L31 Self -management Flashcards

1
Q

What is the biopsychosocial framework for management of patients with neck pain and headache?

A
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2
Q

What are 6 pathophysiological/biological features of biopsychosocial framework?

A
  1. Pain/sensory features
  2. Altered psychosocial features resulting
  3. Altered articular and movement features
  4. Nerve tissue: irritation, compression mechanosensitivity
  5. Altered neuromuscular control; muscle properties
  6. Altered postural control
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3
Q

What are 5 psychological features of biopsychosocial framework?

A

Idiopathic neck pain

  1. Anxiety
  2. Distress
  3. Depression
  4. Fear avoidance behaviours
  5. Poor coping skills

Important to consider….

  1. Difference between idiopathic and traumatic neck pain
  2. 85% of patients have no psychological problems
  3. Some are normal physiological reactions to having neck pain
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4
Q

What are 5 work factors of biopsychosocial framework?

A
  1. Impact of computer use on musculoskeletal symptoms and productivity emerging as important issue
  2. 12 month prevalence neck symptoms in office workers estimated at 50-76%
  3. 60-80% office workers report recurrence of neck pain one year after initial episode (Carroll et al 2008)
  4. Loss productivity –absenteeism, presenteeism
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5
Q

What are 7 social factors of biopsychosocial framework?

A
  1. Gender
  2. Emotional problems
  3. Poor job satisfaction
  4. Poor physical work environment (Eg. confined working space)
  5. Occupation type
  6. Smoking
  7. Awkward work postures
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6
Q

What is the changing biopsychosocial model?

A
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7
Q

What are 3 bio multimodal management approach for neck pain?

A
  1. Manual therapy
  2. Specific exercise
  3. Patient self‐management techniques
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8
Q

What are 2 psycho multimodal management approach for neck pain?

A
  1. Explanation of what influences symptoms
  2. Effects of stress
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9
Q

What are 2 social multimodal management approach for neck pain?

A
  1. Work – ergonomic advice
  2. Discuss how social/lifestyle choices impact
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10
Q

What is the management of neck pain when confirming cervicogenic diagnosis?

A

Confirm cervicogenic diagnosis

  • History and
  • 3 physical findings
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11
Q

What are 5 multimodal biopsychosocial approaches in the management of neck pain?

A
  1. Manual therapy (Csp and Tsp)
  2. Specific exercise cervical muscles
  3. Self‐ management techniques
  4. Education on agg practices
  5. Ergonomic
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12
Q

What are 4 characteristics of self-management?

A
  1. Theories and research
  2. Work is a positive health behaviour for which self management skills are essential (Johnston 2013)
  3. Role of clinician
    1. Problem solving
    2. Decision making
    3. Resource utilisation
    4. Therapeutic alliance
    5. Making an action plan
  4. Mange chronic pain and disability for recurrent MS conditions
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13
Q

What are 5 roles of the clinician in sel-management?

A
  1. Problem solving
  2. Decision making
  3. Resource utilisation
  4. Therapeutic alliance
  5. Making an action plan
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14
Q

How can you do self management?

A
  1. Partnership between therapist and patient
    1. Individual
    2. Groups
    3. Telephone counselling
    4. Web based self‐instruction
  2. May require a change in perspective from carer ‐ role
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15
Q

What are self-management skills and tips?

A
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16
Q
A
17
Q

What are 8 benefits of self-management?

A
  1. Decreased pain
  2. Increased pain self‐efficacy
  3. Decreased general disability
  4. Improved psychological well‐being
    1. Reduced stress
    2. Depression
    3. Anxiety
    4. Catastrophisation
  5. Increased positive self‐talk
  6. Greater use of social support
  7. Increased time physical activity
  8. Increased general self‐efficacy
18
Q

What are 11 steps for self-management?

A
  1. Establish rapport
  2. Active listening
  3. Provide information
  4. Develop an action plan
  5. Set realistic goals with patient (shared decision making)‐SMART
  6. Non‐judgemental approach
  7. Facilitate problem solving
  8. Promote self‐efficacy
  9. Link patients with resources
  10. Keep a health record
  11. Active follow up
19
Q

What are the potential threats to effective self-management?

A
20
Q

Acute WAD

Advice /education

What would your self‐management strategies

include?

A
21
Q

Cervical radiculopathy

Advice /education

What would your self‐management strategies

include?

A
  1. Pain management:
  2. Positions of comfort and relief (antalgic posture –> keep position to not change posture)
  3. GP for
  4. Ergonomic advice (not to aggravate)
  5. Keep active
  6. Comfortable sleeping positions
  7. Exercise (a bit but not closing down the IF)
  8. Movements into easing position –> neutral range
22
Q

Thoracic pain exacerbated by breathing

Advice /education

What would your self‐management strategies

include?

A
  1. ROM exercises
  2. Breathing exercises
  3. SNAG (towel around + MWM = support ribs)
    1. Flexion, ext, rot
  4. Advice
    1. Mechanical pain –> reduce fear
    2. Keep active
23
Q

TMJ pain and restricted mouth opening

Advice /education

What would your self‐management strategies

include?

A
24
Q
A
25
Q

Muscle and articular system involvement

Advice /education

What would your self‐management strategies

include?

A
  1. SNAGs (increase ROM + mobilisation
  2. Motor control (add into everyday tasks –> reminders to do)
  3. Give demonstration (TDT –> change your posture –> can reduce symptoms)