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CPGs Flashcards

1
Q

Adhesive capsulitis Clinical Course

A

B - staged progression of pain mobility deficits and after 12-18 months Mike to moderate mobility deficits may persist.

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2
Q

Adhesive Capsulitis diagnosis and classification

A

F - Gradual progressive onset of painless of active and passive ROM in elevation and rotation.

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3
Q

Adhesive capsulitis differential diagnosis

A

F - clinicians should explore DD if not making progress or resolving with interventions

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4
Q

Adhesive capsulitis Examination - outcomes measures

A

A- DASH ASES or SPADI

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5
Q

Adhesive capsulitis examination activity limitations and participation restrictions

A

F - use any easily reproducible aR or PR

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6
Q

Adhesive capsulitis Examination physical impairment measures

A

E - pain arom prom gh motion

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7
Q

Adhesive capsulitis Interventions

A

A - corticosteroid injections combined with MT and stretching provide 4-6 weeks relief

B - patient education on natural course activity modifications to encourage painfree stretching and rom. Stretching based off phase of progression

C - modalities( shockwave estim US combined with stretching/mobility), joint mobilization, translational manipulation.

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8
Q

Hip OA pathoanatomical features

A

B - mobility of hip joint. Strength. Especially hip ABD strength

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9
Q

Hip OA risk factors

A

A - age , hip developmental disorders, previous history

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10
Q

Hip OA diagnosis/classification

A

A - age> 50, painful IR, limited by 15 compared to opposite side flexion and IR, morning stiffness

CPR
1. Age > 50, painful hip IR > 15 degrees, morning stiffness 50

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11
Q

Hip OA differential diagnoses.

A

E - look for other sources if Sx not consistent with OA

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12
Q

Hip OA Examination

A

Outcomes = A - womac lefs Harris hip score

Activity limitation and participation= A - 6 min walk, self paced walk, stair measure , TUG

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13
Q

Hip OA intervention

A

B - patient education on activity modification and weight loss if applicable. Manual therapy ( short term). Strengthening and flexibility exercises.

C- functional gait and balance training. Including use of AD

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14
Q

Non-arthritic Hip Risk factors

A

F - presence of osseous abnormalities , local or global ligament out laxity, connective tissue disorders, nature of patients activity and participation.

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15
Q

Non-arthritic Hip diagnosis and classification

A

C
Anterior and lateral hip pain, generalized hip pain. Reproduced with FABER, FADIR. Consistent imaging findings. To classify and diagnose

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16
Q

Non-arthritic Hip differential diagnosis

A

F - consider other dx when Sx or hx do not align with hip disorder or fail to respond to treatment

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17
Q

Non-arthritic Hip outcomes measure

A

A
Hip outcome score( HOS)
Copenhagen hip and groin outcome(HAGOS)
International hip outcome tool (iHOT33)

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18
Q

Non-arthritic Hip physical impairments

A

B

Body function, pain mobility, muscle power, movement coordination

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19
Q

Non-arthritic Hip interventions

A 
F
Manual therapy
Patient education/counseling
Therapeutic exercises
Neuromuscular reeducation
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20
Q

Adhesive capsulitis Risk Factors

A

C level. Diabetes thyroid disease 40-65 yo, female, and previous hx of froz shoulder.

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21
Q

Neck Pain Pathoanatomical features

A

E

The tissue causing pain is most often unknown. Assess for impaired function of muscle, connective, and nerve

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22
Q

Neck Pain Risk FActors

A

B

Age > 40, long Hx of neck pain, Cycling as reg activity, loss of strength in hands, poor quality of life, less vitality

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23
Q

Neck Pain Diagnosis/Classification

A

B
1. Motion Limitations
- Cervical active ROM, Cervical and Thoracic segmental mobility
, 2. Headaches,
- Cervical ROM, Segmental mobility, Cervical flexion test
3. Sprain strain
- Cranial cervical flexion test, DNF endurance

  1. Reffered or radiating pain
    - (+) ULTTA, Spurlings, Distraction, ROM limitation 60
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24
Q

Neck Pain Differential Diagnosis

A

B

Consider other serious pathologies orr dx when Sx or hx do not align with disorder or fail to respond to treatment

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25
Neck Pain Outcomes
A | NDI, PSFS
26
Neck Pain Activity limitation measures
F | Utilize easily reproducable activity limitations
27
Neck Pain Interventions
A - Cervical manipulation/mobilization c exercise. Coordination, strengthening, and endurance ex. Patient education and counseling(return to normal activities, provide reassurance) B - TRaction c manual therapy and ex beneficial. Nerve mobilization C - Thoracic manipulation/mobilization, stretching, centralization procedures
28
Achilles Tendinopathy Rick Factors
B Ankle DF ROM, Abnormal subtalar motion, dec ankle PF strength, inc foot pronation, abnormal tendon structure. Obesity, hypertension, hyperlipidemia, diabetes also contribute Also look into training errors, environment, and faulty equipment
29
Achilles Tendinopathy Diagnosis and Classification
C Stiffness in achilles after prolong inactivity that lessons with acute bout of activity but may inc after activity Achilles tendon tenderness, positive arc sign, positive royal london hospital test
30
Achilles Tendinopathy Differential Diagnosis
F | not resolvign with normal care, consider other pathologies as needed
31
Achilles Tendinopathy Outcomes Measures
A Victorian Institute of Sport Assessment Ankle Ability MEasure
32
Achilles Tendinopathy Examin Activity limitation
B | Wlak, descend stairs, perform unilateral heel raises, single leg hop, participate in rec activity
33
Achilles Tendinopathy Physical Impairments
B | DF ROM, subtalar motion, plantar flexion strength, static arch height, forefoot alignment, pain with palpation
34
Achilles Tendinopathy Interventions
A - Eccentric loading B - Low level laser(dec stiffness), Ionto c Dex C - Stretching, Foot Orthosis, night splints(not beneficial compared to eccentric) D = Heel Lifts F - Taping, Manual Therapy
35
Meniscal and Articular Cartilage Lesion CLinical Course
C | Can be result of contact or noncontact, assessm impairments in ROM motor control, strength and endurance
36
Meniscal and Articular Cartilage Lesion Risk Facor Meniscus
C | Age, greater time from injury, high level sports, knee laxity after ACL
37
Meniscal and Articular Cartilage Lesion Risk Factor Articular cartilage
C | Age, presence of meniscal tear, ACL injury, time from ACL injury
38
Meniscal and Articular Cartilage Lesion Diagnosis and Classification
C | Knee pain, mobility impairments, effusion
39
Meniscal and Articular Cartilage Lesion Differenctial Diagnosis
C | Consider other serious pathologies and psychosocial factors, or when patient is not responding to interventions
40
Meniscal and Articular Cartilage Lesion Outcomes MEasure
C | Use validated activity scale
41
Meniscal and Articular Cartilage Lesion Activty limitations
C | Single leg hop tests, 6 minute walk, TUG
42
Meniscal and Articular Cartilage Lesion Interventions
B - Therapeutic exercises, NMES for Quad C - Progressive Knee ROM, Progressive return to activity(meniscus) = early D - Supervised REhab for meniscectomy, Progressive weight bearing(repairs and chondral lesions) E - Progrssive return to activity for cartilage = Delay best
43
Knee Ligament Sprain - Risk Factors
B Shoe surface interaction, increased BMI, Mnarrow femoral notch width, inc joint laxity, preovulatory phase in menstral cycle, combined loading pattern, strong quad activation during eccentric contraction
44
Knee Ligament Sprain - Diagnosis and Classification
A | Passive Knee Instability, Joint Pain, Jooint Effusion, movement coordination impairments
45
Knee Ligament Sprain - Differential Diagnosis
B | Consider other pathologies or when interventions not improving
46
Knee Ligament Sprain - Outcomes Measures
A Use validated outcome measure and general health questionnaire SF36(lower - worse), KOOS(lower = worse), IKDC(MDC 11.5, greater = better), KOS ADLS(lower = more disable)
47
Knee Ligament Sprain - Activity limitation
C | Single leg hop, knee stability
48
Knee Ligament Sprain - Interventions
A - Therapeutic exercises(open and closed chain) B - Immediate postop knee brace no more beneficial., Supervised Rahab (supplemented with HEP), NMES following ACL, Neuromuscular reed, "accelerated" rehab(safe for ACL, Eccentric(ergometer for ACL, Quads for PCL) C-Cryotherapy(post op), Knee bracing(deficient ACL, Early weight bearing, Continuous passive motion D-Functional Knee BRacing following reconstruction F - knee bracing for Acute PCL, Severe MCL, PLC
49
Heel Pain - Risk Factors
B | Limited DF, High BMI, Running, work related weight bearing(poor shock absorption)
50
Heel Pain - Diagnosis and Classification
B Use following Hx and exam: Plantar heel pain c first steps in AM(also worse following prolonged WB, Heel pain after recent inc in WB activity, TTP proximal insertion of plantar fascia, (+) windlass, (-) tarsal tunnel, limited A/PROM TC joint, abnormal foot posture index, high BMI(nonathletic)
51
Heel Pain - Differential Diagnosis
C | Fat pad atrophy, spondyloarthritis, proximal plantar fibroma. or when not responding to interventions
52
Heel Pain - Outcomes measure
A | Foot Ankle abiilty measure(FAAM), Foot health Status Questionaire(FHSQ), Foot funciton index(FFI), LEFS
53
Heel Pain - Activity limitation
F | Use easiliy reproducible activities
54
Heel Pain - Physical Impairments
B | pain initial steps, pain c palpation, active/passive ROM
55
Heel Pain - Intervention
A - Manual Therapy, Stretching(short term 1 week to 4 month relief), Taping(antipronation = 3 weeks relief) Kinesio tape for 1 week relief, Foot orthoses(2 week to 1 year relief), Night Splints(1-3 month program for those with pain in AM) C - Low level laser, phonophoresis ketoprofen gel, Ultrasound(NOT RECOMMENDED) Rocker bottom shoe, changing shoes throughout week E - weight loss counseling F - Strengthening and movement training(control pronation), TDN(not recommended)
56
Ankle Ligament Sprain - Risk Factor(acute Ankle)
B Have Hx of previous sprain, do not use external support, improper warmup wit stretching and dynamic, do not have normal ankle DF, do not participate in balance/proprioception with Hx of previous injury
57
Ankle Ligament Sprain - Risk Factor(instability)
C | Inc talar curvature, not using external support, did not preform balance after acute ankle sprain
58
Ankle Ligament Sprain - Diagnosis of lateral ankle
B | level of function, ligamentous laxity, point tenderness, total ankle ROM, swelling, pain
59
Ankle Ligament Sprain - Diagnosis Instability
B | cumberland ankle instability tool,
60
Ankle Ligament Sprain - Differential diag of lateral ankle sprain
A | utilize ottowa ankle and bernese ankle for radiograph
61
Ankle Ligament Sprain - differential diag ankle instability
F | look for others when does fit or improve
62
Ankle Ligament Sprain - Outcomes
A | FAAM, LEFS
63
Ankle Ligament Sprain - Activity limitation
B | single leg hop tests(lateral diagnoal and directional changes)
64
Ankle Ligament Sprain - physical impairment
A | Swelling, ROM, talar translation, inversion, single leg balance
65
Ankle Ligament Sprain - Intervention
A - Acute and protective motion phase(early weight bearing with support) more severe = better bracing. Cryotherapy(acute), Ultrasound(DO NOT USE), therapeutic exercises, Manual therapy(postacute phase) B- - Manual therapy in Acute phase(painfree motion) C - Diathermy, Therapeutic exercise(post acute), sport related training D Electrotherapy, Low level laser
66
Low Back Pain - Risk Factors
BB | Current literature does not support definitive cause
67
Low Back Pain - clincal Course
E | Acute, Subacute, Reccurant, Chronic
68
Low Back Pain - Diagnosis and classification
B Mobility restrictions, Movement coordination, REferred pain and LBP(glute and thigh), LBP plus RAdiating pain(parathesias numbness, weakness), chornic LBP with cognitive , chronic LBP with generalized pain
69
Low Back Pain - Differential Diagnosis
A | serious psychosocial, serious pathology, inconsistant Sx, not resolving in timely all = referral
70
Low Back Pain - Outcomes Measure
A | ODI, Roland-Morris Disabilty questionaire
71
Low Back Pain - Acitity limitation
F | Easily reproducible
72
Low Back Pain - Interventions
A - Manual Therapy(thrust for acute subacute and chronic) and hip mobility, Stability exercises(subacute and chornic), Centralization(acute subacute chornic), Progressive resistance exercises: moderate to high intensity(chronic without generalized pain);low intensity submax and endurance for chronic(w generalized pain) B - Patient education and counseling(DO NOT: increase fear, bedrest, pathoanatomical) (DO: promotion of strength of spine, pain perception neuroscience, favorable diagnosis of back pain, use of active coping, early resumption of activity, importance of activity improvement(not just pain) C - flexion exercises(chronic), Lower quarter nerve mobilization(subacute and chronic) D - Traction(except nerve root compression) do not use with non-referred/radicular pain

Physical Therapy OCS (2 decks)

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