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Physical Therapy OCS > CPR > Flashcards

CPR Flashcards

1
Q

Lumbar Manipulation

A
  1. Pain less than 16 days
  2. No symptoms distal to the knee
  3. FABQ(work) less than 19
  4. PROMHip IR greater than 35 deg (either hip)
  5. +Lumbar Spring Test (hypomobile + pain)

Child’s study - pretest 44%·
Less than 4 of 5 = + LR 13.2 à posttest prob success 95%
Greater than 3 of 5 = - LR 0.10 à posttest prob success 7%

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2
Q

Cervical Myelopathy

A
  1. Gait deviation
  2. Hoffman’sTest
  3. Inverted supinator sign
  4. Babinski sign
  5. Age less than 45

Pre-test prob 35%
Less than 1 - LR.18 = Posttest prob 43%
Greater than 3 + LR 30.9 = post test Prob 94%

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3
Q

Cervical Radiculopathy

A
    • ULTTA
  2. Cervica lRotation (involved) less than 60 deg
  3. Spurling’s
  4. Distraction(up to 30#)

Pretest prob 53%
3 0f 4 = 85% post test
4 of 4 = 90% posttest

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4
Q

Secondary Shoulder Impingement

A
  1. Hawkins-Kennedy
  2. Painful Arc Sign
  3. Infraspinatus Muscle Test
  • Pretest Prob 65%
  • 3 of 3 → + LR 10.56 → Post test Prob 95%
  • 2 of 3 → + LR 5.03 → Post test Prob 90%
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5
Q

Rotator Cuff Tears

A

Best confirmed with MR-arthrogram
`1. Drop Arm
2. Painful arc sign
3. Infraspinatus Muscle test

  • Pretest Prob 39%
  • 3 of 3 → + LR 15.57 → posttest prob 91%
  • 2 of 3 → + LR 3.57 → posttest prob 69%
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6
Q

Lateral Epicondylagia Tx with MWM (mobilization with movement)

A
  1. Age less 49 → + LR 2.6 → 91% success
  2. Affected UE pain free grip greater 25# → + LR 2.3 →90% success
  3. Unaffected UE PF grip greater 75.5# → + LR 2.1 → 89% success

Pretest Prob 79%
3 of 3 → + LR ∞ → 100% success
2 of 3 → + LR 3.7 → 93% success
1 of 3 → + LR 1.8 → 87% success

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7
Q

Carpal Tunnel Syndrome Diagnosis

A
  • Age Greater than 45
  • Reports shaking hands relieves symptoms
  • Wrist Ratio index > .76 (AP / ML wrist measure)
  • Reduced Median sensory field first digit
  • Symptom Severity Scale Score > 1.9

• Pretest Prob 34%
# + Sen -LR Spec + LR Post %
>2 .98 .14 .14 1.1
>3 .98 . 04 .54 2.1
>4 .77 .28 .83 4.6 70%
5 .18 .83 .99 18.3 90%

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8
Q

CANADIAN CERVICAL SPINE RULES

A

High Risk Factors Present?

  1. Age > 65
  2. Dangerous Mechanism of Injury (i.e. fall > 1m or 5 stairs, axial load to head, high-speed motor vehicle accident, motorized recreational vehicle, bicycle collision)
  3. Paresthesias in extremities

Low Risk Factors that allow safe assessment of range of motion?

  1. Simple rear-end motor accident
  2. Normal sitting posture in emergency department
  3. Ambulatory at any time since injury
  4. Delayed onset of neck pain and absence of midline tenderness

Is the patient able to actively rotate the neck > 45 degrees to the right and the left?

If there is (1) High Risk Factors or (2) Low Risk Factors and the inability to actively rotate the neck > 45 degrees to the right and the left, radiographs are indicated.

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9
Q

DVT (wells Criteria)

A
  1. Active Cancer (treatment ongoing or within previous 6 months): + 1 Point
  2. Paralysis, paresis or recent plaster immobilization of the LE: + 1 Point
  3. Recently bedridden for 3 days or more, or major surgery within the previous 12 weeks requiring anesthesia: + 1 Point
  4. Localized tenderness along the distribution of the deep venous system: + 1 Point
  5. Entire leg swelling: + 1 Point
  6. Calf Swelling at least 3cm larger than asymptomatic leg (measured 10cm below tibial tub): + 1 Point
  7. Pitting Edema confined in symptomatic leg: + 1 Point
  8. Collateral superficial veins (nonvaricose): + 1 Point
  9. Previous DVT: + 1 Point
  10. Alternative diagnosis at least as likely as a DVT: – 2 Points

> 3: High Probability
1-2: Moderate Probability
0: Low Probability

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10
Q

Scaphoid Fx

A 
-	Axial Load of Thumb
o	Sn .89 / - LR .02
o	Sp .98 / + LR 49
-	Scaphoid Shift/ Watson’s test
o	Sn .69 / - LR .47
o	Sp .66 / + LR 2.0
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11
Q

Lumbar Stabilization

A
    • PITS Test - Prone instability test
  2. Aberant motions present
  3. Mean SLR Greater than 91
  4. Age Less than 40

• Pretest prob 33%
• Greater 3 → + LR 4.0 Posttest Prob 67%
•

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12
Q

LBP Tx with Pilates-based Exercises

A
  1. Total Trunk Flexion Greater 70 deg
    2, Duration of symptoms Less 6 month
  2. No symptoms in legs for greater 1 week
  3. BMI Greater 25
  4. Mean hip rotation > 25 deg (either hip)
  • Pretest prob 54%
  • 3 of 5 → + LR 10.64 → posttest prob 93%
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13
Q

SI Joint Pain

A
  1. SI Distraction
  2. SI compression
  3. Thigh Trust
  4. Gaenslen’s
  5. Sacral thrust
  6. FABER
  • Pretest prob 32%
  • 3 pos → + LR 7 → posttest 59%
  • 3 of 6 → Sn 94%, Sp 78%
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14
Q

Cervical Pain

Mobilization / Manipulation of T Spine

A
  1. Symptoms less 30 days
  2. No symptoms distal to shoulder
  3. Looking up does not aggravate symptoms
  4. FABQ(PA) less 12
  5. Diminished upper thoracic spine kyphosis
  6. Cervical extension ROM less 30 deg
  • Pretest prob 54%
  • 3 of 6→ 86%
  • 4 of 6 → 93%
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15
Q

HVLA to Cervical Spine

A
  1. Symptoms less 38 days
    • expectation of HVLA with help (pt believes)
  3. AROM rotation side/side differs greater 10 degrees
    4 . Pain with PA mid cervical spine
  • Pretest prob 39%
  • 3 of 4 → + LR 13.5 → posttest prob 90%
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16
Q

Cervical Traction

A
  1. Peripheralization with c4-c7 mobility testing
  2. Age greater 55
  3. (+) Shoulder abduction test
  4. (+) ULTT A
  5. (+) cervical distraction test
  • Pretest prob 44%
  • 3 of 5 → + LR 4.81 → Posttest 79%
  • 4+ of 5 → + LR 23 → Posttest 94.8%
17
Q

Hip OA

A
  • Self-reported “squat” as an aggravating factor
  • AROM hip extension causes pain
  • AROM hip flexion causes lateral hip pain
  • Scour test with Adduction causes lateral hip and or groin pain
  • PROM hip IR
18
Q

Hip OA (Clusters)

A

1 - (Sn 86%, SP 75%)

  • Hip Pain
  • IR Greater 15 deg
  • Pain with IR
  • Morning stiffness
19
Q

Knee OA Clusters

A

2

Sen 89%, Spec 88% (all groups)
#1
– knee pain & crepitus with active motion
- Morning stiffness 38

– knee pain & crepitus with active motion
- Morning stiffness greater 30 min
- Boney enlargement

– knee pain
- Boney Enlargement

20
Q

Manual therapy – HVLA SIJ mob for Patellofemoral Pain

A
  • Difference in hip IR >14 deg
  • Ankle dorsiflesion >16 deg
  • Navicular Drop Greater 3mm
  • No stiffness with sitting >30 min
  • Squatting is most painful activity
  • Pre-test probability 45%
  • 3/5 present → + LR 18.4 / - LR 0.33
  • 4/5 present → 100% success
21
Q

Taping for Patellofemoral Pain

A
    • Patellar tilt (K=0.49)
  • Tibial Varum Greater 5 degress (ICC = 0.66)
  • Pre-test success – 52%
  • 2/2 present → + LR 4.4 / - LR 0.53
  • Post test success – 83%
22
Q

Orthotics for PFPS

A

Vicenzino, et al:

  1. Age over 25 years
  2. Height less than 165 cm
  3. Worst pain less than 53.25 mm (100 mm visual analogue scale)
  4. Mid-foot width difference greater than 10.96 mm

2+ +LR = 2.2 59%
3+ +LR = 8.8 85%

23
Q

Maitalnd Hip Mobilizatoins for Knee OA

A
  • Hip/ groin pain or paresthesia
  • Anterior Thigh pain
  • Pain with hip distraction
  • Knee flexion PROM
24
Q

Ankle Instability/Stabilization treatment

A
  • Symptoms worse when standing
  • Symptoms worse in the evening
  • Navicular Drop > 5.0 mm
  • Distal Tibiofibular Joint hypomobility
  • Pre-test prob: 75%
  • 3 of 4 → +LR 5.90 → post test 95%
25
Q

Ottawa Ankle Rules

A

Pain in malleolar or midfoot area and Either:
1. Inability to bear weight immediately after injury AND in the ED (taking 4 steps)

OR

  1. Bone tenderness at the posterior edge of tibia or fibula or tip of medial or lateral malleolus
  2. Bone tenderness at the navicular or proximal base of 5th metatarsal
26
Q

Ottawa Knee Rules

A
  1. Age greater 55
  2. Tenderness at the head of the fibula
  3. Isolated tenderness of the patella during palpation
  4. Inability to flex the knee to 90 degrees
  5. Inability to bear weight immediately and upon ER evaluation
27
Q

Meniscus Pathology

A
  1. History of catching or locking reported by the patient
  2. Joint line tenderness
  3. Pain with forced hyperextension (modified bounce home test)
  4. Pain with maximal passive knee flexion
  5. Pain or audible click with McMurray manuver

3+ + LR 3.14
4+ + LR 4.28
5+ + LR 11.20

28
Q

C/T Manipulation for Shoulder Pain

A
  1. Less 90 days of symptoms
  2. No meds for shoulder pain
  3. (-) Neers
  4. Pain free flexion Less 127 deg
  5. IR Less 53 deg @ 90 deg GH abduction
  • Pretest Prob 61%
  • 3+ of 5 → + LR 5.3 → Posttest Prob 89%
29
Q

Cervical Radiculoptahy Predictors for Success

A
  1. Age Less 54 years
  2. Dominant UE not affected
  3. Looking down does NOT increased Sx
  4. Multimodal Tx (greater 50% of time = Manual therapy, Deep cervical flexor strengthening, cervical traction
  • Pretest 53%
  • 3 of 4 → posttest prob 85%
  • 4 of 4 → posttest prob 90%

Physical Therapy OCS (2 decks)

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