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What is the primary focus of diagnostic reasoning in the patient-centered model?
What is the main advantage of adopting hypothetical-deductive reasoning in clinical decision-making?
According to Jones' Category Hypothesis System, what is the primary focus of the seventh category?
Which type of reasoning is concerned with predicting future shifts and their consequences in the patient's condition?
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What is the primary goal of the Patient-Centered Model in clinical reasoning?
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What is the role of functional impairments in the hypothetical-deductive reasoning model?
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What is the main advantage of the Collaborative Clinical Reasoning Model?
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Which type of nociceptor is responsible for detecting thermal stimuli?
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What type of reasoning does the Dialectic Reasoning Model involve?
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What is the primary goal of collaborative clinical reasoning in physical therapy?
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What type of reasoning is involved in explaining treatment plans to patients?
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What is the primary focus of the first category in the Category Hypothesis System?
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What is the main benefit of adopting a collaborative approach to clinical reasoning?
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What is the role of narrative reasoning in the patient-centered model?
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What is the primary goal of diagnostic reasoning in physical therapy?
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What type of reasoning is involved in defining therapeutic procedures in physical therapy?
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What is the primary goal of clinical reasoning in physical therapy?
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What should be assessed first during mobility and muscle strength exploration?
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What is the purpose of movement scanning during active mobility assessment?
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What type of sensation is felt during the final movement sensation of sliding?
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When should palpation be performed during the examination?
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What is the purpose of specificity tests in physical therapy?
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What is clinical reasoning in physical therapy?
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What is the focus of the patient-centered model in physical therapy?
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What type of pain is characterized by high-intensity, throbbing, electrical, and burning sensations?
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Which type of pain is often mislead with somatic pain?
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What is the main characteristic of continuous pain?
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What is the importance of knowing previous treatments in pain assessment?
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What is the main characteristic of intermittent pain?
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What is the main characteristic of somatic pain?
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What is the main characteristic of visceral pain?
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What is the main characteristic of persistent pain?
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What is a sign or symptom that may alert of major pathology in a patient with back pain?
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Which of the following psychosocial factors increases the risk of developing long-term disability in a patient with back pain?
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What is an important aspect to observe during the 1st phase of visual inspection in a patient with back pain?
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Which of the following is a significant red flag in a patient with back pain?
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What is a potential indicator of immunosuppression in a patient with back pain?
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Which of the following is a characteristic of patients at higher risk of developing long-term disability?
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What is an important consideration during the objective assessment of a patient with back pain?
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Which of the following is a significant psychological factor that can contribute to long-term disability in a patient with back pain?
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Study Notes
Clinical Reasoning in Physical Therapy
- Clinical reasoning is a mental process and decision-making that takes place during the evaluation, diagnosis, and treatment of a patient's pathology.
- Autonomous clinical decisions are crucial for professional autonomy, adopting responsible, timely, accurate, and independent clinical decisions.
Diagnostic Reasoning
- Edwards' model (2000-2004) consists of functional and narrative reasoning.
- Functional reasoning involves diagnosing impairments, while narrative reasoning involves understanding the patient's interpretation of their condition.
Treatment Reasoning
- Reasoning of the procedure involves defining therapeutic procedures.
- Interactive reasoning involves establishing the PT-patient relationship.
- Collaborative reasoning involves PT-patient treatment decision-making.
- Teaching reasoning involves explaining the treatment plan to the patient for higher implication.
Pain Assessment
- Nociception is the encoding and processing of harmful stimuli in the nervous system.
- Nociceptors are high-threshold sensory receptors that transduce and encode noxious stimuli.
Initial Models
- Hypothetical-deductive reasoning (HDR) is based on the relationship between clinical patterns and diagnosis.
- Jones' (1992) Category Hypothesis System involves seven categories:
- Functional limitation or disability
- Pathobiologic mechanisms
- Physical and psychological disorders
- Contributing factors
- Precautions and contraindications
- Management and treatment
- Prognosis
Collaborative Models
- Patient-Centered Model highlights the importance of the patient's specific problem context within the clinical reasoning process.
- Collaborative Clinical Reasoning Model involves patient cooperation in the clinical reasoning process.
Mobility and Muscle Strength Exploration
- Active mobility involves physiological movements and combined movement scanning.
- Passive mobility involves evaluating the inert components of the musculoskeletal system.
- Muscle testing is performed to evaluate muscle strength and pain during contraction.
Palpation
- Palpation involves searching for sensations, painful points, and tissue temperature at the end of the scan.
Pain Assessment
- Onset of pain can be sudden or insidious and may be associated with trauma.
- Clinical features of pain include:
- Neuropathic pain: caused by nerve root irritation, characterized by high-intensity, throbbing, electrical, or burning sensations.
- Somatic pain: dull, non-electric, diffuse, and difficult to locate.
- Visceral pain: deep, diffuse, and often mislead with somatic pain.
- Pain behavior can be continuous, intermittent, or persistent.
- Previous treatments, signs, and symptoms are crucial to focus on new treatment and prognosis establishment.
Red Flags
- Red flags include:
- Severe or minor trauma (if there is history of osteoporosis)
- History of cancer/tumors
- Older than 50 or younger than 20
- Recent infection
- Fever
- General asthenia
- Sudden weight loss
- Immunosuppression
- Night or constant pain not associated with clearly varying relief
- Saddle pareses or anesthesia
- Bilateral neurological symptoms involving the lower limb + back pain
- Sudden decrease in muscle strength
- Dorsal or lumbar pain associated with particular food or diet
Psychosocial Factors
- Psychosocial factors that increase the risk of developing long-term disability include:
- Belief that the injury is harmful
- Fear of specific movements and avoidance behaviors
- Tendency to despair and social isolation
- Expectations that passive treatments are more helpful than active training
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Description
This quiz covers the Edwards approach to physical therapy, including diagnosis and treatment processes. It focuses on diagnostic reasoning, narrative reasoning, and interactive reasoning in physical therapy.