DPS studied

Question 1

Gomes Neto

Answer 1

Strength training

(Gomes Neto, 2017)

meta analysis found that progressive strength training improves pain, function and quality of life.

Question 2

Haas

Answer 2

Manual therapy

Haas et al (2016)

meta analysis found exercise and manual therapy is better than just exercise for pain, mobility and function.

Question 3

Dailey

Answer 3

Dailey et al (2018)

Manual therapy

beneficial for mobilisation to be used in post op rehab. People who done exercise + mobs are less likely to take medication for pain after 1year.

Question 4

Knee problem list a

Answer 4

1. ROM
2. Weakness in quad and glute - knee stability and function
3. Concerns - work and recovery = stress = ⬇️recovery
4. High BMI blood pressure and cholesterol may affect recovery and joint health.
5. Swelling

Question 5

Shoulder problem list

Answer 5

1. Pain
2. Stiffness / ROM
3. Postural (kyphosis)
4. Stress/ anxiety (relationship/ concerns of time management)
5. Diabetes = risk of frozen shoulder

Question 6

NICE

Answer 6

NICE 2014
Guidelines in OA care and management
Progressive strength training programme is recommended in improving pain, ROM and function

Question 7

Westby

Answer 7

In sport surgical clinic they said one treatment plan is patella mobilisation and they referenced westby (2014) as he stated it helps to restore normal function and reduce pain and stiffness

Question 8

Knee references

Answer 8

Exercise
Gomes Neto (2017) done a meta analysis and evaluated the effect of progressive strength training and found it helps with pain, ROM and Quality of life.
NICE (2014) guidelines of OA management and care recommended progressive strength training

Manual therapy.
Haas et al (2016) conducted a meta analysis and found that strength training and manual therapy is better than just exercise
Dailey et al (2018) in his study of doing manual therapy on TKR pt, they are less likely to be taking meds after 1 year.
Sport surgical clinic Dublin also suggested to do patella mobs as a treatment option and reference westby et al (2014) as he stated it helps restore movement and pain after TKR

Question 9

Knee outcome measure

Answer 9

TUG = sit, walk 3m and back and sit back down.

Oxford knee score
12 questions (function + pain)

Msk HQ 14 questing (symptoms + quality of life)

Question 10

Shoulder outcome measure

Answer 10

Shoulder pain and disability index
Pain 5Q
Disability 8Q

MSK HQ

Question 11

Shoulder references

Answer 11

Kirker et al 2023 conducted a meta analysis and found many supporting evidence for manual therapy and exercise for frozen shoulder
Kumar et al (2014) conducted a study on the frozen shoulder and found that maitland mobilisation with exercise released pain increased ROM and function
This was later confirmed by Lee et al 2023.