercises to restore normal shoulder ROM eliminates use of supraspinatus mm For frozen shoulder (adhesive capsulitis) and RTC rehab Kegel's exercises (pelvic floor exercises) - ANSWER✔✔ tighten/facilitate the perineum post partum and with incontinence for pregnant women, incontinence Jacobson's exercise - ANSWER✔✔ for biofeedback Stress exercises to relax muscles Delorme exercise protocol - ANSWER✔✔ systematic approach to mm strengthening by increasing the resistance placed on the muscle Used to rehab the knee
Frenkel's Exercises - ANSWER✔✔ Ataxic motion and to develop coordination used to increase coordination and uses a °wobble board* Clayton's Exercises - ANSWER✔✔ Crawling exercises to mobilize the spine, and exercise muscles in scoliosis (cross-crawl). Bobath exercises - ANSWER✔✔ Used for patients with cerebral palsy Patterning plyometrics - ANSWER✔✔ Rapid stretching of a muscle group that is undergoing eccentric stress (the muscle is exerting force while it lengthens), followed by a rapid concentric contraction ballistic exercises open chain exercise - ANSWER✔✔ hand/foot free to move in space ex: bicep curl or leg extensions, bench press, SLR Close chain exercise - ANSWER✔✔ hand/foot fixed, cant move ex: pushups/squats, pullups, lunges, handstand pushups
cardiovascular fitness definition - ANSWER✔✔ Aerobic exercise = vigorous exercise that results in oxygen consumption (from 50-80% max) and HR (from 60- 90% max) maintains this level for at least 15-20 mins Aerobic exercise refers to cyclic movements caused by contraction of large muscle masses relying on aerobic energy pathways McKenzie method/approach - ANSWER✔✔ Spinal assessment and therapy
- based on the behavior of pain and mechanical response to dynamic and static loading 3 types of pain syndromes - ANSWER✔✔ 1. Postural
- end range stress of normal structures
- dysfunction
- end range stress that leads to contracted/adherent structures
- derangement
- anatomical disruption or displacement of structure (herniated disc) Plyometrics is based on what concept - ANSWER✔✔ force x speed = POWER any exercise within mm is contracted eccentrically then immediately concentrically ex: pushup w clap b/w
exercises that enable a mm to reach MAX force in shortest time - ANSWER✔✔ plyometrics (jumps, bounds, box drills, burpees, depth jumps) plyometrics uses a pre-stretch countermvmt that involves the __________ - ANSWER✔✔ SSC: stretch-shortening cycle 3 phases of SSC:
- eccentric
- amortization
- concentric acute care mgmt - ANSWER✔✔ 1st 4 weeks recover care mgmt - ANSWER✔✔ AFTER 4 weeks chronic phase mgmt - ANSWER✔✔ AFTER 12 weeks relationship b/w external demand and functional capacity - ANSWER✔✔ more conditioned you are, the less likely you are to get an injury with high demand conversely, the more deconditioned you are, increases the risk of injury with any load
ADDucts lower limb erector spinae - ANSWER✔✔ EXTENDs vertebral column in lower thoracics draws ribs DOWN Gastrocnemius - ANSWER✔✔ plantar flexes ankle joint and assists in knee flexion O: just above lateral and medial condyles of femur I: achilles tendon Soleus - ANSWER✔✔ Plantar flexes ankle joint with gastrocs O: fibula, medial border of tibia I: calcaneus tendon rectus abdominus - ANSWER✔✔ FLEXES vertebral column by approximating thorax and pelvis anteriorly •with pelvis fixed: thorax moves toward pelvis •with thorax fixed: pelvis moves toward thorax Oblique abdominal group - ANSWER✔✔ Bilaterally: flex vertebral column, support and compress abdominal viscera
Unilaterally: rotate vertebral column, brings thorax forward or pelvis back gluteus maximus - ANSWER✔✔ extends and laterally rotates hip joint •lower fibers assist in ADDuction of hip, upper fibers help with ABDuction •through insertion into IT Bands, helps stabilize knee in extension gluteus medius - ANSWER✔✔ abducts hip joint •anterior fibers medially rotate and may assist in flexion of hip joint •posterior fibers laterally rotate and may assist in extension hamstrings - ANSWER✔✔ • semitendinosus/semimembranosus: flexes and internally rotates knee
- extends ands assists in internal rotation of the hip •biceps femoris: flexes and externally rotates knee
- Long head extends and assists in external rotation of hip pectoralis major - ANSWER✔✔ Origin fixed: adducts and internal rotation of humerus
serratus anterior - ANSWER✔✔ origin fixed: abducts scap, rotates inferior angle lateral and glenoid cranially. Holds medial border of scap firm against rib cage. insertion fixed: with scap stabilized in adduction, serratus may act in forced inspiration Milwaukee brace - ANSWER✔✔ • for scoliosis. •wear 23 hours/day •curves between 20-40° Figure eight brace AKA Louisiana strap - ANSWER✔✔ for inversion ankle sprain Lenox hill AKA derotational brace - ANSWER✔✔ for the knee cockup splint is for? - ANSWER✔✔ wrist; carpal tunnel syndrome proper way to fit crutches - ANSWER✔✔ 2 - 10 - 30 •measure 2" from axilla •tip of crutch 10" from malleolus •crutches should be at 30° contraindications to ALL modalities - ANSWER✔✔ • hemorrhage
•infection w/ suppuration (TB, osteomyelitis) •malignancy (most important) contraindications to ALL heating modalities - ANSWER✔✔ • decreased thermal sensation •active TB •LBP, abdomen P with pregnancy •encapsulated swellings •DM- late stages contraindications to ALL electrical modalities - ANSWER✔✔ • pacemaker patients •LBP/abdomen P with pregnancy •decreased sensation (LVG only) •brain = transcerebral •eyes •heart = transthoracic •carotid sinuses high frequency - ANSWER✔✔ 100,000 Hz or > UV, infrared, short wave diathermy, MWD, US medium frequency - ANSWER✔✔ - most asked
- 2,000-10,000 Hz
- Interferential/IFC
contraindications for massage - ANSWER✔✔ Key = vascular probs phlebitis, thrombosis, varicosities, ulcerations, local acute conditions 6 types of massage - ANSWER✔✔ 1. effleurage: stroking. beginning/ending of every massage. Stroke toward heart = centripetal force
- pretrissage: deep kneading, for mm tissue
- tapotement: percussion (hacking/cupping). 5 types- flat hand/slap, fist pounding, finger tips, ulnar side hack, cupping for cystic fibrosis
- friction: deep rubbing (powder, TFM)
- vibration: shaking (extremities only). genie rub, G5, thumper
- deep pressure: nimmo acupressure Transverse friction massage TFM - ANSWER✔✔ - breaks adhesions in muscles, ligaments, and joint capsule
- decreases chemical cross-linking INDICATIONS:
- sprain/strain
- tendonitis
- bursitis CONTRAINDICATIONS:
- calcific tendonitis or bursitis (will inflame tissue more) Traction: Physiological Effects - ANSWER✔✔ action- mechanical 2 types: constant or intermittent physiologic effects:
- decrease intradiscal pressure
- increase IVF space
- break adhesions- intermittent
- straightens curves- continuous
- breaks mm spasms- intermittent
- gliding of facet joints Traction indications - ANSWER✔✔ - disk herniation
- joint hypomobility
- chronic muscle guarding/spasm
- narrowing of IVF
- nerve root impingement
- fibrotic adhesions
- spinal ligament and other CT contractures
- subacute joint inflammation
