Clinical Practice Guidelines - A-level evidence

Question 1

Risk factors for Hip OA

Answer 1

age, hip developmental disorders, previous hip injury

Question 2

Clinical findings to dx Hip OA

Answer 2

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

Question 3

outcomes measures for hip OA

Answer 3

WOMAC, LEFS, Harris Hip Score

Question 4

Exam tools for hip OA

Answer 4

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

Question 5

outcome measures for neck pain

Answer 5

NDI, Pt specific functional scale

Question 6

interventions for neck pain

Answer 6

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

Question 7

Pt ed for whiplash-assoc disorders should include…

Answer 7

early return to normal, non-provocative activities is important AND good prognosis and full recovery commonly occurs

Question 8

outcomes measures for Adhesive Capsulitis

Answer 8

DASH, ASES, SPADI

Question 9

Intervention for adhesive capsulitis

Answer 9

corticosteroid injection (combined with shoulder mob and stretching) are effective for short-term relief (4-6 wks)

Question 10

Diff dx for LBP

Answer 10

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

Question 11

Outcome measures for LBP

Answer 11

Oswestry, Roland-Morris

Question 12

Interventions for LBP

Answer 12

Manual tx, trunk coord/strength/endurance, directional preference exercises, progressive endurance exs

Question 13

outcome measure for achilles tendonopathy

Answer 13

Victorian Inst of Sport Assessment, FAAM

Question 14

Interventions for achilles tendonopathy

Answer 14

eccentric loading

Question 15

Diff Dx for ankle sprain

Answer 15

Ottawa and Bernese ankle rules should be used to determine whether radiograph is required to r/o ankle fx

Question 16

outcome measure for ankle sprain

Answer 16

FAAM, LEFS

Question 17

Physical impairment measures for ankle sprain

Answer 17

assess ankle swelling, ankle ROM, talar translation/inversion, and SLS

Question 18

acute intervention for ankle sprain

Answer 18

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

Question 19

ultrasound for acute ankle sprains?

Answer 19

NO! (a-level evidence)

Question 20

Other interventions for ankle sprain?

Answer 20

mob, manip, mob with movmnt (WB and NWB) to improve DF, proprioception and wt-bearing tolerance

Question 21

outcome measure for nonarthritic hip joint

Answer 21

Hip Outcome Score, Copenhagen Hip and Groin Outcome Score, International Hip Outcome Tool

Question 22

Outcome measure for heel pain/PF

Answer 22

FAAM, Foot Health Status Questionnaire, Foot Function Index, LEFS

Question 23

A-level intervention for PF

Answer 23

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

Question 24

What are the Bernese ankle rules?

Answer 24

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)

Question 25

What are the Ottawa ankle rules

Answer 25

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