Test 2

Question 1

Explain 3 uses of bandaging. 3

Answer 1

Bandages are used for:

1. ¨Retention
   - To keep the wound clean
   - To keep/retain medicine, ice, POP, in place.
2. Support
   - To stabilize injured area (soft tissue, joints, etc.)
   - To prevent further injuries

¨3. Compression

• To reduce swelling or bleeding
• To encourage circulation

Question 2

Mrs Smith Presents with chronic foot pain (2/5 VAS due to arthritis). Parafin Wax Therapy is your choice of treatment. Motivate the use of parafin wax therapy to treat Mrs Smith. 5

Answer 2

1. Wax therapy is the most convenient method It is the most convenient method in applying conductive heating for extremities and is indicated for the treatment of arthritic conditions
2. Wax has low thermal conductivity, which means it gives off heat slowly and is useful in patients with low heat intolerance
3. More than one patient can be treated at the same time
4. It moulds easily around the hands and feet
5. It improves skin condition after removal of POP.
6. It does not require a coupling medium.
7. The wax can be used after implementation of exercises.

Question 3

Name 2 conditions that can benefit from aquatic rehabilitation. 2

Answer 3

1. Rheumatological conditions
2. Orthopaedic and Musculoskeletal
3. Neurological conditions

Question 4

Explain the effects of aquatic rehabilitation. 8

Answer 4

1. Pain relief: Warmth of water and Suppression of the sympathetic nervous system
2. Ease of movement: Support offered by buoyancy and Reduced effect of gravity
3. Reduction of muscle spasm: Warmth of water
   and Suppression of the sympathetic nervous system
4. Reduction of oedema: Hydrostatic pressure
5. Resistance to movement: Viscosity of water, Negative drag of turbulence, Weight/density of the water and Upward force of buoyancy
6. Enhanced relaxation: Reduced effect of gravity, Support from buoyancy, Reduction in pain, Hypnotic effect of water
7. Enhanced well-being: Ability vs disability (self esteem), Social interaction, Enjoyment
8. Re-education to functional activities: Unencumbered, Support from buoyancy, Resistance to movement and Metacentric effect
9. Enhanced cardiovascular fitness: resistance to movement

Question 5

List three precautions/ contraindications to the manual chest clearance technique. 3

Answer 5

1. Loss of skin integrity
2. Excessive pain
3. Frank haemoptysis
4. Uncontrollable intracranial pressure in patients with traumatic brain injury
5. Multiple rib # or flail rib #
6. Acute bronchospasm that doesn’t respond to bronchodilator therapy
7. Severe osteoporosis
8. Severe clotting disorders (platelets < 50 x 109/L)
9. Pulmonary embolism (not on anti-coagulant therapy)
10. Subcutaneous emphysema
11. Unstable angina or cardiac arrhythmias
12. Caution with unstable spinal cord injury
13. Pulmonary oedema or unstable pulmonary hypertension

Question 6

Mrs Jack complains of an increase in work demands, resulting in cervical and upper back muscle stiffness.

Which massage technique would you use as treatment and what are the effects of each treatment? 6

Question 7

What are the effects of effleurage or gliding strokes?

Answer 7

Effleurage or gliding strokes have the following uses or effects:

1. Used to spread lubricant evenly
2. Used to assess superficial and deeper tissues
3. Enhances lymph and venous blood circulation
4. Warms the tissue
5. Prepares the tissue for deeper work
6. Soothes the tissue after deeper work
7. Increases circulation to ischemic tissues and aids in removing wastes from congested tissues
8. Has a calming eff ect when done slowly and a stimulating eff ect when done briskly
9. Superficial gliding has more reflexive effects, and deep gliding has more mechanical effects

Question 8

What are the effects and benefits of kneading or petrissage?

Answer 8

Kneading or petrissage has the following effects or benefits:

1. Mechanically softens the superficial and deep fascia
2. Encourages circulation and fl ushes out metabolic wastes
3. Improves cellular nutrition
4. Improves muscle tone, elasticity, and pliability and relaxes muscles
5. Improves sensitivity to nerve impulses so that muscle reactions are faster and more coordinated

Question 9

What are the effects and benefits of percussion?

Answer 9

The effects and benefits of percussion techniques vary according to the variation of the technique used, the area of the body, the intensity and the duration of the application, and include the following:

1. Initially has a stimulating effect
2. Prolonged application encourages relaxation.
3. Prolonged applications have an anesthetic effect on some nerve endings.
4. Deeper applications cause vasodilation and increased circulation.
5. Cupping aids in breaking up lung congestion

Question 10

List the principles you will apply prior to the application of massage therapy. 10

Answer 10

1. Make sure you are able to reach all parts
2. Lunge standing
3. Use body weight
4. Assume good body position to avoid straining the back etc
5. Have a good knowledge of the techniques
6. Position the patient in the most comfortable and relaxed position
7. Hands Remove all jewellery relaxed (not sweaty if so, wash and dry them) and nails should be short
8. Maintain firm contact all the time and mold hands to the part being treated
9. Avoid pinching and pulling on patients hair on the limb

Question 11

Explain the aims of rehabilitations services for people living with HIV. 5

Answer 11

The aims of rehabilitation services are:

1. To add life to years lived.
2. Prevent of manage impairments.
3. Reduce activity limitations.
4. Encouraging individuals to participate in their social context and community.
5. Optimise independence

Question 12

Name two blood tests that provide information on a person’s immune status if the person is HIV positive. 2

Answer 12

1. CD4 count
2. Viral load