Introduce yourself to patient
Explain procedure
Gain consent
Allow for patient Questions
Rule out contraindications
1 of 21
Describe the procedure for prescribing exercise.
Demonstrate Exercise
Offer Feedback/Correct
Reps dependent on the individuals exercise tolerance i.e. how long it takes for the muscle to fatigue
2 of 21
What are joint mobilisations and why do we use them?
A skilled passive movement of one joint surface in relation to another.
Used to assess ROM, end feels and pain as well as a treatment for reducing joint stiffness.
3 of 21
What 3 mobilisations will you be assessed on?
Longitudinal Caudad of GHJ in neutral and 90 degrees abduction.
PA Tibia in flexion (sitting)
AP Femur (supine)
4 of 21
Name 3 effects of mobilisation.
Increase ROM/decrease capsule tightness
Promote fluid movement in and out of the cartilage
Decrease pain inhibition
5 of 21
What are contraindications of mobilisation?
Malignancy involving skeleton
RA in inflammatory phase
Active joint infection
Recent acute trauma i.e. fracture
Bone disease
6 of 21
Name other considerations for mobilisation.
Patient and physio positioning for maximum comfort
Plinth height
Always assess unaffected limb first
Locate the joint lines
7 of 21
Name 3 characteristics that would make you suspect RA.
Morning stiffness lasting more than one hour
Positive MCP/MTP squeeze test
Difficulty making a fist
Hot, swollen, painful joints
8 of 21
What aspects are assessed regarding RA?
Joint ROM
Muscular Power
Functional Limitations
9 of 21
What are the core aims of RA treatment?
Patient Education
Pain relief
Preserving joint integrity and function
Maximising patient fitness and functional independence
10 of 21
What advice would you give for dealing with RA flares?
Rest and Ice
Adopt good joint resting positions
Gently take joints through range several times a day to reduce stiffness
11 of 21
What is a total hip replacement and a hemiarthroplasty?
THR= The femoral head and the acetabulum are both replaced with a prosthetic implant
Hemiarthroplasty= Usually only the femoral head is replaced
12 of 21
What are the treatments/advice for hip replacements?
Advice on diet/physical activity/smoking cessation
Bed exercises
Hip Abduction and Extension in standing
Do not drive for 6 weeks and must be able to comfortably perform emergency stop
13 of 21
How to avoid dislocation?
Avoid flexion above 90 degrees, internal rotation and adduction across the midline
For example, bringing heel to buttocks when putting shoes on etc.
14 of 21
What types of knee replacements exist?
Total Knee replacement= weight bearing components of knee are replaced
Unicompartmental Knee replacement= damaged parts of the knee replaced
15 of 21
What types of shoulder replacements exist?
Full replacement= Head of humerus and glenoid cavity replaced
Hemiarthroplasty= Only head of humerus replaced
Reverse Replacement= ball and socket components replaced, often when major damage to rotator cuff has occurred
16 of 21
What risks are associated with joint replacements?
Deep vein thrombosis
Infection
Joint stiffness
Altered leg length
Dislocation
17 of 21
When should you suspect peripheral spondyloarthritis?
Dactylitis (whole digit swelling)
Back pain without apparent mechanical cause
Family history
Psoriasis
18 of 21
What types of Axial spondyloarthritis exist?
Ankylosing= where lesions on SI joints are visible on x-ray
Non-radiographic= SIJ lesions not visible on x-ray
19 of 21
When to suspect Axial Spondyloarthritis?
Back pain lasting longer than 3 months
Onset before 35 years of age
Waking in the second half of the night
Improves with movement
Family history
20 of 21
What are the bath indices?
A series of standardized outcome measures to assess spinal function
-Cervical Rotation
-Tragus to wall distance
-Lumbar Flexion
-Lumbar side flexion
-Intermalleolar distance
21 of 21
Other cards in this set
Card 2
Front
Describe the procedure for prescribing exercise.
Back
Demonstrate Exercise
Offer Feedback/Correct
Reps dependent on the individuals exercise tolerance i.e. how long it takes for the muscle to fatigue
Card 3
Front
What are joint mobilisations and why do we use them?
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