Clinical Reasoning in Physical Therapy
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Questions and Answers

What is considered as subjective information in clinical reasoning?

  • Strength assessment results
  • Patient-reported aggravating factors (correct)
  • Outcomes measures
  • Range of motion

    • Which of the following best describes an objective asterisk sign?

  • Patient's improvement story
  • The patient's emotional state
  • Patient's personal interpretation of pain
  • Data such as ROM or strength collected during an examination (correct)

    • What does 'retest asterisk sign' involve?

  • Reevaluating patient's emotional response to treatment
  • Assessing improvement through objective measures in-session (correct)
  • Checking subjective patient feedback outside the session
  • Ensuring patient understands clinical reasoning

    • Why is the SINSS model important to clinical practice?

    <p>It provides a structured approach to evaluate symptoms (A)</p> Signup and view all the answers

    In the provided patient case study, what indicates a subjective asterisk?

    <p>Pain score of 7/10 after the incident (A)</p> Signup and view all the answers

    What is the main function of the SINSS model in clinical reasoning?

    <p>To help in diagnosis and treatment decisions (A)</p> Signup and view all the answers

    What does 'Severity' in the SINSS model primarily assess?

    <p>The impact on daily activities (C)</p> Signup and view all the answers

    What role does 'Irritability' play in the SINSS model?

    <p>It measures how quickly symptoms escalate and subside (D)</p> Signup and view all the answers

    Which of the following is NOT a component of the SINSS model?

    <p>Synchronicity (A)</p> Signup and view all the answers

    How does the SINSS model assist in patient education regarding prognosis?

    <p>By systematically evaluating symptom factors (C)</p> Signup and view all the answers

    What type of pain is likely experienced by someone with a sympathetic nerve issue?

    <p>Burning, pressure-like, stinging, aching (D)</p> Signup and view all the answers

    Which symptom description typically indicates a fracture?

    <p>Sharp, severe, intolerable (D)</p> Signup and view all the answers

    What is a common feature of mechanical back pain?

    <p>Worsens with exercise (B)</p> Signup and view all the answers

    Which describes the symptom behavior when the symptoms decrease in intensity over time?

    <p>Improving (D)</p> Signup and view all the answers

    What is the nature of acute stage symptoms?

    <p>Symptoms present for less than 3 weeks (B)</p> Signup and view all the answers

    Which condition improves with rest?

    <p>Mechanical back pain (A)</p> Signup and view all the answers

    Which age group is associated with the onset of inflammatory back pain?

    <p>Age of onset &lt; 45 years (C)</p> Signup and view all the answers

    What symptoms are associated with viscerogenic pain?

    <p>Cramping, dull, aching (A)</p> Signup and view all the answers

    How can a patient demonstrate 'asterisk signs' in the symptom behavior model?

    <p>By exhibiting activities or movements that reproduce symptoms (C)</p> Signup and view all the answers

    Which type of back pain improves with exercise?

    <p>Inflammatory back pain (D)</p> Signup and view all the answers

    Flashcards

    Clinical Reasoning

    A complex cognitive process essential for evaluating and managing a patient’s medical problems.

    Importance of Clinical Reasoning

    Separates healthcare professionals from personal trainers by enabling diagnosis, treatment decisions, and prognosis.

    SINSS Model

    A structured framework consisting of Severity, Irritability, Nature, Stage, and Stability, used for clinical reasoning.

    Severity

    The impact level on activities, categorized as high, moderate, or low, often measured with a 0-10 pain scale.

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    Irritability

    The ratio of the aggravating factors to easing factors, determining pain response and intervention aggressiveness.

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    Subjective Information

    Data reported by the patient regarding their symptoms.

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    Objective Information

    Data collected during the examination, such as range of motion and strength.

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    Symptom Behavior Model

    A model that uses hypotheses and signs to guide interventions and assessments.

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    Asterisk Sign

    Key indicators that help assess patient improvement during therapy.

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    Types of Pain

    Different classifications of pain including nociceptive, neuropathic, central, viscerogenic, and autonomic.

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    Nociceptive Pain

    Pain resulting from mechanical or inflammatory sources.

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    Mechanical Back Pain

    Occurs at any age, acute onset, often worsens with movement, improves with rest.

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    Inflammatory Back Pain

    Onset usually before age 45, long duration over 3 months, improves with movement.

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    Acute Symptoms

    Symptoms that have been present for less than 3 weeks.

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    Chronic Symptoms

    Symptoms that persist for more than 6 weeks.

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    Stability of Symptoms

    Classification of symptom progression: improving, worsening, no change, or inconsistent.

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    Study Notes

    Clinical Reasoning

    • Clinical reasoning is a complex cognitive process crucial for evaluating and managing patient medical problems.
    • It includes diagnosing patient problems, making therapeutic decisions, and estimating patient prognosis.
    • It sets physical therapists apart from personal trainers.

    Objectives

    • Define clinical reasoning and understand its importance in clinical practice.
    • Understand and utilize the SINSS model of clinical reasoning.
    • Understand the Symptom Behavior Model of clinical reasoning.
    • Apply SINSS to analyze patient cases.

    SINSS Model

    • A useful model for systematic clinical reasoning.
    • Used to determine diagnosis.
    • Used to aid in treatment/referral decisions.
    • Used to create intervention decisions.
    • Used to teach patients about prognosis.
    • Components include Severity, Irritability, Nature, Stage, and Stability.

    Severity

    • Measured on a 0-10 verbal scale (Numeric Pain Rating Scale).
    • Evaluates the impact of pain on daily activities like work, recreation, and daily living tasks.
    • Categorized as high, moderate, or low.

    Irritability

    • The ratio of aggravating factors to easing factors.
    • Examines how much and how quickly aggravating factors increase pain and how long it takes for easing factors to reduce pain.
    • Categorized as high, moderate, or low.

    Nature

    • Describes the specific diagnosis or condition and the essential nature of the pain.
    • Includes categories like Nociceptive (mechanical or inflammatory), Neuropathic, Central, Viscerogenic, and Autonomic pain types.
    • Examples of types of pain are mechanical back pain and inflammatory back pain

    Stage

    • Categorizes the duration of symptoms as acute (less than 3 weeks), subacute (more than 3 weeks but less than 6 weeks), or chronic (greater than 6 weeks).
    • Stage is evaluated to correlate with tissue healing timeframes. This is important in developing intervention strategies.

    Stability

    • Tracks symptom progression over time.
    • Categories include improving (symptoms decrease), worsening (symptoms increase), no change, and inconsistent (sometimes better, sometimes worse).

    Symptom Behavior Model

    • A framework for testing hypotheses about patient problems using the SINSS model.
    • The hallmark of this model is Test-Treat-Retest.
    • Suggests the role of the practitioner as showing patient improvement, not just expecting the patient to acknowledge improvement.
    • Relies on asterisk signs (activities or movements that re-create symptoms) and subjective and objective data.

    Patient Case

    • A 37-year-old male presented with acute low back pain after squatting.
    • Pain was initially 7/10, but lessened to 5/10.
    • Pain was described as a deep ache with intermittent sharp stabs.
    • Pain worsened when sitting for more than 10 minutes.
    • Pain resolved after 15 minutes of walking or standing.
    • Rotation was severely limited bilaterally.

    Application

    • Applying SINSS to the patient case for justification.
    • Identifying subjective and objective asterisks.
    • Discussing considerations in a group setting or with supervisors.

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    Related Documents

    Intro to Clinical Reasoning PDF

    Description

    Explore the essential aspects of clinical reasoning in physical therapy. This quiz will help you understand the SINSS model and its applications in diagnosing and managing patient cases. By the end, you will grasp how effective clinical reasoning sets professionals apart in healthcare.

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