Clinical Prediction Rules - Intervention

Question 1

Cervical Manipulation for Neck Pain

Answer 1

Symptom duration less than 38 days
Positive expectation that manipulation will help
Side-to-side difference in c/s ROM of >10deg
Pain with PA spring testing of middle c/s
3 =90% success
4 = 100%

Question 2

Cervicothoracic Manipulation for Shoulder Pain

Answer 2

Pain free shoulder flex <127
Shoulder IR <53 at 90 abd
Negative Neer test
Not taking medications for pain
Symptoms <90 days
4 = 100% success

Question 3

Exercise for Ankylosing Spondylitis

Answer 3

SF-36: Physical role >37
SF-36: Bodily pain >27
Bath Ankylosing Spondylitis Disease Activity Index >311

Question 4

Hip Mobilization for Knee OA

Answer 4

Hip or groin pain or paresthesia
Anterior Thigh Pain
Passive knee flex <122
Passive hip IR <17
Pain with hip distraction
2 = 97% success

Question 5

Lumbopelvic Manipulation for Patellofemoral Pain Syndrome

Answer 5

Difference in hip IR >14deg
Ankle DF with knee flexed >16deg
Navicular drop >3mm
No stiffness with sitting 20min
Squatting most painful activity

Question 6

Manipulation for Low Back Pain

Answer 6

Duration of symptoms <16 days
at least 1 hip with >35deg IR
Lumbar hypomobility
No symptoms distal to knee
FABQ-W score <19
all 5 = 100% success

SIJ thrust followed by supine pelvic tilts

Question 7

Manual Therapy and Exercise for Acute Lateral Ankle Sprain

Answer 7

Symptoms worse when standing
Symptoms worse in evening
Navicular drop >5mm
Distal tibiofibular joint hypomobility
3/4 = 95% success
4/4 success drops!

Question 8

Mechanical Traction for Low Back Pain

Answer 8

FABQ-W score <21
No neurological deficit involvement
Age >30
Non-manual work job status

Question 9

Mechanical Traction for Neck Pain

Answer 9

Pt reported peripheralization with C4-7 mobility testing
Positive shoulder abd test
Age >55
+ ULTT-A
+ Neck distraction test
4/5 = 95% success
Followed by: seated posture and supine deep neck flexor exercises

Question 10

Mobilization with Movement for Lateral Epicondyalgia

Answer 10

Age <49
Affected side pain free grip >112 netwon (25.2lbs)
Unaffected side pain free grip <335 newtons (75.3)
Change in pain >25% following MWM
3/4 = 100% success

Question 11

Orthotics for Patellofemoral Pain Syndrome

Answer 11

Age >25
Height <165cm
Worst pain less than 53.25mm (100mm VAS)
Mid-foot width difference >10.96

Question 12

Patellar Taping for Patellofemoral Pain Syndrome

Answer 12

Tibial angulation >5deg

Positive Patellar tilt test

Question 13

Stabilization for Low Back PAin

Answer 13

Age <40
SLR >91deg
Aberrant movement present
Positive prone instability test

Question 14

Thoracic Manipulation for Neck Pain

Answer 14

Symptoms <30 days
No symptoms distal to shoulder
Looking up does not aggravate symptoms
FABQ-PA score <12
Diminished upper t/s kyphosis
C/S ext ROM <30 deg