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Understanding Osteoarthritis & its Management (For Physiotherapists)
Cmone Mishra
CHAPTER 1:
Osteoarthritis: An Overview
QUICK FACTS
Osteoarthritis (OA)
What is Osteoarthritis?
What Causes It?
Who is Prone to Get OA?
How to Make a Diagnosis?
How can Physiotherapy Help?
What will Happen When I See a Physiotherapist?
Are there Physiotherapists with Extra Training in this Area?
Meanwhile, How can I Help Myself?
Joints in Brief
The Synovium and Cartilage
INTRODUCTION
CHAPTER 2:
Osteoarthritis: Types and Pathogenesis
TYPES
Primary
Secondary
PATHOLOGY
PATHOGENESIS
CHAPTER 3:
Osteoarthritis: Clinical Assessment
SIGNS AND SYMPTOMS
Capsular Tightness
CLINICAL ASSESSMENT
Range of Motion (ROM)
Pain Assessment
Site and Distribution of Pain
Strength
Assessment of Endurance, Tone and Volume
Joint Stability
Assessment of Tenderness
Assessment of Deformity
Functional Assessment (Loss of Function)
Mobility and Gait
Example
Sensory Integrity
Environmental Barriers
Example
Investigations
Other Investigations
CHAPTER 4:
Treatment in Osteoarthritis
TREATMENT
Lifestyle Modification
Physiotherapy
Electrotherapy Modalities Used
Free Active Exercises and Mobilizations
Group Therapy
Exercises
Muscle Strengthening
Enhancing Joint Proprioception
Basic Balance Exercises
Intermediate Balance Exercises
Ball circles around leg
Ball throws against wall
Side throw against wall
Advanced Balance Exercises
Mobility of Joints
Orthotic Supports
Maintenance of Joint Range and Muscle Power
Coordination
Minimizing Deformity
Position Sense
Advice to the Patient
Joint Protection Techniques
Respect Pain
Avoid Activities that Hurt Affected Joints
Check Out Assistive Devices Which are Available
Use Largest and Strongest Joints and Muscles
Use Good Posture and Body Mechanics
Avoid Staying in One Position for Too Long
Balance Activity and Rest
Avoid Prolonged Periods of Immobility
Reduce Excess Body Weight
Simplify, Plan and Organize
Weight-bearing Joints Carry the Burden
Medication
Paracetamol
Corticosteroids
Narcotics
Topical
Injectable
Surgery
Alternative Treatments
Acupuncture
Glucosamine/Chondroitin
Other Supplements
CHAPTER 5:
Osteoarthritis: Hip Joint
OSTEOARTHRITIS OF THE HIP (FAMILIARLY CALLED AS MALUM COXAE SENILIS)
General Features of Osteoarthritis
Primary Symptoms and Signs
Symptoms
Signs
Classification
Diagnosis
Treatment
Exercises
Rules of Exercises in the Management of OA Hip
Exercises Lying on the Back
Exercises Lying on your Side with the Painful Hip Up
Exercises in Standing
Suggested Exercise Plan for Patients with Osteoarthritis of the Hips
Exercise Device Suitable for Patients with Arthritis
Operative Options
Choice of Osteotomy
Indications
Hip Resurfacing (Figs 5.6A and B)
Rehabilitation after Total Hip Replacement
Patient Instruction for Total Hip Replacement
Positions to be Adopted during Everyday Activities
Rehabilitation Protocol—Postoperative THR
Goals
Rehabilitation Considerations in Cemented and Cementless Techniques
Preoperative Instructions
Postoperative Regimen
Weight-bearing Status
Isometric Exercises
ROM and Stretching Exercises
Abduction Pillow
Bathroom Rehabilitation
Assistive Devices
Transfer Instructions
Exercise Progression
Home Instructions
Managing Problems after Total Hip Replacement
Additional Rehabilitation Points
Deep Vein Thrombosis in Total Joint Replacement
Other Complications
CHAPTER 6:
Osteoarthritis: Knee Joint
THE ARTHRITIC KNEE
Review of Pertinent Anatomy and Kinesiology
Classification
O's in OA
Biomechanics
Diagnosis
Radiographic Evaluation
NONOPERATIVE TREATMENT ALGORITHM FOR PATIENT WITH OA KNEE
Exercise Regimen
Isometric Exercise
Active ROM Exercises
Isokinetic Exercises
SLR (Straight Leg Raising)
Stretching Exercises
Hamstring Stretching
Strengthening Exercises
Endurance Training
Functional Training
Gait Training
OPERATIVE TREATMENT ALGORITHM
Indications for Surgery
Operative Options
Arthroscopy
Osteotomy
Unicompartmental Knee Replacements
Total Knee Arthroplasty (Fig. 6.28)
Fixation Method for Total Knee Implants
Goals of Rehabilitation after Total Knee Arthroplasty
Rehabilitation of Patients with “Hybrid” Ingrowths Implants Versus those with Cemented Total Knee Replacement
Accelerated Protocol—Postoperative Rehabilitation
Major Complications
CHAPTER 7:
Mobilization Techniques in Arthritic Knee
TYPES OF MOBILIZATION TECHNIQUES
CHAPTER 8:
Osteoarthritis in Various Joints
THE ANKLE JOINT
The Foot
Diagnosis of Foot Osteoarthritis
Symptoms of Foot Osteoarthritis
Treatment of Foot Osteoarthritis
The Shoulder
The Elbow
The Wrist and Hand
OSTEOARTHRITIS OF THE SMALL JOINTS
Summary
Case Study
CASE 1
CASE 2
CASE 3
CASE 4
CASE 5
CASE 6
Appendix 1
Arthritis Impact Measurement Scales 2 (AIMS2-SF)
Biomechanical Consideration Related to Rehabilitation
Exercise and Activity Recommendation
Getting Additional Rest
Energy Conservation to Reduce Fatigue
Core Strengthening Exercises
INDEX
TOC
Index
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