904XPhysiotherapy Management of Lumbar Radiculopathy with Hamstring Injury (Grade-II) Patient by Using Different Clinical Reasoning Process: A Case Report
- Articles
- Submited: October 31, 2019
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Published: September 30, 2019
Abstract
Background: Clinical reasoning is a thinking and decision making procedure which helps the clinician to interact with the patient and their family members and other health care professionals in daily practice. During this process RPS-form (rehabilitation problem solving) can provide beneficial and also serve as linguistic tools between health professionals. The purpose of this study was to manage a case with lumbar radiculopathy with hamstring injury patient by using different clinical reasoning process and to deepen the clinician existing knowledge about CR.
Method:A case based study which was solved by using hypothetico-deductive and narrative reasoning. Also other reasoning process has to use. RPS tools help to solve the problem both from patient and therapist perspectives.
Result:After 21 session of treatment improvement was found in patient pain reduction, both in resting (VAS. 0/10) and movement (VAS. 2/10). Full range of motion (ROM) achieved in all lumbar movement, muscle power of lower limb. Both active and passive straight leg raising (SLR) also improve by treatment. Disability score of lumbar spine measured by Oswestry disability index improved from 75% to 18% and lower limb measured by lower extremity functional scale improved from 29 to 75.
Conclusion:When dealing with a difficult case strictly going through a single reasoning process is difficult, we need to use several reasoning process. It will help us to rapid and accurate assessment of a patient. In this case by using CR process clinician successfully manage the case by conservative treatment.
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References
•Dembowski, S. C., Westrick, R. B., Zylstra,E., & Johnson, M. R. (2013). Treatment ofhamstring strain in a collegiate pole-vaulterintegrating dry needling with an eccentrictraining program: A resident’s case report.The International Journal of sports physicaltherapy, 8 (3),328.
•Dunsford. A., Kumar, S., & Clarke, S.(2011). Interacting evidence into practice:use of McKenzie- based treatment for lowpain. Journal of MultidisciplinaryHealthcare, 4, 392- 402.
•Eberhardt, B., & Greiner, J. (2008).Implementation of the RPS –form in twocentres in Indonesia and Nepal: a descriptivepilot study. European school ofphysiotherapy, 1-6.
•Edwards, I., Jones, M., Carr, J., Braunack-Mayer, A., & Jensen, G.M. (2004). Clinicalreasoning strategies in physical therapy.Physical Therapy, 84(4), 312-330.
•Elstein, A. S., Shulman, L. S., Sprafka , S.A. (1978). Medical problem solving: Ananalysis of clinical reasoning. Cambridge,MA: Harvard University press.
•Ernlund, L., &Vieria, L. D. A. (2017).Hamstring injuries: update article.Revistabrasileria de ortopedia, 52(4), 373-382.
•Fleming, M. H. (1991). The therapist withthe Three-Track Mind. The AmericanJournal of Occupational Therapy. 45(11).
•Heiderscheit, B. C., Sherry, M. A., Silder,A., Chumanov, E. S., &Thelen, D.G. (2010).Hamstring strain injuries: recommendationsfor diagnosis, rehabilitation, and injuryprevention. Journal of orthopaedic& sportsphysical therapy, 40 (2), 67-81.
•Higgs, j., Jones, M., Loftus. S., &Christensen, N. (2008). Clinical Reasoningin the Health Professions. Philadelpia, USA:Elsevier.
•Hopayian, K., &Danielyan, A. (2018). Foursymptoms define the piriformis syndrome :an updated systemic review of its clinicalfeatures, European journal of orthopeadicsurgery and traumatology, 28, 155-164.
•Hoy, D., Brooks. P., Blyth, F.,&Buchbinder, R. (2010) .The Epidemiologyof low back pain. Best Practice & ResearchClinical Rheumatology, 24(6), 769-781.
•Kim, G., Kim, H., Kim, W. K., & Kim, J.(2018). Effect of stretching- basedrehabilitation on pain, flexibility and musclestrength in dancers with hamstring injury: asingle-blind, prospective, randomizedclinical trial. The journal of sports medicineand physical fitness, 58(9), 1287- 1295.
•Kuske, B., Hamilton, D. F., Pattle, S. B., &Simpson, A. H. R. W. (2016). Patterns ofHamstring Muscle Tears in the GeneralPopulation: A Systemic Review. Plos One,11(5), e0152855.doi:10.1371/journal.pone.0152855.
•Manchikanti, L., Singh, V., Falco, F.J.,Benyamin, R.M., & Hirsch, J. A. (2014).Epidemiology of low back pain in adults.Neuromodulation: Technology at the neuralinterface,17, 3-10.
•May, S., Greasley, A., Reeve, S., & Withers,S. (2008). Expert therapists use specificclinical reasoning process in the assessmentof patients with shoulder pain: a qualitativestudy. Australian Journal of physiotherapy,54, 261-266.
•Nesbit, K. C., Randall, K. E., & Hamilton,T. B. (2016). The Development of NarrativeReasoning: Student Physical Therapists’Perceptions of Patient Stories. InternetJournal of Allied Health Sciences andPractice, 14(2), 3.
•Nipa , S. I., Khan, M. M. K.R., Hossain,M. S., Rahman, M. H., & Islam, M. S.(2015). Management of a Guillain BarreSyndrome patient through three trackreasoning: A case study. InternationalJournal of Phyiotherapy, 2(6), 1006-1011.
•Omar, S., Azmat, S., Mirza, T. M., Javed,K., Ishtiaq, O., & Fatima, K. (2016).Accuracy of straight leg raise test in patientswith lumbar disc herniation keepingmagnetic resonance imaging as a referencestandard. Pakistan armed forces medicaljournal, 66(1), 53-56.
•Rahman, M. H., Islam, M. S., Rahman, E.,Kakuli, A. A., Nipa, S. I., Haque, M. O.(2016). Management of an atypical anklesparin patient through hypothetico deductivereasoning model of clinical reasoningimplemented by international classificationof functioning, disability and health: a case
study. International journal of physiotherapy, 3(3), 263-266.
•Ramos, G. A., Arliani, G. G., Astur, D. C.,Pochini, A. D. C., Ejnisman, B., & Cohen,M. (2017). Rehabilitation of hamstringmuscle injuries: a literature review.Revistabrasileira de ortopedia, 52(1), 11-16.
•Rehman, L., Khaleeq, S., Hussain, A.,Ghani, E., Mushtaq, & Zaman, K.U. (2007).Correlation between clinical features andmagnetic resonance imaging findings inpatients with lumbar disc herniation. Journalof postgraduate medicalinstitute, 21(1),65-70.
•Ropiak, C. R., & Bosco, J. A. (2012).Hamstring injuries. Bulletin of the NYUhospital for joint diseases, 70(1), 41-48.
•Singh, U. S., Meena, R. K., Singh, C. A. K,Singh, A. K. J., Singh, A. M., &Langshong,R. (2018). Prevalence of piriformissyndrome among the cases of low back/buttock pain with sciatica: A prospectivestudy. Journal of medical society, 27(2), 94-99.
