W1- PROM, pt history, assessment, diagnosis

Question 1

nonanalytic reasoning processes

Answer 1

-fast, automatic
-pattern recognition
-cognitive load is reduced
-error prone

Question 2

analytic reasoning processes

Answer 2

-slower
-higher cognitive load
-hypo deductive reasoninng
-more reliable

Question 3

2 models of professional reasoning

Answer 3

1. clinic reasoning cycle
2. biopsychosocial model

Question 4

monitoring/ evaluating patient outcomes should include

Answer 4

qualitative and quantitative outcome measures

Question 5

what is a PROM and whats its purpose

Answer 5

patient reported outcome measure
-enhancing interactions
-comparing effects of different treatments
-population surveillance and informing policy

Question 6

examples of PROMS for lower limb

Answer 6

• manchester oxford foot questionaire
  -short form 36
  -foot function index
  -lower extremity functional scale
  -VAS pain scale

Question 7

what is the manchester oxford foot questionaire, what does it incorporate and what type of reliabilty

Answer 7

16 items across 3 domains

1. walking/standing
2. pain
3. social interaction

good reliability

Question 8

what is the short form-36

Answer 8

a measure of quality of life

36 questions that cover 7 domains
1. limits in activity
2. limits in socialsing
3. limits in usual role
4. pain
5. mental health
6. energy and fatigue
7. general health perceptions

reliable

Question 9

foot function index

Answer 9

impact of pathology on function
1. pain
2. disability
3. activity restrictions

moderate to very good reliability

Question 10

what are ausTOMs

Answer 10

a measure made by the clinician on how the client is functioning by assessing impairment, activity limitations, participation restriction and wellbeing.

Assess twice
first appointment/assessment
after intervention, discharge appointment

Question 11

Things to consider when designing a management plan for a patient

Answer 11

1. what are patients goals
2. how is the condition impacting patients quality of life?
3. are there any barriers to the treatment (cost, time, function, cultural)
4. what is the evidence behind the management
5. what is my clinical experience with the management

Question 12

types of outcome measures

Answer 12

1. clinical measures
   -VAS, PROMS, patient reports
2. non clinical measures
   -objective measures of pathology (skin, muscle, tendon)
3. surrogate measures
   -clinical meaning outcomes that serve as a substitute

Question 13

evidence for overuse injury

Answer 13

anti-pronatory taping is a good indicator that orthoses would be beneficial for the patient.
3 reverse 6s - medial mall start point

Question 14

what non clinical /objective measures can you use as outcome measures

Answer 14

Zebris
EMED
pedar

these need to be conducted before and after an intervention

Question 15

what is the intervention influencing and what objective tests can help measure this over time?

Answer 15

Range of motion?- lunge test, biomechanical measurement with ruler or halo digital goniometer

muscle strength?- capacity test

plantar pressures- emed

spatiotemporal paramters- zebris
function during tasks- functional assessments (balance, hops, timed, etc), gaitrite

balance- zebris, functional assessment

neurological gait, assisted ambulation, children- gaitrite

Question 16

pedar instructions

Answer 16

insoles in shoes
belt on
connect cables to the insoles
elastic bands around calves and upper thigh to hold cables (allow for slack)
confirm on computer, it will then prompt you to lift left and right feet to calibrate sensors
after calibration, fasten shoes
instructions on where to walk, how long for and what velocity
press record and stop

Question 17

red flags and where to refer to

Answer 17

1. criticallimb ischaemia (6 p’s)
   pain, parasethesia, pulselessness, perishing cold, pale, paralysis- refer to emergency department
2. melanoma- refer to GP/derm
3. fast progressing infection - refer to GP or ED
4. night pain- imaging, GP

Question 18

biomechanical assessments how to determine what to do when theres no medical history

Answer 18

1. fit of footwear while shoes still on
2. stance assessments to guage what other assessments i should be conducting
3. specific assessments

Question 19

ganglion cysts what are they

Answer 19

firm, mobile mass in the subcutaneous level of tissue attached to joint or tendon sheath. Caused by repetitive injury or trauma. 3 times more common in women. Aged 20-50 years

Question 20

treatment options for ganglion

Answer 20

spotaneously resolves in 50-60% of cases
1.immobilisation
offload with padding, fan taping, rocker sole or carbon plate-mortons ext if in appropriate shoes.
-topical anti inflammatory for symptom relief

or
2. aspiration, likely recurrence within 3 years
3. with steroid injection - 70% success rate in wrist
4. surgery 84% success in wrists

Question 21

if someone has an allergy to tape what could you do

Answer 21

friars balsm - occlusive
hypafix first
taping over that