L11 Knee OA

Question 1

What helps inform the eval of the data?

Answer 1

1. progression and/or stage of S/S
2. stability of condition
3. presence of preexisting conditions
4. functional limitations
5. Limitations and abilities of patient
6. Age, motivation, resources, self-efficacy

Question 2

Diagnosis is

Answer 2

process and end result of information obtained in teh exam and eval

Question 3

To arrive at a diagnosis, you must

Answer 3

1. perform an exam, arrive at initial hypothesis during the subjective portion of visit, confirm/refute during physical exam
2. evaluate your data after exam

Question 4

Prognosis

Answer 4

process of determining the level of optimal improvement that may be obtained from intervention and the amount of time required to reach that level

Question 5

Plan of care

Answer 5

specific interventions to be used and the proposed duration and frequency of interventions taht are required to reach the anticipated goals/outcomes

Question 6

PT vs Surgery for Meniscal Tear + OA

Answer 6

no significant differences in magnitude of improvement in functional status and pain after 6 to 12 mo between pts that were assigned surgery vs PT

Question 7

CPG Recommendations for OA

Answer 7

patients with symptomatic OA of the knee should participate in self-management programs, strengthening, low-impact aerobic, neuromuscular education consistent with national guidelines

Question 8

Non-obstructive meniscal tears

Answer 8

PT may be considered an alternative to surgery

Question 9

Individuals with _____ had less improvement with treatment for OA

Answer 9

greater age
pain intensity

Question 10

Individuals with ______ had more improvement with treatment for OA

Answer 10

higher self-efficacy
self-rated health

Question 11

OA and mental impacts

Answer 11

OA has significant negative impacts on patients’ self-esteem

pain becomes central aspect of their lives

patients will cut down on PA and lifestyle due to pain

Question 12

Patient education to share

Answer 12

1. regular PA and individualized exercise programs can reduce pain, prevent worsening, improve daily function
2. Significant benefits to losing weight for OA pain
3. OA S/S can be reduced without surgery

Question 13

Exercise Rx for OA

Answer 13

150 min/wk of mod intensity or 2 days a week of vigorous PA

OR 7500 steps per day for aerobic exercise and 5750 steps per day for vigorous PA

Question 14

What should exercise look like for OA?

Answer 14

patient centered rehab
land-based exercise involving strengthening, cardio, balance or mind-body exercise like yoga

Question 15

Why is exercise underused in knee OA patients?

Answer 15

patient beliefs
socioeconomic barriers
fear of movement
lack of confidence
lack of time
pain aggravation

lack of encouragement from HCP

Question 16

How to increase exercise adherence in patients with knee OA?

Answer 16

1. Review how pain and function can be treated and progression
2. Development of plan that clearly states how often the pt will exercise and modes
3. Development of specific and achievable goals related to pts knee pain and function
4. Review, supervision, correction of exercise techniques at future sessions
5. Follow-up sessions more than 3 months after initial session

Question 17

Adjunct therapies for OA

Answer 17

lack of evidence for thermal modalities, laser therapy, e-stim, manual therapy, taping

Question 18

Surgery for OA

Answer 18

typically last resort

strongly recommend against the use of arthroscopy in degenerative knee disease

1/5 pts are not satisfied with outcome

Question 19

Poor outcomes with surgery for OA

Answer 19

anxiety/depression
high pt expectations
pain at rest before surgery
complications after surgery