This lecture is on spinal pain and the clinical methods used in treating the pain. Clinical prediction rules is a research method done systematically describing when to use which method of treatment approach
Clinical reasoning is one of the pillars for good physiotherapy practice. It is an integral component of evidence based practice. It is a thought process that develops over time in a clinician. The first step is to start thinking of a clinical problem.
The lecture is delivered to first year physiotherapy students at Kathmandu University School of Medical Sciences, Nepal. The students will continue with case discussion using similar model proposed by Mark Jones and Darren Rivett in his book. Further real cases and the cases in Mark Jones will be discussed in the subsequent classes over the Bachelor of Physiotherapy course.
Neurophysiological Facilitation of Respiration is a treatment technique used for respiratory care of patients with unconscious or non-alert, and ventilated, and also with a neurological condition
NPF is the use of external proprioceptive and tactile stimuli that produce reflex respiratory movement responses and that increase the rate and depth of breathing
Clinical reasoning is one of the pillars for good physiotherapy practice. It is an integral component of evidence based practice. It is a thought process that develops over time in a clinician. The first step is to start thinking of a clinical problem.
The lecture is delivered to first year physiotherapy students at Kathmandu University School of Medical Sciences, Nepal. The students will continue with case discussion using similar model proposed by Mark Jones and Darren Rivett in his book. Further real cases and the cases in Mark Jones will be discussed in the subsequent classes over the Bachelor of Physiotherapy course.
Neurophysiological Facilitation of Respiration is a treatment technique used for respiratory care of patients with unconscious or non-alert, and ventilated, and also with a neurological condition
NPF is the use of external proprioceptive and tactile stimuli that produce reflex respiratory movement responses and that increase the rate and depth of breathing
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
PPT that made a short and crisp description on physiotherapy role in women's health at a glimpse.
Physical therapist plays a over all role in all stages of a women.Physiotherapist or a pelvicfloor physicall therapist plays a all arounder in childbirth educator, as a labour doula, as lactation expert , as a postpartum doula, as a pelvicrehab practitioner etc.. So all you need to understand is a WOMEN'S HEALTH/ PELVICFLOOR PT is a person who benifits women at all the stages.
Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Corrective exercises in the treatment of scoliosisNikos Karavidas
Physiotherapeutic Scoliosis Specific Exercises (PSSE) can be used as an exclusive treatment for mild scoliosis and in combination with bracing for greater curves. There are 3 RCT's and 1 Systematic review with meta-analysis, which prove the effectiveness of the PSSE (Level of Evidence I)
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
PPT that made a short and crisp description on physiotherapy role in women's health at a glimpse.
Physical therapist plays a over all role in all stages of a women.Physiotherapist or a pelvicfloor physicall therapist plays a all arounder in childbirth educator, as a labour doula, as lactation expert , as a postpartum doula, as a pelvicrehab practitioner etc.. So all you need to understand is a WOMEN'S HEALTH/ PELVICFLOOR PT is a person who benifits women at all the stages.
Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Corrective exercises in the treatment of scoliosisNikos Karavidas
Physiotherapeutic Scoliosis Specific Exercises (PSSE) can be used as an exclusive treatment for mild scoliosis and in combination with bracing for greater curves. There are 3 RCT's and 1 Systematic review with meta-analysis, which prove the effectiveness of the PSSE (Level of Evidence I)
Can Primary Care Provide Effective Management of Chronic Pain?epicyclops
This lecture was given by Professor Gary Macfarlane, Professor of Epidemiology at the University of Aberdeen, to the North British Pain Association Spring Scientific Meeting in Edinburgh on Friday 18th May, 2007. Professor Macfarlane is introduced by Dr Colin Rae. The lecture forms part of a conference "Blurring the Boundaries - Managing Pain in Primary Care and Secondary Care".
www.wspg.org.uk
Presented an in-service on the evidence behind and the application of thoracic spine manipulation to the Martinsburg VA Medical Center's rehabilitation staff including: 7 PTs, 8 PTAs, 3 OTs, and 4 students.
The evaluation of back pain can be a pain in the neck or a back-breaking exercise, so to speak. However, the diagnosis hinges always on a focused History and Physical Exam and not really on labs or imaging. Knowing what to ask and where to look can make the evaluation of this all-too-common condition manageable for the internist.
This lecture focuses on the evaluation of low back pain and will guide the reader on the key points in the Hx and PE and prevent unnecessary testing/imaging. It also presents 3 "unusual" cases of low back pain which may be disabling if not recognized immediately.
Manual and physical therapists use a postural-structural-biomechanical (PSB) model to ascertain the causes of various musculoskeletal conditions.
The most important question is consistently being ignored is can a person’s physical shape/posture/structure/biomechanics be the cause of pain in spine
Using Enhanced Recovery After Surgery (ERAS) to Enhance Postoperative OutcomesWellbe
Speaker: Francesco Carli, MD, MPhil, senior staff anesthesiologist at the McGill University Health Centre
Cost: Complimentary, sponsored by Wellbe
There is strong evidence that many of aspects of surgical care have little evidence, and therefore the Enhanced Recovery After Surgery (ERAS) program has been set up to accelerate the recovery process and decrease the rate of postoperative complications. There is an opportunity to improve outcomes by using team approach and revision of the standard procedures.
Learn about:
– The elements of ERAS protocols
– How to structure the Team approach
– The role of the patient in ERAS
– How to perform an audit of your program
About the Speaker:
Francesco Carli, MD, MPhil, is Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University and a senior staff anesthesiologist at the McGill University Health Centre. He is currently an Elected Member of the American Academy of Anesthesia and a Board Member of the Enhanced Recovery After Surgery (ERAS) Society. Dr. Carli completed his medical training and anesthesia training in Turin, Italy, Paris, France, and London, England. He completed a Master’s Degree in surgical metabolism at the University of London, England.
His research interests are: metabolic changes associated with surgery and the impact of perioperative interventions (regional analgesia, nutrition, hormones, exercise) on postoperative recovery; evaluation of functional outcome measures during the surgical recovery process; prehabilitation of surgical patients. He is the author of over 250 peer-review scientific articles and has been a recipient of over 50 peer and non peer-review grants.
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. CONTENTS:
Introduction to Clinical prediction rule
What are CPR
Levels of CPR
Types of CPR
Examples
Summary
Reference
3. INTRODUCTION
A trend in manual therapy has been the development of
Clinical Prediction Rules (CPR).
CPRs are derived statistically i.e. literally “translated” from
research evidence with the aim of identifying the combinations
of clinical examination findings that can predict a condition or
outcome.
(Fritz et al., 2003; Fritz, 2009; Cook, 2008)
4. Clinical prediction rules are decision-making tools that contain
predictor variables obtained from patient history, examination,
and simple diagnostic tests; they can assist in making a
diagnosis, establishing prognosis, or determining appropriate
management.
5. WHAT ARE CLINICAL
PREDICTION RULES (CPRS)?
Evidence-based medicine
Clinical decision making algorithm
Increase sensitivity and specificity of clinical examination
Decrease use of unnecessary tests
Decrease use of ineffective treatments
Glynn & Weisbach (2011)
6. How are they developed?
4 LEVELS OF CPRS
I: demonstrated effectiveness in a varied population on a large
scale
II: validated in a broad patient population
III: validation of the CPR in a patient sample; confirm predictor
variables weren’t due to chance or errors within the study; new
patients, new investigators
IV: rule has been developed and tested in a specific population;
predictor variables are selected
Glynn & Weisbach (2011)
7. TYPES OF CPRS
Diagnostic: Probability that a specific condition exists.
Prognostic: Likely outcome for patients with a specific
condition.
Prescriptive: Determine which patients will likely respond
favorably to a specific treatment or combination of treatments.
Glynn & Weisbach (2011)
9. Purpose: Identify signs and symptoms indicative of lumbar
spinal stenosis.
Rule:
1. Bilateral symptoms
2. Leg pain > back pain
3. Pain during walking/standing
4. Pain relief upon sitting
5. > 48 years old
Diagnosis :
Lumbar Spinal Stenosis (JS)
10. Purpose: To identify patients with neck and arm pain likely
presenting with cervical radiculopathy based on specific patient
characteristics.
Rule:
1.Positive Upper Limb Tension Test A
2. Involved cervical rotation < 60 degrees
3. Positive Distraction Test
4. Positive Spurling’s A
Diagnosis :
Cervical Radiculopathy
12. RECOVERY WITH LBP
Predictor variables Initial pain < 8/10
pain less than 6 days
No more than 1 previous episode of LBP
All three predictor variables present
Study participants received mobilization therapy
95% better at 12 weeks pain 0-1/10 for 1 week
Hancock et al. (2009)
14. Mechanical Traction for Neck Pain
Purpose: Identify patients with neck pain likely to improve
with cervical traction and exercise.
Rule:
1. Patient reported peripheralization with lower cervical
spine (C4-7) mobility testing
2. Positive shoulder abduction test
3. Age > 55
4. Positive upper limb tension test A
5. Positive neck distraction test
Three or more predictor variables indicates a moderate
likelihood that traction and exercise will produced a
perceived benefit
Raney et al. (2009)
16. MECHANICAL TRACTION FOR
LOW BACK PAIN
Purpose: Identify patients with low back pain who
likely will respond favorably to mechanical lumbar
traction.
Rule:
1. FABQ-W score < 21
2. No neurological deficit involvement
3. Age older than 30
4. Non-manual work job status
18. THORACIC MANIPULATION FOR
NECK PAIN
Purpose: Identify patients with neck pain who are
likely to experience early success from thoracic spine
thrust manipulation, exercise, and patient education.
Rule:
1. Symptoms < 30 days
2. No symptoms distal to the shoulder
3. Looking up does not aggravate symptoms
4. FABQ-PA score < 12
5. Diminished upper thoracic spine kyphosis
6. Cervical extension ROM < 30 degrees
20. LUMBAR MANIPULATION FOR LOW
BACK PAIN
Purpose: Identify patients with low back pain who likely
will improve with spinal manipulation.
• Rule:
• 1. Duration of symptoms < 16 days
2. At least one hip with > 35° of internal rotation
3. Lumbar hypomobility
4. No symptoms distal to the knee
5. FABQ-W score < 19
Hancock et al. (2008)
22. CERVICAL MANIPULATION FOR
NECK PAIN
Purpose: Identify patients with mechanical neck pain who will
demonstrated favorable outcomes following cervical
manipulation.
Rules:
1. Symptom duration of less than 38 days
2. Positive expectation that manipulation will help
3. Side-to-side difference in cervical rotation ROM of 10° or
greater
4. Pain with poster anterior spring testing of the middle cervical
spine
(puentedura,et al 2012)
24. SUMMARY
• Most diagnostic CPRs are in their initial development phase
and cannot be recommended for use in clinical practice at this
time.
•
• while useful as part of decision making CPRs should not
replace clinical judgment and should be seen as
complementary to that process which needs to involve
experience, clinical opinion, intuition as well as research
evidence.
25. REFERENCES
• Cook, C., Potential it falls of clinical prediction rules.
Journal of Manual & Manipulative Therapy, 2003.
• Falk, G., Fahey , T., Clinical prediction rules. British
Medical Journal , 2009.
• Fritz, J. M ., Delitto , A., Erhard , R., Comparison of a
classification - based approach to physical therapy
and therapy based on clinical practice guidelines for
patients with acute low back pain: a randomized clinical
trial. Spine 28, 2003.
• Glynn, P. E., & Weisbach, P. C., Clinical prediction rules.
A physical therapy reference manual. Boston: Jones and
Bartlett Publishers, 2011.
26. • Laupacis A, Sekar N, Stiell I. Clinical prediction rules:
A review and suggested modification of
methodological standards.
• Cook C, Brown C, Michael K, Isaacs R, Howes C,
Richardson W, Roman M, Hegedus E. The clinical
value of a cluster of patient history and observational
findings as a diagnostic support tool for lumbar spine
stenosis. Physiother Res Int. 2011;
• Waldrop MA., Diagnosis and treatment of cervical
radiculopathy using a clinical prediction rule and a
multimodal intervention approach: a case
series. Journal of Orthopedics Sports Physiotherapy,
2006;
27. • Laslett, M., Aprill, C. N., McDonald, B., & Young, S.
B., Diagnosis of sacroiliac joint pain. Validity of
individual provocation tests and composites of tests.
2005, Journal of Manual Therapy.
• Lee, D., Differential diagnosis and management
ofchronic pelvic pain. In: Chaitow, L., Lovegrove, R.
(Eds.),Chronic Pelvic Pain & Dysfunction, Churchill-
Livingstone, Edinburgh,in press.