RA/OA

Question 1

what is periarticular pain?

Answer 1

pain outside the joint itself

Question 2

what is articular pain?

Answer 2

joint pain

Question 3

fusiform swelling

Answer 3

excess fluid in the capsule

Question 4

boggy swelling

Answer 4

when the joint capsule is full of fluid and its spongy/soft to the touch

Question 5

when does boggy swelling occur in relation to RA?

Answer 5

in the mild to moderate and severe stage

Question 6

when does fusiform swelling occur in relation to RA?

Answer 6

in the mild to moderate stage

Question 7

hard end range indicates what?

Answer 7

bony blockage at the end of the joint

Question 8

what does a firm end range indicate?

Answer 8

that the joint capsule and ligaments are limiting motions

Question 9

in RA which joints are preserved?

Answer 9

the DIP joints

Question 10

what is the severe stage of RA?

Answer 10

stage 3:
- joint is unstable and deformities can occur
- panus [overgrown tissue] has formed
- boggy swelling is occurring

Question 11

what is the end stage of RA?

Answer 11

stage 4:
- inflammation actually stops, joint constructers has occurred

Question 12

what is the moderate stage of RA?

Answer 12

inflammation damage is occurring
- ROM is lost
- boggy and fusiform swelling is occurring

Question 13

what is the early stage of RA?

Answer 13

Stage 1:
- joint lining/fluid is occurring
- inflamed –> boggy swelling

Question 14

what is the moderate stage of OA?

Answer 14

Stage 3:
- erosion of cartilage, bone polishing and spurs occur
- joint mice breaks off

Question 15

what is the minor stage of OA?

Answer 15

stage 1:
- bone spurs

Question 16

what is the severe stage of OA?

Answer 16

Stage 4:
- cartilage is gone
- polishing has caused greater amounts of pain

Question 17

what is the mild stage of OA?

Answer 17

stage 2:
- bone spur growth
- mild joint pain
-stiffness
- cartilage breakdown

Question 18

when is it best to work with RA clients?

Answer 18

afternoon’s due to morning stiffness

Question 19

when is it best to work with OA clients?

Answer 19

in the morning due to the evenings being when they have most issue and pain

Question 20

during the subacute phase of RA what type of range in the joint should be seen?

Answer 20

firm end range with slight fusion in the joint capsule

Question 21

what is Bouchard’s nodes and what type of arthritis does it occur in?

Answer 21

bone enlargements typically found in the PIP joints and found in OA

Question 22

what is Heberden’s nodes and what type of arthritis does it occur in?

Answer 22

bone enlargements typically found in the DIP joints and found in OA

Question 23

what is anklyosing?

Answer 23

when you are unable to bend at the joint

Question 24

when does anklyosing typically occur?

Answer 24

in the morning for those with RA

Question 25

during the sub-acute stage of RA can tendon glides be preformed?

Answer 25

yes but not to the end range for that it is contraindicated

Question 26

during the acute phase of RA what do you stay away from during interventions?

Answer 26

- heat - stretching - isotonic or intense workouts/exercises - PROM

Question 27

in acute or early/moderate stages of RA what PAMS and splinting can be used?

Answer 27

ice/cold packs, resting or anti-deformity splints to assist with pain

Question 28

during the subacute stage what is the goal for interventions?

Answer 28

- AAROM - gentle PROM - pain free isometric only - gentle stretch

Question 29

when would a splint be utilized with arthritis?

Answer 29

for comfort and reduction of inflammation or pain

Question 30

when considering joint protection with arthritis must be considered?

Answer 30

- promote 2 handed techniques - use large joints to off set weight

Question 31

when considering joint protection with RA what must be considered?

Answer 31

- splinting - promote neutral positioning. - activity MOD during flare ups - energy conservation

Question 32

when considering joint protection with OA what must be considered?

Answer 32

- avoid repetitive movements/strains - use heat before activities = Paraffin

Question 33

during the chronic-active RA stage what is the goal?

Answer 33

- FULL AROM/PROM + stretching - light isotonic - endurance

Question 34

during the chronic-inactive RA stage what is the goal?

Answer 34

- prevent deformity - maintain function - maximize strength - FULL AROM/PROM + stretching - isotonic & resistance

Question 35

during chronic stages of RA what type of stretching is allowed?

Answer 35

stretching to the end-range as long as its tolerated

Question 36

to improve mobility in RA and OA NOT during the acute inflammatory staged what PAM can be used and why?

Answer 36

heat to improve mobility

Question 37

what is the goal for the acute phase of OA and some considerations?

Answer 37

- pain reduction - joint unload - swelling management -- use heat prior to ROM

Question 38

what is the goal for the subacute phase of OA and some considerations?

Answer 38

- restore mobility - maintain function -- gentle stretching is okay

Question 39

what is the goal for the chronic-active phase of OA and some considerations?

Answer 39

- improve ADL/IADL - reduce stress on joints - activity pacing --- isotonic strengthening

Question 40

what is the goal for the chronic-stable phase of OA and some considerations?

Answer 40

- progressive resistive exercises as tolerated

Question 41

regardless of flare-ups in arthritis what do we not want to discontinue?

Answer 41

ROM which means that if AROM isn't an option then we will continue with PROM no matter what.