Interventions in MSK

Question 1

patient centered care is focused around

Answer 1

individual context
effective communication
shared decision-making

Question 2

what two things correlate to outcomes

Answer 2

patient expectations and rapport

Question 3

increased therapeutic alliance leads to

Answer 3

increased patient confidence in PT
better outcomes

Question 4

what is an aspect of therapeutic alliance that is often overlooked

Answer 4

documentation can lead to better inter-therapist treatment

Question 5

5 overarching themes from patient perspective regarding therapeutic alliance

Answer 5

meeting a competent and warm therapist

being understood as a whole person

feeling appreciated, tolerated, and supported

gaining new strength/hope for the future

overcoming initial fears and apprehension

Question 6

6 overarching themes from therapist point of view regarding therapeutic alliance

Answer 6

balancing technical with interpersonal

showing genuine desire to understand

openly supporting client agency

adjusting to create a sense of safety

paying attention to body language

providing helpful experiences during the first session

Question 7

findings of history/examination that indicate high severity

Answer 7

high pain (>7/10)
consistent pain through night/rest
pain before end ROM
high disability

Question 8

interventions focused on high severity

Answer 8

minimization of physical stress
activity modification
monitor impairments

Question 9

findings of history/examination that indicate moderate severity

Answer 9

moderate pain (4-6/10)
intermittent night/rest pain
pain at ROM
AROM similar to PROM
moderate disability

Question 10

interventions for moderate severity

Answer 10

mild-moderate physical stress
addressing impairments
basic level functional activity restoration

Question 11

findings of history/examination that indicate low severity

Answer 11

low pain (<3/10)
absent night or rest pain
minimal pain with overpressure
AROM = PROM
low disability

Question 12

interventions for low severity

Answer 12

moderate-high physical stress
address impairments
high-demand functional activity restoration

Question 13

what is one of the most forgotten interventions

Answer 13

education

Question 14

explain patient education on pain

Answer 14

reflection that pain is not always a true representation of the state of tissue

instead, it is the nervous system’s interpretation of the threat of injury

Question 15

what can pain be modulated by? why are these important?

Answer 15

psychological factors
- fear avoidance, catastrophizing, expectations, cognition, beliefs

–> NEED TO BE SCREENED

Question 16

x amount of CPGs encourage education
- what specifically do they encourage regarding education?

Answer 16

10
self management and active treatments
informing/reassuring patients about condition/management

Question 17

types of patient education

Answer 17

biomedical/biomechanical
general advice
pain neuroscience
cognitive behavioral principles

Question 18

biomedical education definition

Answer 18

providing in-depth, pathoanatomical explanations for specific cause of patient’s pain

Question 19

biomechanical education definition

Answer 19

role of positions, postures, movements that are related to patient’s pain

Question 20

what form of education is nonadvisable for patients?

Answer 20

biomedical/biomechanical

Question 21

what is general advice

Answer 21

reassurance of favorable prognosis
promotion of activity / mvmt
graded activity
paired education and activity

Question 22

what is a principle associated with general advice

Answer 22

acting as usual, slight backing off initially

Question 23

definition of PNE

Answer 23

pain neuroscience education

providing patients with concept of pain symptoms that are comprehensible and reassuring

Question 24

what is a very important aspect of PNE

Answer 24

explaining that pain isn’t always an accurate representation of tissue

pain is the body’s response to possible threat

the more you are in pain, the better the brain gets at producing the pain signal

Question 25

what is cognitive behavioral therapy

Answer 25

form of talk therapy that can identify and develop skills to change negative thoughts/behaviors

Question 26

goal of CBT

Answer 26

changing thoughts, emotions, and behaviors related to pain improving coping strategies putting discomfort in a better context

Question 27

how to facilitate effective self-management

Answer 27

1 - help patient identify their barriers / goals 2 - assist in identification of optimal strategies to reduce or avoid irritation of symptoms through problem solving 3 - support patient to identify ways to measure the effectiveness of self-management

Question 28

what effect do passive self-management approaches have

Answer 28

can increase likelihood of pain behavior and disabilities

Question 29

how to approach patient education

Answer 29

make an educated diagnosis establish tailored pt education with learning focused on perceptual inconsistencies plan and provide individual/group education assess acquired skills/knowledge and adjust as needed

Question 30

when recommending physical activity, it is important to remember

Answer 30

general exercise is good - regular performance has more benefits no need to recommend highly specific exercise, general does just fine encourage management of pain in different modes in conjunction with exercise

Question 31

what is important to educate the pt on when recommending exercise?

Answer 31

that there will be some form of pain and that is normal, but do what is tolerable

Question 32

what is important to remember about inflammation stage vs proliferative stage of healing

Answer 32

inflammation - loading can cause disruption in this phase proliferation = load promotes optimal regeneration and tissue will respond to the load placed on them

Question 33

what is mechanotherapy

Answer 33

tissue will respond to the load placed on them

Question 34

remodeling and protein synthesis relationship

Answer 34

> protein synthesis = more contractile proteins and more dense myofiber

Question 35

PEACE & LOVE

Answer 35

Protection Elevation Avoidance of anti-inflammatories Compression Education Load Optimism Vascularization Exercise

Question 36

using the ICF, what categories are related to ____________ interventions - foundational - performative - functional

Answer 36

foundational = body structure/function performance = activity limitations functional = participation restrictions

Question 37

exercise progression

Answer 37

1 - normalize dysfunctional structure 2 - correct muscle/movement balance 3 - increase proprioception and facilitate subcortical reorganization 4 - improve endurance in coordinated movement

Question 38

activity guidelines

Answer 38

moderate intensity for at least 150 min a week (or 75 min vigorous) and muscle strengthening at least 2 days a week

Question 39

components of physical fitness

Answer 39

cardiorespiratory musculoskeletal flexibility balance speed

Question 40

how does load and recovery affect capacity?

Answer 40

appropriate dosage of load and recovery leads to increased capacity/threshold for exercise

Question 41

when is manual therapy typically done

Answer 41

early on in therapy in adjunct with other treatments

Question 42

what are the typical applications of manual therapy

Answer 42

reduction of pain / disability initially to get patients moving in following interventions

Question 43

what is the timeline associated with most MSK guidelines and surgery

Answer 43

conservative care for 3-6 months prior to surgical indication

Question 44

when surgery is indicated, what is the therapist's role

Answer 44

education on expectations of procedure, outcomes and role of rehabilitation after - maybe rehab prior to

Question 45

risk factors that determine continuation/resumption of work

Answer 45

socioeconomic status work environment

Question 46

what examination factors affect continuation/resumption of work

Answer 46

self-reported measures psychological factors job demands performance measures

Question 47

interventions that can facilitate continuation/resumption of work

Answer 47

graded, modified or transitional work ergonomic consultation psychologically informed practice education / communication/ coordination progressive graded exercise