Final-Outcome Measures

Question 1

When do you use outcome measures and why

Answer 1

At baseline and after treatment periodically to assess progress and show treatment is effective, reasonable and necessary

Question 2

VAS

Answer 2

Visual analog scale

“Vertical like to indicate your level of pain today”

from none-worse pain

Question 3

NRS

Answer 3

Numeric pain rating scale

“Circle the number that indicates your level of pain”

Question 4

VAS vertical

Answer 4

Better understood by elderly

Question 5

Quadruple VAS

Answer 5

• pain now
• typical or average pain
• at its best
• at its worst

Question 6

Pain diagram

Answer 6

Image of body parts

Question 7

Disability

Answer 7

Ability of a person to perform common activities

Measure function

Question 8

ODI

Answer 8

Oswestry diability index

-low back disability

• 10 sections of daily activities with 6 options for each.
• scored 0-5

Add each section. Greatest disability is 50. X2 for %

Question 9

NDI

Answer 9

Neck disability index

Modified from ODI 10 sections, 6 options. 0-5 scale. Add.

Question 10

Roland Morris Questionaire (RMQ)

Answer 10

Low back disability

24 disability statements.

Score number of statements marked

Question 11

Bournemouth low back and Bournemouth neck questionnaires

Answer 11

7 items each 0-10.

Take points and divide by 70 for %

Question 12

Headache disability index

Answer 12

2 sub scales: emotional/functional

Plus total composite score

Question 13

UEFI/LEFS

Answer 13

Upper extremity functional index

20 items score 0-4

Total score/80 x 100= % diability

Question 14

FAOS/ HOOS/KOOS/RAOS

Answer 14

Questions assessing 6 areas
5 options scored 0-4. Out of 168.

Require change of 10% for meaningful improvement

Question 15

Global-well being scale

Answer 15

Worst-best

**opposite of VAS.

Make vertical line between the two

Question 16

Yellow flat outcomes

Answer 16

Fear avoidance beliefs question are
Modified work APGAR
Waddell’s signs

Question 17

Modified work APGAR

Answer 17

Almost always, sometimes, hardly ever

Hardly ever enjoy job tasks were 2.5 X more likely to have back injuries than opposite

Question 18

Waddell’s signs

Answer 18

• superficial/non-anatomic tenderness
• simulation (LBP with axial loading or standing and rotating UE)
• distraction (40-45 degree difference between supine SLR and sitting)
• regional disturbances (unexplained weakness/sensory findings)
• over-reaction

Question 19

Simulation-Waddell

Answer 19

1. Patient standing and doc rotates patients shoulder and hips

No pain

2. Patient stands and doc applied compression down to head

No pain

Question 20

Analysis of waddell’s signs

Answer 20

3+ = abnormal illness behavior

• psychological overlay to pain
• treat pain and overlay

Question 21

Pain diagram yellow flags

Answer 21

• pain outside body
• pain in all 4 extremities
• multipl types of pain qualities ex: ache, burn, stab, numb, pins etc.

Question 22

Decreased trunk and hip strength/endurance has been correlated with?

Answer 22

Back pain-current and future

Question 23

Yellow flag vs. red

Answer 23

Hits/exam findings that are at risk for developing chronic pain

Vs.

Prompt doc to do more tests

Question 24

Yellow flag

Answer 24

Risk factor for chronicity
-most work or psychosocial factors
Assess within first 4-12 weeks

Question 25

Yellow flags for cervical and upper

Answer 25

Severe pain after 1 month (RR 10.5= risk never go away after 3 mo) - upper extremity co-morbidity - low job support/stress - catastophizing pain coping style - # of pain treatment episodes - recommendations for surgery

Question 26

Low back yellow flags

Answer 26

- 4+ weeks of s/s - sciatica - previous episodes - severe pain after 3 weeks - delaying treatment 1 week - widespread pain

Question 27

Yellow flags seen in exam

Answer 27

+ straight leg raise test + neurological signs + orthopedic tests +lack of centralization with repetitive ROM Centralizes is good

Question 28

Psychosocial yellow flags

Answer 28

``` 3+ Waddell Fear avoidance Anxiety/depression Low expectancy of recovery Blaming others Negative social ```

Question 29

Low back yellow flag function aspects

Answer 29

Light work intolerance Sleep disruption 20/100 + on oswestry disability

Question 30

Yellow flag questionaire

Answer 30

13 Qs < 55 = low risk of chronic disability 55-65= moderate 65+ high risk

Question 31

Are yellow flags patients fault?

Answer 31

No. They are experiencing abnormal illness behavior and additional management strategies are needed - cognitive-behavioral approach - co-manage Higher risk for surgery

Question 32

Red flags

Answer 32

``` Fracture/dislocation Neoplasm Infection Rediculopathy General/non-specific ```

Question 33

Red flags for fracture

Answer 33

``` Trauma Osteoporosis Age: F 55+, M: 65+ Hormonal: post menopause, hypogonadism Again/Caucasian Smoker Medication: steroids, heparin, CA to ```

Question 34

Red flag neoplasm

Answer 34

``` 50+ Hist of CA Weight loss No relief of s/s with rest/position change Failure of conservative tax ```

Question 35

Red flags for infection

Answer 35

``` Immunosuppression (HIV, DM, steroids) IV drugs Recent UTI Recent dental procedure Penetrating wound ```

Question 36

Red flags for general/non-specific

Answer 36

- under 18 or over 45 with precipitating event - night pain - bowel/bladder change - systemic illness