MSK 1: Wrist and hand therapeutic interventions

Question 1

What is included in the progression during the post-immobilization phase of a scaphoid fracture?

Accepted Answer

neuromuscular reeducation, open and closed chain exercises, pain-free weight bearing, return to functional and sport specific activities

Question 2

How long does it typically take for a fracture to heal?

Accepted Answer

6-8 weeks

Question 3

What are the precautions to be considered with RA

Accepted Answer

do not overstress lax ligaments, Respect fatigue and increased pain

Question 4

What are the treatment options for CRPS?

Accepted Answer

Physical therapy, Cognitive therapy, Nerve block, Pain medication

Question 5

If a CRPS pt is seeing you for PT early intervention is key

Accepted Answer

True

Question 6

Is early postoperative mobilization of repaired tendons beneficial for preventing scar tissue formation?

Accepted Answer

True

Question 7

What force should be avoided for the first 2-6 weeks for Gamekeeper’s/Skier’s Thumb?

Accepted Answer

Abduction

Question 8

Ulnar drift splinting helps to lock the fingers back into a neutral position

Accepted Answer

True

Question 9

What is the recommended intervention for Flexor Tendon Rupture?

Accepted Answer

Surgical intervention based on zone of rupture, early post-op mobilizations of repaired tendons

Question 10

What are the positions in which the fingers move during tendon-gliding exercises

Accepted Answer

full fist (all joints are flexed), straight hand (all joints extended), Intrinsic plus (tabletop, MCPs flexed & IPs extended), hook fist (MCPs are extended IP joints are all flexed)

Question 11

W/ scaphoid fractures it's important to be conservative and look for signs of necrosis

Accepted Answer

True

Question 12

What is the purpose of flexor tendon blocking exercises?

Accepted Answer

can progress to manual resistance as tissues heal, To develop gliding of the tendon w/ respect to tendon sheaths and bones, develops neuromuscular control of individual joint motions, progresses flexor tendon gliding exercises

Question 13

What are the contraindications in treating a pt w/ RA?

Accepted Answer

Do not sretch the swollen joint, do not apply head resistance exercises that cause the joint stress

Question 14

Manual interventions/exercises than can be done for pts w/ carpal tunnel syndrome

Accepted Answer

stretching of the carpal tunnel/ thenar eminence, median nerve glides, isolated tendon excursion exercises for finger flexor tendons

Question 15

What thermal modality can be used for Osteoarthritis - CMC of Thumb?

Accepted Answer

Paraffin, Moist heat

Question 16

Conservative and post-op interventions for carpal tunnel syndrome

Accepted Answer

Contrast bath, ergonomics modification, Diueretics and NSAIDs, night splints preventing the wrist from going into flexion, day splints to help with aggravating factors

Question 17

Treat all wrist fractures as a scaphoid fracture even after initial negative radiographs

Accepted Answer

True

Question 18

What position does the CMC joint need to be in for splinting a patient with OA of the thumb?

Accepted Answer

Palmar abduction

Question 19

What exercises can be done in pts with RA

Accepted Answer

Stretching of the hand intrinsics, ROM exercies that encourage excursion of the long flexors, Resistance exercises carefully introduced due to inflammatory nature of RA, Gentle sponge squeezes in a tub of warm water

Question 20

What intervention is recommended for Grade III Gamekeeper’s/Skier’s Thumb?

Accepted Answer

Surgical Intervention

Question 21

What is typically lost and needs mobilization in distal radius fractures post immobilization

Accepted Answer

Supination, Wrist Extension

Question 22

What techniques can be done for tendon adhesions?

Accepted Answer

tendon gliding, active stretching techniques, cross friction massage, passive stretching techniques

Question 23

Flexor tendon gliding exercises should be initiated w/ the wrist in neutral so tendons are not taught or slack

Accepted Answer

True

Question 24

What is the most important rule in treating a pt w/ CRPS

Accepted Answer

Control pain while introducing motion

Question 25

Conservative intervention for a TFCC lesion involves a long arm cast/splint in what position?

Accepted Answer

Elbow in 90 degrees of flexion, Forearm/wrist in extension, forearm/wrist in ulnar deviation

Question 26

What can be done during the immobilization period for a pt w/ a distal radius fx?

Accepted Answer

AROM of elbow, AROM of shoulder in all planes, Finger flexion and extension

Question 27

What determines the stage of intervention for distal radius fractures?

Accepted Answer

Physician's orders

Question 28

What should be avoided in pts w/ carpal tunnel syndrome?

Accepted Answer

sustained pinching, gripping, sustained full wrist extension, repettive wrist motions

Question 29

Intervention for CRPS requires a team approach

Accepted Answer

True

Question 30

What should be done in the post-immobilization phase of a scaphoid fracture?

Accepted Answer

AROM wrist flexion/extension & radial/ulnar deviation early as possible, gentle-pain free strengthening with light weight bands & putty, PROM beginning two weeks later

Question 31

What exercises should be initiated following removal of the cast or splint for a TFCC lesion?

Accepted Answer

Wrist and forearm exercises, AROM/AAROM are initiated first, radial/ulnar deviation added last, emphasis on flexion/extension intitially

Question 32

What is the purpose of joint protection in RA?

Accepted Answer

Reduce forces on joints during functional activit

Question 33

What are some alternatives to medication for pain management in RA?

Accepted Answer

Thermotherapy, cryotherapy, Relaxation techniques, Adopting a positive outlook

Question 34

When does AROM of flexion and extension begin for Gamekeeper’s/Skier’s Thumb?

Accepted Answer

3 weeks

Question 35

What interventions can a pt do in the post-immobilization period of a distal radius fx?

Accepted Answer

Wrist extension AROM performed w/ digits flexed to improve motion, PROM when cleared by the physcian, AROM wrist in all planes

Question 36

When full passive extension is possible, but the patient is not able to actively extend joint through full rom

Accepted Answer

extension lag

Question 37

What should be avoided to the wrist during progressive strengthening for a TFCC lesion?

Accepted Answer

Torsional loads

Question 38

Is immobilization in a thumb spica cast necessary for 3 weeks?

Accepted Answer

True

Question 39

What should be avoided for Osteoarthritis - CMC of Thumb?

Accepted Answer

Sleeping on the hand, Sustained pinching, Mechanical stress

Question 40

When should flexor tendon blocking exercises NOT be used due to stress placed on tendons

Accepted Answer

in the early stages fowling repair

Question 41

What should a pt with RA be educated on?

Accepted Answer

avoid repetitive activities, increased awareness of stressful activities, use adaptive equipment to reduce force, avoiding tight and prolonged grasping, Avoid lifting heavy weight, use larger/stronger proximal joints when available

Question 42

What are the general concepts of management?

Accepted Answer

focus on joint systems rather than isolated joints, control the inflammation, Consider the status of all tissues in the hand (part vs whole)

Question 43

What is the recommended intervention for DeQuervains Tenosynovitis?

Accepted Answer

Surgical, Conservative

Question 44

What is the purpose of splinting in RA?

Accepted Answer

prevent further deformity, Immobilize painful joints

Question 45

What should be done during the chronic phase of a distal radius fx?

Accepted Answer

plyometrics if needed, return to sports drills, functional activities, NE re-education

Question 46

RA can cause pain and instability at the wrist preventing power from the forearm muscles being transmitted to the hand.

Accepted Answer

True

MSK 1: Wrist and hand therapeutic interventions

Questions 46

MSK 1: Wrist and hand therapeutic interventions

Questions 46