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NBCOT: Biomechanical
Information from Ch. 11: Biomechanical approaches
| Question | Answer |
|---|---|
| What is the focus of the biomechanical approach? Which patients is it commonly used for? | -focuses on ROM, strength, & endurance required to perform an occupation -used to treat patients w/ LMN deficits, orthopedic problems |
| What is normal ROM for the cervical spine? | 0-45* flexion, 0-45* extension, 0-45* lateral flexion, 0-60* rotation |
| What is normal ROM for the thoracic & lumbar spine? | 0-80* flexion, 0-30* extension, 0-40* lateral flexion, 0-45* rotation |
| What is normal ROM for shoulder flexion/extension and ab/adduction? | 0-170* flexion, 0-60* extension, 0-170* abduction, 0* adduction |
| What is normal shoulder ROM for horizontal ab/adduction? | 0-40* horizontal abduction, 0-130* horizontal adduction |
| What is normal ROM for shoulder internal/external rotation? | 0-70* int. rotation w/ arm in abduction, 0-60* int. rotation w/ arm in adduction, 0-90* ext. rotation w/ arm in abduction, 0-80* ext. rotation w/ arm in adduction |
| What is normal ROM for the elbow? | 0-135(-150)* flexion, 0* extension |
| What is normal ROM for the forearm? | 0-80(-90)* pronation, 0-80(-90)* supination |
| What is normal ROM for the wrist? | 0-80* flexion, 0-70* extension, 0-30* UD, 0-20* RD |
| What does 5 mean in the MMT grading system? | moves through full ROM against gravity, takes max resistance |
| What does 4 mean in the MMT grading system? | moves through full ROM against gravity & takes mod resistance |
| What does 4- mean in the MMT grading system? | moves through full ROM against gravity, takes less than mod resistance |
| What does 3+ mean in the MMT grading system? | moves through full ROM against gravity, takes min resistance before it breaks |
| What does 3 mean in the MMT grading system? | moves through full ROM against gravity, is unable to take any added resistance |
| What does 3- mean in the MMT grading system? | moves less than full ROM against gravity |
| What does 2+ mean in the MMT grading system? | part moves through full ROM in gravity-eliminated plane w/ no added resistance |
| What does 2- mean in the MMT grading system? | part moves less than full ROM in gravity-eliminated plane |
| What does 1 mean in the MMT grading system? | tension is palpated in muscle or tendon, but no motion occurs @ joint |
| What does 0 mean in the MMT grading system? | no tension is palpated in muscle or tendon |
| What are the types of edema? | -pitting: acute -brawny: chronic |
| When is the change in volume of edema considered significant? | When change is 10mL or greater |
| How does an OT test sensation? | -demonstrate sensory test w/ vision, then occlude vision for actual testing -test uninvolved side first -spinal cord injuries are tested proximal to distal -peripheral nerve injuries are tested distal to proximal |
| What is the order of nerve return for peripheral nerve injuries? | pain, moving touch, static light touch, touch localization |
| How is moving two point discrimination tested? | -testing begins w/ points 5-8mm apart -applied proximal to distal on fingertips in horizontal orientation -7/10 responses must be correct before decreasing distance of 2 pts -normal=2mm |
| How is static two point discrimination tested? | -test begins @ 5mm -applied to fingertips in longitudinal orientation -distance between pts is increased until 7/10 responses are correct -test is stopped at 15mm -normal=5mm, fair= 6-10mm |
| What spinal segments are associated with respiration? | T2-T12 |
| What spinal segments are associated with elbow flexion? | C5 |
| What spinal segments are associated with shoulder abduction & wrist extension? | C6 |
| What spinal segments are associated with the dermatome at the thumb & radial forearm? | C6 |
| What spinal segments are associated with the dermatome at the middle finger? | C7 |
| What spinal segments are associated with the dermatome at the little finger & ulnar forearm? | C8 |
| What spinal segments are associated with ab/adduction of fingers (hand intrinsics)? | T1 |
| What spinal segments are associated with the dermatome at the nipple line? | T4-T6 |
| What spinal segments are associated with bladder retention? | S2 |
| What spinal segments are associated with reflex voiding? | L2 |
| What does the Purdue Pegboard test? | fingertip dexterity & assembly job simulation |
| What does the Minnesota Manual Dexterity Test measure? | test of gross hand and arm movements |
| What does the Crawford Small Parts Dexterity test measure? | test of fine motor dexterity using small tools (tweezers & screwdrivers) |
| What is the Jebson Hand Function Test? | test of hand function using a variety of timed activities: writing, simulated page turning, picking up common objects, simulated feeding, stacking, picking up large light/heavy objects |
| What is Codman's exercise? | common form of PROM used for post surgical shoulder patients- pendulum swing |
| When should AROM be performed? | When PROM is greater than AROM |
| What can be a result of overstretching? | myositis ossificans- small growth of bone within the muscle |
| When should isometric exercises be contraindicated? | for persons with hypertension and cardiovascular problems |
| How hard should one work when trying to increase endurance? | work at 50% of maximal resistance or less |
| When is elevation as a edema reduction technique contraindicated? | when a person has circulation problems |
| When are the use of edema reduction techniques contraindicated? | -infections -grafts or wounds -vascular damage -unstable fractures -congestive heart failure |
| How are slings positioned if used? | sling is applied with 90* angle of pull |
| What is the resting splint position? | -wrist: 10-20* extension -MCPs: 30-45* flexion -IPs: 0-20* flexion -thumb abducted |
| What is the safe splinting position? | -wrist: 20-30* extension -MCPs: 50-70* flexion -IPs: in extension -thumb: abducted & extended |
| What is the splint position for hand burns? | -wrist: 15-30* extension -MCPs: 50-70* flexion -IPs: full extension |
| What are benefits of superficial heat? | -relieves pain -increases tissue extensibility (increases ROM) -assists w/ wound healing |
| What are the benefits of cryotherapy? | -relieves pain -controls edema -decreases abnormal done -facilitates muscle tone |
| What are the benefits of whirlpool? | -cleans & debrides open infected wound -temperature of water does not reach a therapeutic range to use as a heat modality |
| What are the benefits of electrical stimulation? | -relieves pain -decreases swelling -stimulates & strengthens muscles -stimulates denervated muscle |
| What are the benefits of ultrasound? | -relieves pain -decreases inflammation -increases tissue extensibility (increases ROM) -decreases adhesions |
| What are the benefits of contrast baths? | -reduces edema |
| What are the general contraindications for PAMs? | -cancer -pacemaker -pregnancy -cognitive impairment -sensory impairment -vascular impariment |
Created by:
Jbardenw