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;
54 Cards in this Set
- Front
- Back
BIOMECHANICAL APPROACH
|
Focus: ROM, strength and endurance
Commonly used to treat patients with lower motor neuron deficits and orthopedic problem Common settings: hand clinics, work programs, physical medicine and rehabilitation, ergonomics programs |
|
MMT GRADE: 5
|
Normal
Full ROM against gravity & max resistance |
|
MMT GRADE: 4
|
Good
Full ROM against gravity & mod resistance |
|
MMT GRADE: 4-
|
Good minus
Full ROM against gravity & less than moderate reistance |
|
MMT GRADE: 3+
|
Fair plus
Full ROM against gravity & minimal resistance |
|
MMT GRADE: 3
|
Fair
Full ROM against gravity & no resistance |
|
MMT GRADE: 3-
|
Fair minus
Less than full ROM against gravity |
|
MMT GRADE: 2+
|
Poor
Full ROM in gravity-eliminated with no added resistance |
|
MMT GRADE: 2-
|
Poor minus
Less than full ROM in gravity-eliminated |
|
MMT GRADE: 1
|
Trace
Tension is palpated in the muscle or tendon, but no motion occurs at the joint |
|
MMT GRADE: 0
|
No tension is palpated in the muscle or tendon
|
|
EDEMA EVALUATION
|
Body's initial response to injury
Pitting - acute Brawny - chronic Measure with tape measure, record in centimeters Compare extremities, document landmarks Volumeter, records in millileters, signficant change in edema is more than 10 ml |
|
SENSORY TESTING
|
Text uninvolved side first, apply stimulus to volar and dorsal surfaces
SCI: test proximal to distal Periphreal nerve injuries: distal to proximal Neurological disorders: assess for dermatone patterns |
|
PURDEU PEGBOARD
|
Test of fingertip dexterity and assembly job simulation
|
|
MINNESOTA MANUAL DEXTERITY TEST
|
Test of gross arm and hand movements
|
|
O'CONNER TWEEZER TEST
|
Test of hand-eye coordination using tweezers
|
|
CRAWFORD SMALL PARTS DEXTERITY TEST
|
Test of fine motor dexterity using small tools (tweezers and screwdrivers)
|
|
NINE HOLE PEG TEST
|
Measures finger dexterity
- The Perdue Pegboard is preferred over the Nine Hole Peg Test because it is unilateral and bilateral, it is also more reliable |
|
JEBSON HAND FUNCTION TEST
|
Test of hand function
7 substests: Writing, simulated page turning, picking up common objects, simulating feeding, stacking, picking up large light objects, picking up heavy large objects |
|
EDEMA REDUCTION TECHNIQUES
|
1. Elevate extremity (contraindicated for individuals with circulation problems)
2. Retrograde massage 3. Compression garments 4. Cold packs 5. Contrast baths; immerse hand in warm than cold water, technique is conflincting as ot its effectivness in reducing edema 6. Manual edama mobilization: special technique that requires training Heat is commonly contraindicated for edema (can be used in mild cases in combination with elevation) Precautions/Contraindications: Infection Graft/wound Vascular damage Unstable fractures CHF |
|
SCAR MANAGEMENT
|
1. ROM
2. Massage 3. Compression 4. Scar pad with compression 5. Splinting to prevent contractures from resting scar 6. Edema control |
|
IMPROVING COORDNATION
|
1. Begin with gross motor activities and gradually grade up to fine motor activities
2. Select activities in which the ROM required is within the person's reach and yet challenging 3. Focus on accuracy and speed, begin with slow gross movements and gradually progress to faster precise movements |
|
JOINT PROTECTION PRINCIPALS AND METHODS
|
1. Maintain ROM by using maximal ROM during activities
2. Maintain strength by using maximal strength during daily activities 3. Use strongest and largest joints possible for task completion 4. Use each joint in its most stable and functional position 5. Avoid holding joints in one position or sustaining muscle contractions for extended periods of time 6. Avoid positions of deformity and activities in the direction of deformity (eg ulnar drift) 7.Do not start activities that cannot be immediately stopped 8. Recognize discomfort may be a reality of activity, but pain is a warning sign |
|
HAND SPLINT DESIGN STANDARDS
|
1. Maintain arches of hand (proximal transverse arch, distal transverse arch, longitudinal arch)
2. Do not impinge upon crease of the hand (distal and proximal palmar creases, distal and proximal wrist creases, thenar crease) |
|
MECHANICAL PRINCIPALS OF SPLINTING
|
1. Decrease pressure; wide, longsplint base is the most disirable, round edges needed
2. Use sling applied with a 90 degree angle of pull 3. Use low load to increase duration 4. Maintain three point pressure verse circumfrence 5. Avoid postisions of deformity (wrist flexion, MCP hyperextension, IP joint flexed, thumb adducted) 6. Select appororaite splinting position |
|
RESTING POSITION (SPLINTING)
|
Wrist: 10-20 degrees extension
MCPs: 30-40 degrees flexion IPs: 0-20 degrees flexion Thumb: abducted |
|
SAFE POSITION (SPLINTING)
|
Wrist: 20-30 degrees extension
MCPs: 50-70 degrees IPs: extension Thumb: abducted and extended |
|
BRACHIAL PLEXUS INJURY
|
Flail arm splint
|
|
RADIAL NERVE PALSY
|
Dynamic wrist, finger and thumb extension splint
|
|
MEDIAN NERVE INJURY
|
Opponens splint, C-Bar or thumb post splint
|
|
ULNAR NERVE INJURY
|
Dynamic/static splint to position MPs in flexion
|
|
COMBINED MEDIAN ULNAR
|
Figure-of-eight or dynamic MCP flexion splint
|
|
SPINAL CORD (C6-C7)
|
Tenodesis splint
|
|
CARPAL TUNNEL SYNDROME
|
Wrist splint positioned in neutral
|
|
CUBITAL TUNNEL SYNDROME
|
Elbow splint positioned at 30 degrees flexion
|
|
DEQUERVAINS
|
Thumb splint, includes wrist, IP joint free
|
|
SKIER'S THUMB (UCL)
|
Hand based thumb splint
|
|
CMC ARTHRITIS
|
Hand based thumb splint
|
|
ULNAR DRIFT
|
Ulnar drift splint
|
|
FLEXOR TENDON INJURY
|
Dorsal protection splint
|
|
SWAN NECK
|
Silver rings or buttonhole splint
|
|
BOUTONNIERE
|
Silver rings or PIP extension splint
|
|
ARTHRITIS
|
Functional splint or safe splint, depending on stage
|
|
FLACCIDITY
|
Resting splint
|
|
SPASTICITY
|
Spasticity splint or cone splint
|
|
MUSCLE WEAKNESS (ALS, SCI, GUILLAIN-BARRE)
|
Balaced forearm orthosis (BFO), deltoid sling/suspentsion sling
- mounts to wheelchair, -individual MUSThave shoulder or trunk movement |
|
HAND BURNS
|
Wrist 15-30 degrees extension, MCP 50-70 degrees flexion, IP in full extension
|
|
BENEFITS OF SUPERFICIAL HEAT
|
1. Relieves pain
2. Increases tissue extensibility (increase ROM) 3. Assists with wound healing |
|
BENEFITS OF CRYOTHERAPY
|
1. Relieves pain
2. Controls edema 3. Decreases abnormal tone 4. Facilitates muscle tone |
|
BENEFITS OF WHIRLPOOL
|
1. Cleans and open infected wound
2. Temperature of water does not reach a therapeutic range to use as a heat modality |
|
BENEFITS OF ELECTRICAL STIMULATION
|
1. Relieves pain
2. Decreases swelling 3. Stimulates and strengthens muscles 4. Stimulates denervated muscles |
|
BENEFITS OF ULTRA SOUND
|
1. Relieves pain
2. Decreases inflammation 3. Increases tissue extensibility (increase ROM) 4. Decreases adhesions |
|
BENEFITS OF CONTRAST BATH
|
1. Reduces edema
|
|
CONTRAINDICATIONS FOR PAMS
|
1. Cancer
2. Pacemaker 3. Pregnancy 4. Cognitive impairment 5. Sensory impairment 6. Vascular impariment |