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4120- Arthritis
Question | Answer |
---|---|
what is arthritis | a general term for conditions of joint flammation, 1+ joints |
how many forms of arthritis exist | 100+ |
what are the diff types of arthritis classified on | degree of joint damage, restriction of movement, functional limitation, pain |
3 main classifications of arthritis | osteoarthritis rheumatoid arthritis ankylosing spondylitis |
what is the number one cause of disability | arthritis |
how does arthritis affect social funcitoning | increased isolation, stress, depression because of pain, leads to decreased QOL |
what is osteoarthritis | hands, feet, spine, and weight bearing joints have issues |
secondary affect of osteoarthritis | decreased strength due to decreased movement |
pathophysiology of osteoarthritis | constant remodeling of joint tissues in abnormal ways |
what is periarticular atrophy | muscle atrophy around joints |
what happens to cartilage in osteoarthritis | decreased cartilage, leads to bone on bone rubbing and inflamation, strained ligmanets, weak and pain |
steps of osteoarthritis degradation | rough, brittle cartilage damage bone thickens to decrease load synovial swelling fluid increase ligaments thicken, bad movement decrease joint space loss of cartilage bc bone on bone weakens ligaments |
what is rheumatoid arthritis | a chronic autoimmune form |
which gender is RA more common in | women |
how is RA infllamation different | systemic inflammation instead of localized to joints |
symmetrical polyarthritis | multiple joints, both sides of the body, min 4 |
main type of joint/issue with RA | synovial joints, synovitis |
common comorbities/risks of RA | muscle atrophy, increased fat mass, fatigue, cv/m disease, t2d, osteoporosis |
pathophysio of RA | immune dysfunction begins attack synovitis pannus, esp w synovial hyperplasia cartilage and bones erode joint detruction/ankylosis (stiffness) |
two causes of synovitis | excess fluid synovial cell hyperplasia |
what is pannus | abnormal tissue layers over joints |
anklyosis | when the joints become stiff and narrow so movement is restricted |
which type is more daily wear and tear | OA |
which type is asymmetric | OA |
which type occurs at younger ages | RA |
which type occurs more at smaller joints | rA |
which type has obvious inflammation | Ra |
which type does not normally need medical treatment besides pain pills | OA |
ankylosing spondylitis | chronic autoimmune disorder |
which gender is AS more common in | men |
which joints is AS more common at | spine, sacroiliac, cervical, peripheral joints |
pathophysio of AS | autoimmune response attack lower spine ligaments become inflamed bone growths and bone spurs form IN ligaments as response vertebrae bridges/fusion lower back pain, immobility, bad posture |
where do bone spurs form in AS | in the ligament |
4 steps of AS response | inflammation erosion syndesmophytes fusion |
syndesmophytes | bony outgrowths on spinal ligaments |
secondary effects of AS | decreased: ex tolerance strength aerobic capacity ROM biomechanic efficency proprioreception social functioning |
3 stages of arthritis | acute/mind chronic/moderate chronic+acute exacerbation of joint symptoms/severe |
acute arthritis | reversible s/s @ joints, especially decrease synovitis |
chronic/moderate arthritis | stable s/s but structural damage is irreversible |
severe arthritis | increase pain, decreased rom and function, increased inflammation |
s/s/ of affected arthritic joints | pain stiffness joint locking deformity synovitis creptius effusion bone spurs |
effusion | fluid around joints |
crepitus | popping and cracking noises |
how can extent and severity affect testing | ROM, alignment, function, pain mays be impaired |
functional levels can affect _____ | interventions |
what sign can help diagnose arthritis | extra articular formations |
common s/s that may display | redness, swelling, pain, heat around inflammed joint |
what is the diagnostic for arthritis | there is no definitive test or marker |
two useful screening tools for arthritis | serum/synovial tests joint imaging/mri/ultrasounds to see degradation and abnormalities |
why would we need ex testing | may be needed for other risks assessments |
which type has higher comorbidity (especially cv) risk | RA |
what main symptom increases risk | inactivity |
what should we use to form baseline for change and guide Rx | muscular skeletal and ROM testing |
how should intensity be adjusted for rx | small increases |
how should modes be decided | based on ability level |
what stage should use treadmill | minimal/mild |
what stage should use cycle ergo | mild/moderate in lower extremeties |
what stage should use arm ergo | severe in lower extremities |
how does ex benefit arthritic indiviuals | control progression minimize symptoms |
4 main arthritis treatment goals | decrease inactivity manage s/s/improve adl and qol restore/maintain body comp (some may accumate fat mass from inactivity) decrease comorbidities, symptoms, risks |
non drug treatments for arthritis | education canes PT/OT shoe mods (orthotics) BRACES/BANDAGES ice/heat decrease weight to decrease load no reptitive motion jobs joint irrigation/surgery |
what is joint irrigation | flush the joint to remove debris |
common drug treatments for arthritis | nsaids, opiod pain relievers (anagesics), corticiosteroids (anti inflammatory), DMARDs |
what are DMARDs | disease modifying artirheumatic drugs used to treat RA and ankylysing spondylosis |
goals of ex rx with arthritis | increase physical function better body comp decreased bw decrease inflammation pain and stiffness prevent deformities and contractures |
what is a contracture | permanent shortening and tightening of joints that causes movement to be stuck |
what is the most physically limited clinical population | arthritis |
6 special considerations for arthritis | avoid high impact morning stiffness/cold Cl in water therapy footwear ankylos spondylitis posture/back brace corticosteroid degradation |
high impact ex and arthritis | avoid it, prevent injury and may have had previous replacement |
why underwater therapy is beneficial | increased buoyancy decreases joint pressure |
chlorine and underwater therapy considerations | Cl can increase rashes and redness w/inflammed joints, may cause respiratory issues |
orthotics | inserts and supports in the shoe to help w shock support and ADL pain |
how do corticosteroids affect long term | bone loss and atrophy due to cortsiol mimicking which is bad long term |
KAATSU study main take away | low load less joint stress but still ex. benefits blood flow restriction lead to decreased inflammation by increasing post ex bfloww to better remove and filter inflammatants |