Intervention Development and Treatment Progression Flashcards

1
Q

What are the different types of clinical reasoning

A

Inductive
Hypothetico-Deductive
Pattern Recognition

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2
Q

What is the inductive reasoning method

A

Standard method; process of labeling a disorder based on specific signs and symptoms

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3
Q

What is ex of inductive reasoning

A

patient has pain, swelling, ROM loss, is unstable, but is able to bear full weight on their limbs following “twisting” their ankle:

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4
Q

What is hypothetico-deductive reasoning

A

Clinician takes history and comes up with a hypothesis (tentative pathology)

  • clinician determine which signs and symptoms are commonly present in the assumed disorder
  • clinician determines if the signs and symptom are actually present
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5
Q

What is an example of hypothetic-deductive reasoning

A

Patient is a 90yo M who has shoulder pain with no history of shoulder injuries

  • deduced pathology is OA
  • signs and sx are rom loss, strength loss, and joint stiffness
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6
Q

What is pattern recognition method

A

Used with more obscure disorders where complete testing not always possible due to multiple factors; usually only used when a clinician has seen many patients with a specific pathology
important to have a cluster of symptoms

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7
Q

What is an example of pattern recognition reasoning

A

Patient is a 45 yo F with insidious onset of shoulder pain, she has good general health, has no history of trauma, or overuse injury, but is getting progressively worse. the patient is unable to sleep and cannot perform ADL secondary to significant soullder pain

dx: Adhesive Capsulitis

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8
Q

What are the steps to the treatment plan development

A
  • hx and pe
  • develop a problem list
  • develop the rationale for the problems listed
  • general hypothesis
  • determine testing criteria, for assessment of rx to determine modification, progression, or D/C of treatment
  • establish goals
  • determine outcome measures
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9
Q

Who can create a problem list

A

The pt or the clinician

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10
Q

What is usually on the pts problem list

A

What is most important to the pt

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11
Q

what is typically on non pt problems list

A

typically impairments and anticipated problems

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12
Q

what is a hypothesis

A

a rationale based on theory or evidence as to the cause of the pts problems (most likely impairments) that are the cause of their functional loss and disability

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13
Q

What is the purpose of testing criteria

A

Determine effect of treatment tactics and strategy

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14
Q

What should your rx always be focused on

A

what the pt is concerned about

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15
Q

Decrease pain, increase ROM, increase strength/motor control, decrease inflammation, pt education, prevention, strategies would be an example of a

A

treatment strategy

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16
Q

What is a treatment strategy

A

Develop a strategy and tactics for the problems lists

17
Q

what are ways to determine if a pt is getting better or if your treatment is working

A
  • Pt rated measures
  • clinician rated measures
  • clinician rated performance measures
  • have they been compliant with HEP
  • are they achieving the goals that were set
  • are pain, functional loss/disability measures changing
  • ask questions about how they are doing
18
Q

What are things to consider when deciding on whether to progress a patient

A
  • what is your goal for the pt
  • stage/phase of injury
  • irritability
  • time from injury
  • what does pt need to get back to
  • how does the pt respond to PT
  • how does pt respond to life activies
  • how does pt respond to life activities
  • is pt getting better or worse
19
Q

What does best external clinical evidence mean

A

clinically relevant research from basic science, PT centered studies, treatment or diagnostic studies

20
Q

what does clinical expertise mean

A

the ability to use your clinical skills and past experiences to identify each pts unique health state, risks, benefits of treatment, personal values, and expectations

21
Q

what doe pt values mean

A

the unique pt preferences, concerns, and expectation each pt brings

22
Q

what is the advantage of systematic reviews and meta-analysis

A

summarize the evidence

23
Q

what is a disadvantage of systematic reviews and meta-analysis

A

can miss a study that contains a pt sample that is very similar to your pt

24
Q

What are clinical practice guidelines usually derived from

A

the results of a systematic review or meta-analysis