1. Joint, Connective Tissue, and Bone Disorders and Management
Chapter 11

2. Arthritis and Arthrosis
Clinical Signs and Symptoms
Impaired mobility
Impaired muscle performance
Impaired balance
Functional limitations
Table 11.1 compares Osteoarthritis and Rheumatoid Arthritis.

3. Rheumatoid Arthritis Characteristics
Signs and Symptoms: Periods of Active Disease
Principles of Management: Active Inflammatory Period
Patient education
Joint protection and energy conservation
Joint mobility
Exercise
Functional training
Arthritis and Arthrosis
Box 11.1 contains Criteria for Diagnosis of Rheumatoid Arthritis.
Box 11.2 contains Management Guidelines: Rheumatoid Arthritis/Active Disease Period.
Box 11.3 contains Principles of Joint Protection and Energy Conservation.

4. Rheumatoid Arthritis (cont'd)
Principles of Management: Subacute and Chronic Stages
Treatment approach
Joint protection and activity modification
Flexibility and strength
Cardiopulmonary endurance
Arthritis and Arthrosis

5. Osteoarthritis: Degenerative Joint Disease
Characteristics
Principles of Management
Patient instruction
Pain management: early stages
Pain management: late stages
Assistive and supportive devices and activity
Resistance exercise
Stretching and joint mobilization
Balance activities
Aerobic conditioning
Arthritis and Arthrosis
Box 11.4 contains Management Guidelines: Osteoarthritis

6. Fibromyalgia and Myofascial Pain Syndrome

7. Fibromyalgia Prevalence Characteristics
Contributing Factors to a Flare
Management
Figure 11.7 illustrates fibromyalgia tender points.

8. Myofascial Pain Syndrome
Possible Causes of Trigger Points
Chronic overload of muscle
Acute overload of muscle
Poorly conditioned muscles
Postural stresses
Poor body mechanics

9. Myofascial Pain Syndrome (cont'd)
Management
Correct contributing factors to chronic overload of the muscle
Eliminate the trigger point
Strengthen the muscle

10. Osteoporosis Risk Factors Prevention Primary osteoporosis
Secondary osteoporosis
Prevention
Physical activity
Effects of exercise

11. Osteoporosis (cont'd) Recommendations for Exercise
Mode: Aerobic
Frequency
Intensity
Mode: Resistance
Precautions and Contraindications

12. Fracture Identification
Site
Extent
Configuration
Relationship of the Fragments
Relationship to the Environment
Complications
Fractures and Post-Traumatic Immobilization
Table 11.3 describes Causes and Types of Fractures.

13. Risk Factors for Fracture
Sudden Impact
Osteoporosis
History of Falls
Fractures and Post-Traumatic Immobilization

14. Bone Healing Following a Fracture
Cortical Bone
Inflammation phase
Reparative phase
Stage of clinical union
Stage of radiological union
Rigid internal fixation
Healing time
Cancellous Bone
Epiphyseal Plate
Fractures and Post-Traumatic Immobilization
Box 11.6 contains Types of Abnormal Healing of Fractures.

15. Principles of Management: Period of Immobilization
Local Tissue Response
Immobilization in Bed
Functional Adaptations
Fractures and Post-Traumatic Immobilization
Box 11.7 contains Complications of Fractures.
Box 11.8 contains Management Guidelines: Post-fracture/Period of Immobilization.

16. Post-Immobilization Impairments Principles of Management
Joint mobilization
PNF stretching
Functional activities
Muscle performance
Scar tissue mobilization
Fractures and Post-Traumatic Immobilization
Box 11.9 contains Management Guidelines: Post-fracture/Post-immobilization.

17. Independent Learning Activities
Critical Thinking and Discussion