Patient Education Handouts and Home Exercise Programming for the Orthopedic and Juvenile Rheumatoid Arthritis population.

1
Patient Education Handouts and Home Exercise
Programming for the Orthopedic and Juvenile
Rheumatoid Arthritis population.

• Tia Barbour-Hale
• Mandy DAmour
• Donna Trotter

2
Question

• What information is most important to put in a
  handout for patients and their parents and what
  exercises should be used for the home exercise
  program sheets for the most commonly seen
  orthopedic diagnoses in clinic?

3
Goals for CQI 2008-2009

• Provide families with increased education through
  handouts, specifically for the JRA and
  orthopedics diagnoses.
• Develop home exercise programs for most commonly
  seen orthopedic diagnoses.
• Improve consistency of home programs and
  education provided to families.

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Process

• Compiled a list of most commonly seen diagnoses
• Literature review on available education and
  protocols for the above diagnoses
• Developed format for education handout
• Assembled data according to format for handout
  and home exercise programs
• Printed and educated practitioners for clinic use

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Most Commonly Seen Diagnoses Addressed

• Elbow Fracture
• Brachial Plexus Injury
• Ankle Sprain
• Low Back Pain
• Patellafemoral Pain
• Hip Pain
• Shoulder Pain
• JRA (lower and upper extremity joints)

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Education Handout Example

• Elbow Fracture
• Information for Parents Caregivers
• How are elbow fractures caused?
• An elbow fracture is caused by trauma to the
  elbow bone(s). Trauma can be caused by falling
  on an outstretched arm, falling directly on the
  elbow, direct blow to the elbow, or twisting the
  elbow beyond the elbow's normal range of motion.
• Symptoms
• Symptoms include pain, often severe, tenderness,
  swelling, and bruising around the elbow, numbness
  in fingers, hand, or lower arm, decreased range
  of motion, a lump or visible deformity over the
  fracture site
• Treatment
• Treatment will depend on the severity of the
  injury. Treatment involves putting the pieces of
  the bone back in position, which may require
  surgery and keeping the pieces together while the
  bones heals itself.
• Devices that may be used to hold the bone in
  place while it heals include a cast or splint
  (may be used with or without surgery), a metal
  plate with screws (requires surgery), and screws
  alone (requires surgery)
• Rehabilitation for Elbow Fracture
• A therapy program usually begins with
  range-of-motion and resistive exercises, then
  incorporates power, aerobic and muscular
  endurance, flexibility, and coordination drills.
  As a patient, your number one concern is getting
  back to full strength as soon as possible so that
  you can return to normal activity. The major
  objectives of rehabilitation from an elbow
  fracture, once it's healed, are to improve the
  elasticity of the elbow joint and to gradually
  increase pain-free range of motion.
• How long will the effects of an injury last?
• The goal of rehabilitation is to return you to
  your sport or activity as soon as is safely
  possible. If you return too soon you may worsen
  your injury, which could lead to permanent
  damage. Everyone recovers from injury at a
  different rate. Return to your activity is
  determined by how soon your elbow fracture
  recovers, not by how many days or weeks it has
  been since your injury occurred. It also depends
  on how serious the injury is. Instances where
  reconstructive surgery is required will obviously
  create a longer recovery period than patients
  with a Type I fracture.
• References
• Ashwood N, Bain G, Unni R. Management of Mason
  Type III radial head fractures with a titanium
  prosthesis, ligament repair, and early
  mobilization. J Bone Joint Surg. 200486274-80.
• Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y.
  comminuted fractures of the radial head. J Bone
  Joint Surg. 200587 76-84.

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For the Future

• Continue to add diagnoses as they become common
  in the clinic
• Take current handouts and HEPS and make changes
  according to most available research
• Continue to educate practitioners in the clinic
  about these diagnoses
• Make these handouts a part of the orientation
  manuals