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Index
Cover image
Title Page
Table of Contents
Copyright
Foreword
Preface
References
Contributors
Introduction
References
Section 1 Theory Informing Clinical Reasoning in Musculoskeletal Practice
1 Clinical Reasoning
Introduction
The Scope of Clinical Reasoning
Clinical Reasoning in a Biopsychosocial Framework
Focus of Our Clinical Reasoning: Clinical Reasoning Strategies
Categories of Clinical Decisions Required: Hypothesis Categories
Factors Influencing Clinical Reasoning
Skilled Clinical Reasoning Contributes to Clinicians' Learning
Summary
References
2 Understanding Pain in Order to Treat Patients in Pain
Understanding Pain
The Biology of Pain – A Brief Primer
Classifying Pain
Implications of Pain Type Categorization
Conclusions
References
3 Influence of Stress, Coping and Social Factors on Pain and Disability in Musculoskeletal Practice
Theoretical Framework
Behavioural Factors in Musculoskeletal Disorders
Managing Stressors: Coping With the Stressor of Pain
Managing Stressors: Coping With the Stressor of Disability
Self-Rated Health as a Psychosocial Construct
Social Cognitive Theory and the Psychosocial Construct of Self-Efficacy
Social Relationships and Health
Conclusion
References
4 Assessment, Reasoning and Management of Psychological Factors in Musculoskeletal Practice
Musculoskeletal Clinicians' Lack of Knowledge and Ability to Assess and Manage Psychological Factors
The ‘Flag’ System of Screening for Psychosocial-Related Risk Factors
Psychological Factor Screening by Questionnaire
Psychological Factor Screening by Patient Interview
Three Avenues for Psychological Factor Screening and Monitoring
Psychological Factor Management
Summary
References
5 Clinical Prediction Rules
An Overview of Statistics in Healthcare Clinical Reasoning
Clinical Prediction Rules
Development of Clinical Prediction Rules
Methodological Considerations
Readiness for Application in Clinical Practice
Clinical Application of CPRs in Musculoskeletal Practice
Future Directions
References
Section 2 Reasoning in Action: Case Studies From Expert Musculoskeletal Practitioners
6 A Multifaceted Presentation of Knee Pain in a 40-Year-Old Woman
Subjective History
Physical Examination
Treatment 1
Treatment 2 (1 Week Later)
Treatment 3 (4 Weeks Later)
Treatment 4 (1 Month Later)
Treatment 5 (2 Months Later)
Treatment 6 (2 Months Later)
Treatment 7 (2 Weeks Later)
Treatment 8 (3 Months Later)
Review Note (6 Months Later)
References
7 Lateral Elbow Pain With Cervical and Nerve-Related Components
Initial Examination
Physical Examination
Treatment (Appointment 1, Day 1)
Appointment 2, Day 4 (3 Days Later)
Appointment 3, Day 8 (4 Days Later)
Appointment 4, Day 11 (3 Days Later)
Appointment 5, Day 15 (4 Days Later)
Appointment 6, Day 22 (1 Week Later)
Appointment 7, Day 35 (2 Weeks Later)
Follow-Up (1 Month Later)
References
8 Nonspecific Low Back Pain
Patient History
Physical Examination
Prognosis and Goals
Treatment 1 (Day 1)
Treatment 2 (3 Days Later)
Treatment 3 (5 Days Later)
Treatment 4 (5 Days Later)
References
9 Chronic Facial Pain in a 24-Year-Old University Student
Interview
Current Symptoms
History
Examination
Further Assessments
Treatment (Sessions 1 and 2)
Session 3 (1 Week Later)
Sessions 4–8 (Held on Consecutive Days)
Sessions 9–13 (Held Once Per Week)
Sessions 14–16 (Held Once Every 2 Weeks)
Sessions 17 and 18 (Held Over Consecutive Months)
Session 19 (7 Months After Initial Presentation)
References
10 Targeting Treatment Distally at the Foot for Bilateral Persistent Patellofemoral Pain in a 23-Year-Old
Patient Interview
Physical Examination
Treatment
Appointment 2 (3 Days After Initial Appointment)
Appointment 3 (11 Days After Initial Appointment)
Appointment 4 (27 Days After Initial Appointment)
Appointment 5 (48 Days After Initial Appointment)
Appointment 6 (16 Weeks After Initial Appointment)
Appointment 7 (32 Weeks After Initial Appointment)
References
11 Post-Partum Thoracolumbar Pain With Associated Diastasis Rectus Abdominis
Tara's Story
Physical Examination
Treatment – First Session
Follow-up – 1 Month Later
Physical Examination
Seven Months Later
References
12 A Construction Project Manager With Insidious Onset of Lateral Hip Pain
Subjective Examination
Physical Examination
Treatment
Treatment 2 (1 Week Later)
Treatments 3–14 (Weeks 3–8)
Outcomes After 8 Weeks
References
13 A Pain Science Approach to Postoperative Lumbar Surgery Rehabilitation
Subjective Examination
Physical Examination
Postoperative Physical Therapy Appointment 1 (5 Weeks Post-op)
Physical Examination
Management
Treatment
Appointment 2 (4 Days Later)
Appointment 3 (4 Days Later)
Appointment 4 (1 Week Later)
Appointment 5 (1 Week Later)
Appointments 6, 7 and 8 (Over the following 2 Weeks)
Appointments 9, 10, 11 and 12 (Over the Following 4 Weeks)
References
14 A Lawyer With Whiplash
Patient Interview
Physical Examination
Treatment 1
Treatment 2 (4 Days Later)
Treatment 3 (4 Days Later)
Treatment 4 (1 Week Later)
Treatment 5 (1 Week Later)
Treatment 6 (1 Week Later)
Treatment 7 (2 Weeks Later)
Treatment 8 (2 Weeks Later)
Treatment 9 (4 Weeks Later)
References
15 Management of Profound Pain and Functional Deficits From Achilles Insertional Tendinopathy
Subjective Assessment
Physical Assessment
Treatment
Second Appointment (2 Months After Initial Assessment)
Third Appointment (7 Months Later; 9 Months After Initial Assessment)
References
16 Cervicogenic Headache
Subjective Examination
Appointment 1
Appointment 2 (1 Week Later)
Appointment 3 (1 Week Later)
Appointment 4 (1 Week Later)
Appointments 5–8 (Weekly Intervals)
Further Management
References
17 Shoulder Pain
Appointment 1
Physical Examination
Treatment
Appointment 2 (1 Week Later)
Assessment 3 (1 Week Later)
Appointment 4 (3 Weeks Later)
Appointment 5 (3 Weeks Later)
Weeks 8–14
Appointment 6 (Week 14)
Appointment 7 (34 Weeks After the Start of Treatment)
References
18 Post-Traumatic Neck Pain, Headache and Knee Pain Following a Cycling Accident
First Appointment Subjective Assessment – Part 1
First Appointment Subjective Assessment – Part 2
Objective Assessment
References
19 Orofacial, Nasal Respiratory and Lower-Quarter Symptoms in a Complex Presentation With Dental Malocclusion and Facial Scoliosis
Subjective Examination
Physical Examination
First Appointment Treatment (Day 1)
Second Appointment (8 Days Later)
Third Appointment (2 Weeks Later, Day 21)
Fourth Appointment (2 Weeks Later, Day 34)
Fifth Appointment (2 Weeks Later, Day 47)
Sixth Appointment (4 Weeks Later, Day 72)
Seventh (2 Months Later, Day 91) and Eighth (3 Months Later, Day 108) Appointments
References
20 Cervical Radiculopathy With Neurological Deficit
History
Physical Examination
Management Day 1
Second Appointment (24 Hours Later)
Third Appointment (2 Days After the Second Appointment)
Fourth Appointment (6 Days After the Third Appointment)
References
21 Incontinence in an International Hockey Player
Subjective Assessment
Education
Physical Assessment
Discussion of Findings and Management
Second Consultation (2 Weeks Later)
Third Consultation (2 Weeks Later)
Fourth Consultation (2 Weeks Later)
Abdominal Muscle Training
Outcomes
Ongoing Management
References
22 Neck and Upper Extremity Pain in a Female Office Assistant
History
Physical Examination
Outcome
References
23 Managing a Chronic Whiplash Problem When the Patient Lives 900 Kilometres Away
First Appointment
Second Appointment (Next Day)
Third Appointment (Next Day)
Fourth Appointment (1 Week Later)
Fourth Appointment (1 Week Later) (Because Sabrina Was Back for 4 Days Attending a Professional Development Course, We Agreed to Have at Least Three Appointments in This Time)
Appointments 5 and 6 (Next Day)
Appointment 7 (2 Days Later)
References
24 A Professional Football Career Lost
Subjective Examination
Physical Examination
Cognitive Functional Therapy (CFT) Intervention
Session 2 (1 Day Later)
CFT Intervention
1-Year Follow-up
References
25 Applying Contemporary Pain Neuroscience for a Patient With Maladaptive Central Sensitization Pain
A Brief Background of Pain Neuroscience
History
Questionnaires
Clinical Examination
Treatment
Outcome and Conclusions
Acknowledgments
References
26 Thoracic Spine Pain in a Soccer Player
History of Present Complaint
Planning the Physical Examination
Physical Examination
Home Programme and Take-Home Message
Second Session (1 Week Later)
Outcome
Acknowledgments From Christopher McCarthy
References
27 Incorporating Biomechanical Data in the Analysis of a University Student With Shoulder Pain and Scapula Dyskinesis
Subjective Examination
Physical Examination
Questionnaire Assessment of Disability
Management
First-Appointment Treatment
Appointment 2 (1 Week Later)
Appointment 3 (1 Week Later)
Appointment 4 (1 Week Later)
Appointment 5 (3 Months Later)
References
28 Acute Exacerbation of Chronic Low Back Pain With Right-Leg Numbness in a Crop Farmer
Subjective Examination
Aggravating and Easing Factors
Past and Present History
Medication and Special Questions
Imaging
Self-Report Questionnaires
Physical Examination
Active Physiological Movements
Passive Physiological Movements
Palpation and Passive Accessory Intervertebral Movements (PAIVMs)
Neurodynamic Testing
Functional Instability Testing
Management
Clearing or ‘Ruling Out’ Adjacent Areas
References
29 Physical Therapy Chosen Over Lumbar Microdiscectomy
Subjective Examination
Physical Examination
Treatment (First Appointment)
Appointment 2 (1 Week Later)
Appointment 3 (1 Week Later)
Fourth Appointment (1 Week Later)
Acknowledgements
References
30 A 30-Year History of Left-Sided ‘Chronic Sciatica’
Subjective Examination
Physical Examination
Management
Outcome
References
Section 3 Learning and Facilitating Clinical Reasoning
31 Strategies to Facilitate Clinical Reasoning Development
Introduction
Describing Clinical Reasoning
Clinical Reasoning and Transformative Learning
Clinical Reasoning Capability
Making Learning More Likely
The Role of Skilled Clinical Mentoring in the Facilitation of Clinical Reasoning
Using Technology to Enhance Opportunities for Clinical Reasoning Development
Specific Strategies for Independent Self-Directed Learning
Conclusion
References
Appendix 1 Clinical Reasoning Reflection Form
Perceptions/Analysis
Perceptions/Analysis
Perceptions/Analysis
Appendix 2 Clinical Reasoning Reflection Worksheet
Clinical Reasoning Based on the Subjective Examination
Perceptions, Interpretations and Implications
Implications of Perceptions and Interpretations for Ongoing Management
After Third Visit
After Sixth Visit
After Discharge
Index
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