IPPA Flashcards
5 A’s of EBP?
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Access best available evidence
Appraise evidence
Apply evidence
Assess for impact
What is WOCSSNOR?
Where is the pain
Other sources of pain
Continuous or Intermittent
Superficial or Deep
Severity
Nature of pain (burning, nauseating)
Other symptoms (pins and needles)
Relationship between pains
What is evidenced based research?
High quality clinical research
Patient preferences
Professional practice
3 B’s of Determinants of Health?
Biomedical risk factors
Behavioural risk factors
Broad social determinants
Also described as individual, social and community, socioeconomic/cultural/environmental
What are the aspects of the ICF model
Health Condition
Body Functions
Activities
Participation
Environment
Personal Factors
What is a strength and weakness of the medical model, social model, biopsychosocial model and ICF model?
MM: helps with physical problems, does not consider other factors and views patient as broken
SM: recognizes that attitudes of society makes a patient disabled not the patient, however removing barriers is not the whole answer
BPS: more holistic but doesn’t explain relationships between factor types
ICF: provides a holistic view, does not distinguish between disabled and non-disabled
What are the two measurement errors?
Systematic- only in one direction, predictable, constant
Random- the opposite
What are test-retest, intra-rater and inter-rater reliability?
TR- no tester e.g. questionnaire
Intra- Same tester multiple times
Inter- Different tester multiple times
What are the four validities and describe them?
Face- instrument appears to test what it should, subjective assessment
Content- instrument represents all content areas of importance
Construct- extent to which test measures a theoretical construct/trait, at least 75% of results in line with hypothesis with 50+ patients
Split into convergent and divergent, proving and disproving
Criterion- comparison to a gold standard
Split into concurrent, at the same time, or predictive, at different times
What are the three rockers? What muscles are involved in these?
1st rocker: heel strike, dorsiflexion by tibialis anterior
2nd rocker: tibia moving over foot, soleus works eccentrically
3rd rocker: Push off with toes, gastrocnemius working concentrically
What are the five prerequisites of gait?
- Swing phase prepositioning of foot (heel strike)
- Foot clearance
- Stability
- Energy Conservation
- Adequate step length
What does active ROM, passive ROM, muscle strength, muscle length test?
Active ROM- P1 and P2, first pain and intolerable pain, if reduced compared to passive then it is likely muscular
Passive ROM- joint stiffness
Muscle strength- oxford grading scale, apply force to muscle to test strength
Muscle length test- opposite, is muscle tight restricting movement
What is an isotonic, isometric, functional muscle test?
Isotonic- throughout full range of movement, resistance applied by therapist
Isometric- measured at one point using a dynamometer
Functional- performing daily activities e.g. squat
What is the objective assessment framework (OPAPMN)?
Observation (posture, gait, facial expression)
Palpitation (anatomical structures, recreate symptoms, swelling)
Active Range of Motion
Passive Range of Motion
Manuel Muscle Tests (Strength + Length)
Neurological Tests (dermatomes, myotomes, reflexes)
What is the difference between physiological and accessory passive ROM tests?
Physiological- joints under conscious control e.g. shoulder
Accessory- joints not under conscious control e.g. sliding/gliding
Difference between relative and absolute reliability?
R- Individual in repeated measures
A- Repeated measures variance for many individuals
What is PICO?
Patient Population Problem
Intervention
Comparator
Outcome
3 websites for high quality research?
Pubmed, Medline, Pedro
How do you right PICO questions for experiences, prognosis and diagnosis
E: Patient and Phenomenon e.g. what are the principle concerns of adults with LBP
P: Population and Timeframe e.g. what is the probably of being pain free in 6 weeks for adults with LBP
D: Population, Intervention Diagnosis, e.g. what is the likelihood in adults with LBP of a straight leg test diagnosing nerve compromise
What are the definitions of gestation extremely preterm, very preterm, moderate-late preterm and term?
EP: <28 weeks,
VP: 28 to <32 weeks,
MLP: 32 to <37 weeks,
T: 37 to <42 weeks
What is normal birth weight?
2500-4500g
Milestones for 3 months
Motor: Head in midline supine
Externally rotated, flexed lower limbs supine
Hands loosely open
Cooing
Bears weight on forearms prone
Milestones for 6 months
Swimming
Pivoting
Roll prone to supine
Supported standing
Sit to stand
Start of side protective reflex
Propping on extended upper limbs prone
Hands to knees/feet
Explores toys with mouth
Vowel sounds
Palmar grasp
Start to show shyness to strangers
Milestones for 9 months
Quickly moves out of position, prone/supine
W sitting
Arms for play more than balance
Pull to stand
Purposeful stepping
Roll supine to prone
Inferior pincer grip
Meaningful vocalizations
Reacts to mum/dad
Milestones for 12 months
Rise prone/supine to stand easily
Crawls/bumshuffles with speed
Pull to stand frequently
Walks with trolley
May walk indepently
Cruising
Babble
Pincer grip
Milestones for 15 months
Independent walk
Unaided stand to sit
Kneels unaided
Crawls up stairs quickly
Frequent pincer
Few words
Pointing to familar things or demanding
Milestones for 18 months
Mature gait
Runs, trouble avoiding obstacles
Hand preference
Walks up stairs with hand held
Squats to pick up toys
No toys to mouth
Milestones for 2 years
Squat, no hands to rise
Running with avoiding obstacles
Stairs, using rail
Turns book page
Builds 6-7 blocks
50+ words
Parallel play
Milestones for 2.5 years
Runs well
Jumps with two feet off low step
Climbs on equipment
Throw/kick ball
Confidently on stairs
Puzzles
Tripod grip
Milestones for 3 years
Rides trike
Confident stairs
Runs well
Momentary single leg stance
Throw, catch, kick
Cuts toy scissors
Count to 10
Lots of questions
Make believe play
Milestones for 4 years
Sharp turns on trike
Adult up down stairs
3-5s single leg stance
Hopping
Milestones for 5 years
8-10s SLS
Skips
Walks narrow line
Climbing, swinging, sliding
Dance rhythmically
Controlled writing, painting, drawing
Builds LEGO
Milestones for 6 years
Balance beam
Rides a bike
Leaps and bounds
Writing endurance
Starts to tie shoes
Keyboard/mouse
What are the four main AHPRA principles?
Confidentiality, Privacy, Informed Consent, Professional Behaviour
What does irritability mean?
Ease to provoke
What is compensated trendelenburg and uncompensated trendelenburg?
Trendelenburg is when the abductors are weak, resulting in a pelvic tilt in single leg stand. In compensated, the trunk moves to the affected side to compensate
Describe the SLS milestones
Momentary- 3 years
3-5 seconds/Hopping- 4 years
8-10/Skipping- 5 years
Describe walking milestones
Pull to stand- 9 months
Frequent pull to stand/cruising/trolley- 12 months
Independent walk- 15 months
Mature gait- 18 months
Describe stair milestones
Crawl up stairs- 12 months
Crawls up stairs quickly- 15
Walk with hand held- 18
Walk with railing- 2 years
Climb confidently 2.5 years
Equality vs Equity definitions
Equality: everyone gets the same
Equity: everyone gets according to their needs
Roughly what do the points on the oxford scale mean
0: no movement
1: muscle contraction no movement
2: movement, gravity eliminated
3: movement against gravity
4: movement against gravity and external resistance
5: normal movement
Why is an isometric test generally used in favour of an isotonic test?
In movement pain may confound the muscle strength
What does pain reproduction and no pain reproduction indicate in an isometric test?
Pain: muscle tendon unit
No pain: less contractile elements such as joint capsule/ligament
What’s the difference between stride length and step length?
Stride, from one left foot to the other left foot
Step, right step length is from left foot to right foot, left step length is from right foot to left foot
What is cadence?
Stride per minute or steps per minute
What is walking speed?
Stride length/stride time OR
Stride length * cadence
