Patient Interview Flashcards
What should guide your initial physical examination
- Techniques that confirm your primary hypothesis
- Things that rule out the alternatives
- things the patient cana actually do with their pain/condition
What are the two MOI categories
Acute and Overuse
What are the factors of acute injury
- single identifiable traumatic event
- force exceeds tissue capacity
- intrinsic or extrinsic
What is the difference between intrinsic and extrinsic acute injuries
Intrinsic - nothing around you made the injury happen
Extrinsic - outside contact e.g. collision
What are questions to ask about acute injuries
Activity performing
Position of limb
Contact/non-contact
Amt of force
Noises heard
Immediate symptoms
Speed of swelling
Initial bruising
Immediate management
Functional limitations
What classifies an overuse injury
- structures exposed to repetitive force
- force exceeds structure to withstand
- associated with chronic repetitive activity
What are some possible causes of overuse injuries
- training error
- equipment/shoes
- surface/environment
- nutrition
- psychological factors
- intrinsic factors e.g. biomechanics
What are questions to ask about overuse injuries
- how long pain takes to come and go
- pattern of onset/offset
- pain severity
- type of training
- change in load, duration or volume
- period of detraining
- equipment/footwear
- environment - flat, hills etc
How can you rule out certain injuries
MOI
What scale describes impact on function
PSFS - Patient Specific Functional Scale
0 = Unable to do –> 10 = Not limited
How many hypotheses should you have after interview
Three
1 primary
2 alternative
What are psychological factors associated with pain
- pain self efficacy
- pain catastrophisation
- kinesiophobia (fear of mvt)
- anxiety
- depression
What are questionnaires for hip pain
- HOOS
- Copenhagen Hip and Groin Outcome Score
- International Hip Outcome Tool
- VISA - G
What are questionnaires for knee pain
- lower extremity functional scale LEFS
- KOOS
- kujala patellofemoral scale
- lysholm knee scoring scale
- VIVA -P
Questionnaires for ankle pain
- AOS
- foot and ankle OA outcome score
- FAAM
- cumberland ankle instability tool
- VISA - A
What injury and life context questions should guide your goals
- How does life normally look (sport, work, recreation, social)
- How is the injury affected this
- How has the problem changed over time (better or worse)
What to ask to gain more life context
- any previous LL or back injuries
- any imaging been done
- seen anyone b4 physio
What is THREADS
T - Thyroid
H - heart/hypertension
R - respiratory
E - epilepsy
A - arthritis
D - diabetes
S - surgery
Important within context of injury
REDs and associated problems
Relative Energy Deficiency in Sport
having this deficiency can affect (or be the result of) other body system problems, symptoms being present can change the indication of the injury
What indicates a ligament sprain/tear
Acute MOI
Pain at ligament site
Swelling
Noise
Giving way at site
Must consider limb position at time of injury to indicate specific ligament
What indicates a muscle sprain/tear
Acute MOI
Pain specific to muscle region (not tendon)
Stretch v contract MOI
