1 / 15

Students Be Advised For your own protection and to meet clinical education requirements you must:

Students Be Advised For your own protection and to meet clinical education requirements you must:. Have Proof of Health Insurance (caution if you are turning 25!) UD Health plan application must be received by January 31,2010 www.universityhealthplans.com Annual cost $1,551-$1,885

prue
Télécharger la présentation

Students Be Advised For your own protection and to meet clinical education requirements you must:

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Students Be AdvisedFor your own protection and to meet clinical education requirements you must: Have Proof of Health Insurance (caution if you are turning 25!) UD Health plan application must be received by January 31,2010 www.universityhealthplans.com Annual cost $1,551-$1,885 Malpractice Insurance (HPSO $29.50/year)

  2. What subjective information should be obtained from this patient? Why?

  3. What other information can you ask that will help you with the differential diagnosis of this patient?

  4. Question # 1 • Which type of imaging is the best evaluation of the ACL? • MRI • Dexa scan • CT scan • PET scan

  5. What objective data should be collected? Why?

  6. What are the patient problems? Think ICF Disablement Model

  7. Disablement Model: ICF • Health Condition • Impairments • Functional Limitations: Activity/Participation

  8. What are your PT Goals?

  9. What is your Plan of Care/ Interventions?

  10. Question #2 • The patient was dispensed a GII medial unloading brace mainly because • he has a partial ACL tear • he has a varus knee with medial compartmental OA • he has a meniscal tear • he has quadriceps weakness

  11. POLL • What do you think, the patient is…. • Getting better • Staying the same • Getting Worse

  12. Question #3 • With his response to physical therapy thus far, what would you recommend… • Discharge physical therapy immediately as it has been an inappropriate intervention • Refer back to the physician with the recommendation of possible surgical consultation • Continue with the current POC, doubling his strengthening exercises • Don’t panic, reassess in 6 weeks, strengthening is a slow process

  13. Question #4 • Theoretically, preoperative quadriceps strength is • Important because it may maximize postoperative recovery and be predictive of functional outcomes in patients with total knee arthroplasty • Important, the stronger the quad the less likely to have medical complications following surgery • Not important, he can get stronger later • Quad strength is no big deal, he is getting better, his KOS has increased

  14. Question #5 • It was important to get the patient in for a manipulation as soon as possible because • he shouldn’t have been manipulated, lacking 1°-90° of knee ROM is functional • manipulation is highly effective at any stage of TKA recovery • studies show that manipulation is most effective in patients manipulated within 8 weeks • Stim the quads, I thought we only manipulate backs?

  15. Preoperative Quadriceps Strength Predictive of Postoperative Outcomes • Functional limitations: • Inability to perform heavy lifting that is required of his job • Walking • Prolonged Standing • Inability to run and play with his children • Descending stairs • KOS: 48% • GRS: 50% Uninvolved Quadriceps Strength: 1006 N; 100% CAR Preoperative Strength Uninvolved Quadriceps Strength: 905 N; 100% CAR Postoperative Strength 12 wks post op 851 N 100% CAR 781 N 76% CAR Initial PT Evaluation • Functional limitations: • Difficulty kneeling and squatting only • KOS: 91% • GRS: 90% 683 N 90% CAR 1 Month T K A 585 N 82% CAR 1 Week Later Falls Risk

More Related