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