Clinical Practice Guidelines - A-level evidence Flashcards
Risk factors for Hip OA
age, hip developmental disorders, previous hip injury
Clinical findings to dx Hip OA
lat/ant hip pain during weight bearing, >50 yo, am stiffness >1 hr, limited hip IR and hip flex by more than 15 deg vs non-painful side
outcomes measures for hip OA
WOMAC, LEFS, Harris Hip Score
Exam tools for hip OA
6 min walk, self-paced walk (400 m walk as quickly as possible), stair measure (time for one flight of stairs up and down), TUG
outcome measures for neck pain
NDI, Pt specific functional scale
interventions for neck pain
cervical manip/mob; combining Mtx with exercise is more effective than manual alone; use coord/strength/endurance exercises; pt education important for whiplash-assoc disorders
Pt ed for whiplash-assoc disorders should include…
early return to normal, non-provocative activities is important AND good prognosis and full recovery commonly occurs
outcomes measures for Adhesive Capsulitis
DASH, ASES, SPADI
Intervention for adhesive capsulitis
corticosteroid injection (combined with shoulder mob and stretching) are effective for short-term relief (4-6 wks)
Diff dx for LBP
refer if…1) clinical findings suggest serious pathology, 2) activity limitations or impairments are not consistent with PT dx, 3) pt’s sx not resolving
Outcome measures for LBP
Oswestry, Roland-Morris
Interventions for LBP
Manual tx, trunk coord/strength/endurance, directional preference exercises, progressive endurance exs
outcome measure for achilles tendonopathy
Victorian Inst of Sport Assessment, FAAM
Interventions for achilles tendonopathy
eccentric loading
Diff Dx for ankle sprain
Ottawa and Bernese ankle rules should be used to determine whether radiograph is required to r/o ankle fx
outcome measure for ankle sprain
FAAM, LEFS
Physical impairment measures for ankle sprain
assess ankle swelling, ankle ROM, talar translation/inversion, and SLS
acute intervention for ankle sprain
Depending on severity of injury - protection should be used - in more severe injuries, immobilization ranging from semi-rigid brace to casting may be indicated; intermittent application of ice is indicated, as well as exercises
ultrasound for acute ankle sprains?
NO! (a-level evidence)
Other interventions for ankle sprain?
mob, manip, mob with movmnt (WB and NWB) to improve DF, proprioception and wt-bearing tolerance
outcome measure for nonarthritic hip joint
Hip Outcome Score, Copenhagen Hip and Groin Outcome Score, International Hip Outcome Tool
Outcome measure for heel pain/PF
FAAM, Foot Health Status Questionnaire, Foot Function Index, LEFS
A-level intervention for PF
joint and soft tissue mob for LE mobility and calf flexibility deficits; stretching for 1 wk to 4 months (w/ heel pad to increase benefits), anti-pronation tape for up to 3 wks; kt tape for 1 wk; foot orthoses to support arch and cushion heel (esp in pts who respond to taping), night splints for 1-3 months for pts who consistently have am pain
What are the Bernese ankle rules?
Applying indirect stress to evaluate for foot/ankel fx.
1. compression of tib/fib 10 cm proximal to malleoli
2. direct pressure on medial malleolus
3. compression of heel and forefoot towards each other
(can be more sensitive than xray for fx)
What are the Ottawa ankle rules
Ankle x ray if: tenderness in malleolar zone or inability to bear weight
Foot x ray if: tenderness at navicular or 5th met or inability to bear weight
NOT FOR USE IN PTs UNDER AGE 18
