Week 1 Masterclass Flashcards
Red flags during screening
Unexplained weight loss
Constant pain
Severe night pain
History of cancer with new onset of pain
Neurological deficits not limited to one nerve root
Recent infection or high risk of infection
Use of corticosteroids or immunosuppressant drugs
Structural deformity
What makes a good assessment
CREPS
Comprensive
Reliable and valid
Efficient
Patient centered
Systematic
Common mistakes in assessment
Skipping a thorough subjective history missing pt symptoms, history and contributing factors
Not using standardised outcome measures
Relying too much on one test.
Ignoring red flags
Over reliance on imaging - can lead to overtreatment or unnecessary concern
Not reassessing and adjusting treatment
What are the 6 things that the ICF framework covers?
Health condition
Body function/structures (impairments)
Activity
Participation
Environmental Factors
Personal Factors
What are some examples of impairments
Pain
Swelling
ROM/Stiffness
Balance
Strength
Proprioception
Sensation
Activity Limitation examples (ICF)
Walking
Standing up
standing for long periods
Sitting
Just anything the patient may struggle/can no longer do
Participation examples (ICF)
Decreased participation in family, work and social life
Decreased confidence due to increased risk of falling
What should the order be of clinical reasoning framework
Assessment
Diagnosis
Treatment Planning
Implementation
Evaluation
Subjective assessment examples
WHIP method
SCEBSW
Body chart
Patient Reported Outcome Measures (PROM)
Patient Reported Experience Measures (PREMs)
What is the WHIP method
When - When did the symptoms start? Is that the first onset or flare up? Acute or chronic?
How - How did it happen? How did the symptoms start?
Intervention to Date - Have you seeked treatment before? Was it helpful?
Pattern Since Onset - Are symptoms getting better or worse over time? Why do you think this is?
What model of pain does the SCEBSW method fall under
Biopsychosocial
What is SCEBSW
Somatic - complaints, symptoms, imaging
Cognitive - what do you expect from me?, explanation from complaints, how do you feel when you have symptoms?
Emotional - how do you feel about the symptoms? Do they worry you? Do you feel overwhelmed by them
Behavioural - What do you do if you have symptoms? How do you reduce symptoms?
Social - Do people around you notice when you have complaints? Do the complaints affect your social life?
Work - Do you work? Have you had to adapt your work/hobbies?
What do the 3T questions do
measure how easily a pt symptoms can be provoked (ie irritability)
What are the 3T questions
T1 Time to onset of symptoms - “How long does it take for your symptoms to come on?”
T2 Time that the patient can sustain an activity before symptoms force them to stop - “Once your symptoms start, how long can you continue doing the activity before you have to stop?”
T3 Time to cessation of symptoms - “After you stop the activity that brings on your symptoms, how long does it take for the symptoms to settle down?”
What is a PROM
Pain Reported Outcome Measure
What does a PROM do?
Is a direct report from a pt about how they feel/functionW
What is a PREM
Patient Reported Experience Measure
What does a PREM do
Collect pt feedback on their experiences
Provide insights into the pt’s journey and satisfaction with healthcare services
Provide feedback to healthcare service wanting to improve quality
What is specificity in relation to measurement properties
A test used for ruling IN a condition (SpIN). Has few false positives
e.g the specificity of the SARS-CoV-2 diagnostic PCR tests is reported as 98%, that means that a positive test tends to rule in for COVID-19 infection.
What is sensitivity in relation to measurement properties
A test used for ruling OUT a condition (SpIN). Has few false negatives
e.g the Neer’s Test has been reported to have a sensitivity of 93% for detecting subacromial impingement. So, if the test is negative, the examiner can be confident that the patient does not have impingement.
When should heat be used vs cryotherapy
Heat therapy for muscle spasms and increase blood flow. Good for low back pain as it helps relax
Cryotherapy used to reduce pain
What does the common fibular nerve innervate
Short head of the bicep femoris
