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What is clinical reasoning?

A multidimensional, non-linear cognitive process that involves synthesis of information and collaboration with the patient, caregivers, and health care team” –O’Sullivan


What is a clinical decision?

The outcome of the clinical reasoning process.


What forms the basis for patient management?

Clinical Decision


What are the factors that influence clinical reasoning for the clinician?

• Setting of PT Practice
• Goals
• Psycho-Social Skills
• Problem Solving Strategies
• Procedural Skills
• Knowledge & Expertise


What are the patient characteristics that influence clinical reasoning?

• Physical
• Psycho- Social
• Educational
• Cultural
• Time &/or Resources
• Goals, Values, Beliefs


What are some of the biases that can affect clinical reasoning?

1. Having prior information about the patient’s diagnosis
2. Confirmation bias: structuring the exam to confirm what you already suspect is true
3. Memory bias: influenced by a past patient episode of care
4. Conservatism: continue to maintain initial hypothesis despite gathering information that does NOT support it


What is logical thinking?

Making justified deductions based on what is obviously relevant


What is lateral thinking?

Taking information that may not have a clear connection to the health condition and considers possibility that there is a cause-effect relationship


What does lateral thinking include?

The development of a hypothesis and pursuit of information to support or eliminate that hypothesis


What is inductive reasoning?

Pattern recognition, whihc generally involves experience to identify a clinical pattern and treatments may follow a protocol. And clinical reasoning is considerably fast


What is deductive reasoning?

Form hypothesis on the basis of information gathered from examination, using the results of PMHx, patient interview and clinical exam which are evaluated to develop a hypothesis and includes multiple variables to determine Dx or treatment plan


The ___ model is a form of deductive reasoning

The *ICF* model is a form of deductive reasoning


What is the ICF model?

A classification system developed by the WHO that is used to describe the health of a person at a particular point in time


What does the ICF model place emphasis on?

Emphasis of this system is on the function of the patient, not on the health condition (diagnosis)


What does the ICF model take into consideration?

Takes into consideration influences that may impact the patient and health condition


What are the main components of the ICF model?

• Functioning and Disability
• Contextual Factors


What are the components included in the functioning and disability category of the ICF model?

- Body functions and structures. EX: physical impairments
- Activities: capabilities and restrictions in function
- Participation: capabilities and restrictions


What are the components included in the contextual factors category of the ICF model?

- Environmental factors
- Personal factors


What are the environmental factors that are in the contextual factors category of the ICF model?

Factors that are not within the person's control like government agencies, laws, religious & cultural beliefs. Also includes family and work


What is the purpose of the Exercise is Medicine Initiative?

To encourage physicians and health care providers to include exercise in the management plan for patients


Why is Exercise Considered Medicine?

• Physical activity and physical fitness are immensely powerful in their ability to both prolong and enhance the quality of life.
• Every tissue in the body benefits from regular physical
• Exercise can prolong health and reduce the risk of
developing chronic diseases


How can exercise benefit people with chronic conditions?

• Reducing the severity of the chronic condition
• Improve co-morbidities related to chronic conditions
• Improve the quality of life


What are the health benefits of regular physical activity at a moderate level of intensity?

• 22% reduced mortality in highly active vs low active men
• Men over age 65, mortality reduces by:
- 33% for moderate activity
- 45% for vigorous activity
• Men < 65 have a 19% drop in mortality with physical


What are the effects of resistance training on mortality?

• Higher levels of strength are associated with lower levels of all-cause mortality in middle aged and older populations
• Resistance training of 30 min or more per week is associated with a 23% lower risk of coronary heart disease


What is the primary reason to emphasize a physically active

To avoid the “disease syndrome” also known as the “downward spiral of chronic disease” which includes:
• Low functional capacity
• Reduced gait speed
• Loss of independence
• Increased weight gain
• Insulin resistance
• Gradual deterioration toward disability
• Higher all-cause mortality rates


In what gender is a more pronounced benefit from exercise seen?

In women