Clinical reasoning of an experienced physiotherapist: insight into clinician decision-making regarding low back pain

2001 ◽  
Vol 6 (1) ◽  
pp. 40-51 ◽  
Author(s):  
Eric Noll ◽  
Aaron Key ◽  
Gail Jensen
Keyword(s):  
Decision Making ◽  
Low Back Pain ◽  
Back Pain ◽  
Clinical Reasoning ◽  
Low Back ◽  
Insight Into ◽  
Experienced Physiotherapist

scholarly journals Cognitive–Evaluative Dimension of Pain in Neuropathic Pain Relapse in Sciatica: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 658
Author(s):  
Tsubasa Kawasaki ◽  
Takuya Yada ◽  
Masahiro Ohira
Keyword(s):  
Neuropathic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Acute Phase ◽  
Low Back ◽  
Evaluative Dimension ◽  
Long Duration ◽  
Improvement Process ◽  
Insight Into

The cognitive–evaluative (C–E) dimension of pain is commonly observed in patients with a relatively long duration of pain. However, little is known about the effects of pain relapse on the C–E dimension of pain. Moreover, the improvement process of the C–E dimension of pain following treatment is unknown. The objective of this case report was to (a) demonstrate that the C–E dimension was affected in the acute phase of neuropathic pain in cases of pain relapse, and (b) demonstrate the improvement process of the C–E dimension of pain. A woman was diagnosed with low back pain (LBP) and sciatica. The patient had previously experienced symptoms of LBP and sciatica; thus, this episode was a case of pain relapse. At the beginning of rehabilitation, the C–E dimension of pain was present in addition to the sensory–discriminative (S–D) dimension of pain. It was observed that improvement of the C–E dimension of pain was delayed in comparison with that of the S–D dimension of pain. The C–E dimension of pain was observed with pain relapse even though it was in the acute phase of pain. This case provides a novel insight into the C–E dimension of pain. Moreover, the delay in improving the C–E dimension of pain indicates a difference in the improvement process for each pain dimension.

Inter-examiner reliability of a proposed decision-making treatment based classification system for low back pain patients

2012 ◽  
Vol 17 (2) ◽  
pp. 164-171 ◽  
Author(s):  
Birgitta Widerström ◽  
Niclas Olofsson ◽  
Inga Arvidsson ◽  
Karin Harms-Ringdahl ◽  
Ulla Evers Larsson
Keyword(s):  
Decision Making ◽  
Low Back Pain ◽  
Back Pain ◽  
Classification System ◽  
Low Back ◽  
Pain Patients

scholarly journals Physical Therapist Management of Acute and Chronic Low Back Pain Using the World Health Organization's International Classification of Functioning, Disability and Health

2009 ◽  
Vol 89 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Sean D Rundell ◽  
Todd E Davenport ◽  
Tracey Wagner
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Reasoning ◽  
Chronic Low Back Pain ◽  
Physical Therapist ◽  
World Health ◽  
Low Back ◽  
Disability And Health ◽  
Icf Model

Background and PurposeThe World Health Organization's Classification of Functioning, Disability and Health (WHO-ICF) model was developed to describe, classify, and measure function in health care practice and research. Recently, this model has been promoted as a successor to the Nagi model by some authors in the physical therapy literature. However, conceptual work in demonstrating use of the WHO-ICF model in physical therapist management of individual patients remains sparse. The purpose of this case report series is to demonstrate the application of the WHO-ICF model in clinical reasoning and physical therapist management of acute and chronic low back pain.Case DescriptionTwo patients, 1 with acute low back pain and 1 with chronic low back pain, were treated pragmatically using the WHO-ICF model and other applicable models of clinical reasoning.InterventionManual therapy, exercise, and education interventions were directed toward relevant body structure and function impairments, activity limitations, and contextual factors based on their hypothesized contribution to functioning and disability.OutcomeBoth patients demonstrated clinically significant improvements in measures of pain, disability, and psychosocial factors after 3 weeks and 10 weeks of intervention, respectively.DiscussionThe WHO-ICF model appears to provide an effective framework for physical therapists to better understand each person's experience with his or her disablement and assists in prioritizing treatment selection. The explicit acknowledgment of personal and environmental factors aids in addressing potential barriers. The WHO-ICF model integrates well with other models of practice such as Sackett's principles of evidence-based practice, the rehabilitation cycle, and Edwards and colleagues’ clinical reasoning model. Future research should examine outcomes associated with the use of the WHO-ICF model using adequately designed clinical trials.

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