Intervention Development and Treatment Progression Flashcards
What are the different types of clinical reasoning
Inductive
Hypothetico-Deductive
Pattern Recognition
What is the inductive reasoning method
Standard method; process of labeling a disorder based on specific signs and symptoms
What is ex of inductive reasoning
patient has pain, swelling, ROM loss, is unstable, but is able to bear full weight on their limbs following “twisting” their ankle:
What is hypothetico-deductive reasoning
Clinician takes history and comes up with a hypothesis (tentative pathology)
- clinician determine which signs and symptoms are commonly present in the assumed disorder
- clinician determines if the signs and symptom are actually present
What is an example of hypothetic-deductive reasoning
Patient is a 90yo M who has shoulder pain with no history of shoulder injuries
- deduced pathology is OA
- signs and sx are rom loss, strength loss, and joint stiffness
What is pattern recognition method
Used with more obscure disorders where complete testing not always possible due to multiple factors; usually only used when a clinician has seen many patients with a specific pathology
important to have a cluster of symptoms
What is an example of pattern recognition reasoning
Patient is a 45 yo F with insidious onset of shoulder pain, she has good general health, has no history of trauma, or overuse injury, but is getting progressively worse. the patient is unable to sleep and cannot perform ADL secondary to significant soullder pain
dx: Adhesive Capsulitis
What are the steps to the treatment plan development
- hx and pe
- develop a problem list
- develop the rationale for the problems listed
- general hypothesis
- determine testing criteria, for assessment of rx to determine modification, progression, or D/C of treatment
- establish goals
- determine outcome measures
Who can create a problem list
The pt or the clinician
What is usually on the pts problem list
What is most important to the pt
what is typically on non pt problems list
typically impairments and anticipated problems
what is a hypothesis
a rationale based on theory or evidence as to the cause of the pts problems (most likely impairments) that are the cause of their functional loss and disability
What is the purpose of testing criteria
Determine effect of treatment tactics and strategy
What should your rx always be focused on
what the pt is concerned about
Decrease pain, increase ROM, increase strength/motor control, decrease inflammation, pt education, prevention, strategies would be an example of a
treatment strategy
What is a treatment strategy
Develop a strategy and tactics for the problems lists
what are ways to determine if a pt is getting better or if your treatment is working
- Pt rated measures
- clinician rated measures
- clinician rated performance measures
- have they been compliant with HEP
- are they achieving the goals that were set
- are pain, functional loss/disability measures changing
- ask questions about how they are doing
What are things to consider when deciding on whether to progress a patient
- what is your goal for the pt
- stage/phase of injury
- irritability
- time from injury
- what does pt need to get back to
- how does the pt respond to PT
- how does pt respond to life activies
- how does pt respond to life activities
- is pt getting better or worse
What does best external clinical evidence mean
clinically relevant research from basic science, PT centered studies, treatment or diagnostic studies
what does clinical expertise mean
the ability to use your clinical skills and past experiences to identify each pts unique health state, risks, benefits of treatment, personal values, and expectations
what doe pt values mean
the unique pt preferences, concerns, and expectation each pt brings
what is the advantage of systematic reviews and meta-analysis
summarize the evidence
what is a disadvantage of systematic reviews and meta-analysis
can miss a study that contains a pt sample that is very similar to your pt
What are clinical practice guidelines usually derived from
the results of a systematic review or meta-analysis
