Foundation of treatment

Question 1

where does tx come in in the ‘flow of reasoning’

Answer 1

after we determine how we will know if the condition is changing and determine objective asteriks and before our POC

Question 2

what should our treatment selection reflect?

Answer 2

-relevent to cheif complaint
- centralization concept, if applicable
movement dysfxn

Question 3

what is the goal of treatment

Answer 3

proves the value of the intervention

aids in differential diagnosis

Question 4

should treatment provide a dichotomous response

Answer 4

yes, we need to know if it works or not

Question 5

when we treat our pt, and the dose is too high or low, what will happen?

Answer 5

Too high: flare up patient unnecessarily

•Too low: change is not reported despite good technique selection

Question 6

what do we do with pts who are high and low irritability?

Answer 6

• High Irritability:
• Initiate treatment in positions which ease symptoms
• Patients with low irritability
• Initiate treatment in painful position & mobilize to ease symptoms

Question 7

should we address dosage or irritability first?

Answer 7

irritability

Question 8

when should passive interventions be used?

Answer 8

when A window of opportunity is needed on way to patient performing activities relevant to functional limitations

Question 9

what are considerations for passive interventions?

Answer 9

•Direction
-Distraction or Compression? -Tissue considerations or Pain considerations

• Desired outcome
• Starting position of patient and PT
• Localization of forces/tissues
• Application of forces/technique (mob grades)
• Progression decision, based off pt response

Question 10

what happens when you have a green light response after Technique Application?

Answer 10

Pain with technique, eases after ceasing= green

BUT if pain with technique does not ease quickly: Yellow/Red light

Question 11

when should you stop passive interventions?

Answer 11

• Inflammatory signs
• Increased pain that lasts
• Neural conductivity affected
• Increased muscle guarding, breathing problems-difficulty relaxing
• Self-efficacy beliefs, external locus of control, passive coping- you shoudl shift to pt edu instead

Question 12

what is the hierarchy of intervention rx/

Answer 12

activation> control> strength> endurance> speed of contraction

Question 13

what type of question should you ask a pt to get their response to the intervention?

Answer 13

“Better, worse or same?”

Question 14

what should you do if progress is stalled ?

Answer 14

•First, assess whether you’re approach is correct

• Monitoring the correct asterisks?
• Am I treating the source?
• Is my dosage high enough?
• Is the patient doing their part with self-management?

•Planned break or treatment holiday necessary at times

• Be realistic with the disorder, some will not achieve full recovery•Give them a 2-week break and re-assess
• If improved, stay at that frequency, if not, give a few treatments, then another 2-week break