CAET cheat sheet

Bone remodeling follows coupled resorption (osteoclast) and formation (osteoblast) phases; immobilization shifts the balance toward net resorption and disuse osteopenia.

Skeletal muscle fiber types: type I slow-twitch, oxidative, fatigue-resistant; type II fast-twitch, glycolytic, high force but fatigable.

Peripheral nerve injury Seddon classification: neuropraxia (conduction block, recovery expected), axonotmesis (axonal loss, intact sheath, spontaneous regeneration), neurotmesis (complete disruption, requires repair).

Wallerian degeneration begins distal to the injury within days; regeneration proceeds at roughly 1 mm per day under favorable conditions.

Wolff's law: bone remodels along lines of mechanical stress; Hueter-Volkmann law: compression slows growth-plate growth while tension accelerates it.

Joint motion terminology: osteokinematics describes voluntary bone movement; arthrokinematics describes accessory roll, glide, and spin at the joint surface.

Convex-on-concave joint surfaces glide opposite to bone motion; concave-on-convex surfaces glide in the same direction as bone motion.

Cartilage is avascular and aneural; nutrition depends on cyclic loading and diffusion from synovial fluid, so sustained static compression impairs cartilage health.

Manual muscle testing grades 0-5: 0 no contraction, 1 trace, 2 active movement with gravity eliminated, 3 antigravity movement, 4 antigravity with some resistance, 5 normal.

Deep tendon reflex grading 0-4+: 0 absent, 1+ diminished, 2+ normal, 3+ exaggerated, 4+ clonus.

Upper motor neuron signs include hyperreflexia, spasticity, Babinski sign, and clonus; lower motor neuron signs include atrophy, fasciculations, and hyporeflexia.

Sensation dermatomes: C5 lateral shoulder, C6 thumb, C7 middle finger, C8 little finger, T4 nipple line, T10 umbilicus, L4 medial malleolus, L5 dorsum of foot, S1 lateral foot.

Glasgow Coma Scale sums eye (1-4), verbal (1-5), and motor (1-6); total 3-15, with 8 or below indicating severe impairment.

Sensitivity is the proportion of true positives detected; specificity is the proportion of true negatives correctly excluded; predictive values depend on prevalence.

Phalen and Tinel tests support carpal tunnel syndrome; a positive test changes post-test probability but does not confirm diagnosis alone.

Vital sign red flags: systolic BP below 90 mmHg, respiratory rate above 30 or below 8 per minute, or oxygen saturation below 90% warrant urgent escalation.

Postoperative hip precautions after posterior approach arthroplasty: avoid hip flexion beyond 90 degrees, adduction past midline, and internal rotation.

Sternal precautions after median sternotomy: avoid lifting more than roughly 5-10 lb, avoid pushing/pulling with arms, and splint the incision when coughing.

Weight-bearing orders: non-weight-bearing, toe-touch, partial, and full weight-bearing are surgeon-directed and must not be upgraded by the therapist.

Signs of compartment syndrome: pain out of proportion, pain with passive stretch, paresthesia, pallor, and pulselessness (late); it is a surgical emergency.

Anticoagulation after major orthopedic surgery reduces venous thromboembolism risk; therapists monitor for unilateral calf swelling and report before mobilizing.

Autonomic dysreflexia in spinal cord injury above T6 presents with sudden hypertension, headache, and bradycardia; sit the patient upright and remove the noxious stimulus.

Corticosteroid use raises risk of osteoporosis, hyperglycemia, and impaired wound healing; prolonged use requires gradual tapering.

Fracture healing stages: hematoma and inflammation, soft callus, hard callus, and remodeling; early controlled motion can support healing depending on fixation stability.

Progressive overload, specificity, and reversibility govern exercise adaptation; load must exceed current capacity and be periodically increased to drive change.

Strength gains from 8-12 repetitions at moderate-to-high intensity reflect hypertrophy; 1-5 repetitions at high load primarily reflect neural adaptation.

Aerobic prescription uses frequency, intensity, time, and type; moderate intensity equals 40-59% heart rate reserve or 3-6 METs.

Karvonen method: target heart rate = ((maximal HR minus resting HR) times intensity) plus resting HR.

Motor learning: practice variability and random practice enhance retention and transfer; blocked practice enhances immediate performance.

Neurodevelopmental treatment and task-specific training emphasize functional, repetitive practice; constraint-induced movement therapy restricts the less affected limb.

Spasticity management includes positioning, stretching, and serial casting; botulinum toxin and intrathecal baclofen are medical adjuncts.

Gait training progression moves from parallel bars to walker, then crutches, then cane, then unassisted, as balance and endurance permit.

Transtibial prostheses use patellar-tendon-bearing or total-surface-bearing sockets; the patellar tendon bar is a primary load-bearing region.

Transfemoral sockets use quadrilateral or ischial-ramal containment designs; ischial containment improves coronal plane stability.

Prosthetic knee stances: stance-control and microprocessor knees resist knee flexion during loading; mechanical friction knees require hip extensor effort.

Prosthetic foot categories: solid ankle cushion heel (SACH) for low activity, single-axis for ankle motion, energy-storing for higher activity.

Lower-limb amputation energy cost rises with proximal level: transfemoral ambulation costs more metabolic energy than transtibial.

Ankle-foot orthoses control dorsiflexion and plantar flexion; a rigid AFO limits ankle motion while a hinged AFO permits controlled range.

Upper-limb prosthetic options: body-powered (cable, harness) is durable and proprioceptive; myoelectric uses surface EMG and offers greater grip force.

Assistive technology selection matches device capability to user goals, environment, and funding; a trial with the actual user in the actual setting is standard.

Informed consent requires capacity, disclosure of risks and alternatives, comprehension, and voluntariness; it is a process, not a signature.

Patient confidentiality may be breached only when required by law, when a serious threat exists, or with patient authorization.

Scope of practice is defined by state licensure law and professional standards; a therapist must not perform acts outside that scope even if requested.

Duty to warn arises when a patient poses a credible threat to an identifiable third party; the therapist notifies the threatened person and authorities as the law requires.

Documentation should be objective, timely, and specific; late entries are labeled as such and never altered retroactively.

Fall prevention basics: bed in lowest position, call light within reach, non-skid footwear, and gait belt use during transfers.

Patient identification uses two identifiers (name and date of birth) before any intervention; never rely on room number alone.

Mandatory reporting includes suspected abuse or neglect of children, older adults, and dependent adults, and reportable communicable diseases.

Levels of evidence descend from systematic reviews and randomized controlled trials to cohort, case-control, case series, and expert opinion.

Randomized controlled trials reduce selection bias through randomization and allocation concealment; blinding reduces performance and detection bias.

Intention-to-treat analysis preserves randomization by analyzing participants in their assigned group regardless of adherence.

A p-value below 0.05 conventionally indicates statistical significance, but clinical significance depends on effect size and confidence intervals.

Confidence intervals that exclude the null value indicate statistical significance; width reflects precision and sample size.

Internal validity concerns causal inference within the study; external validity concerns generalizability to other populations and settings.

Sensitivity and specificity are properties of the test; positive and negative predictive values depend on disease prevalence in the tested population.

Quality improvement uses Plan-Do-Study-Act cycles and measures structure, process, and outcome to test small changes before scaling.

SBAR handoff structure: Situation, Background, Assessment, Recommendation; it standardizes communication during transitions of care.

Closed-loop communication confirms receipt of an order by having the receiver repeat it back to the sender.

Teach-back verifies patient understanding by asking the patient to restate instructions in their own words.

Health literacy strategies include plain language, chunking information, and avoiding unexplained jargon; universal precautions assume any patient may struggle.

Interpreter use is required when a patient has limited English proficiency; family members should not substitute except in emergencies.

Conflict resolution separates the people from the problem, focuses on interests rather than positions, and seeks mutual-gain options.

Team roles in rehabilitation include physician, nurse, physical therapist, occupational therapist, speech-language pathologist, and social worker, each contributing distinct assessment.

Documentation of patient refusal and of education provided protects both patient autonomy and the clinician in interprofessional records.