scholarly journals Misdiagnosis of Serotonin Syndrome as Fibromyalgia and the Role of Physical Therapists

2008 ◽  
Vol 88 (6) ◽  
pp. 757-765 ◽  
Author(s):  
Gregory M Alnwick
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Serotonin Syndrome ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Diagnostic Testing ◽  
Signs And Symptoms ◽  
Activity Level ◽  
Medical Evaluation ◽  
Successful Recovery

Background and Purpose With increased use of serotonergic medications, a condition triggered by serotonin excess within the brain and spinal cord has emerged and may be gaining prevalence. The purposes of this case report are to describe how to identify serotonin syndrome in a patient who is taking citalopram (a selective serotonin reuptake inhibitor) on the basis of signs and symptoms and to promote the ability of physical therapists to recognize such signs and symptoms. Case Description The patient was a 42-year-old woman referred for physical therapy with a diagnosis of fibromyalgia. The physical therapist recognized that the patient's symptoms did not resemble those of fibromyalgia and recommended referral to a neurologist for further diagnostic testing. Outcomes The patient was referred to a neurologist, who diagnosed serotonin syndrome related to the use of citalopram. The patient was weaned off citalopram and made a successful recovery, with scores on the Oswestry Disability Index decreasing from 70% to 28% at discharge from the physical therapy treatment and to 0% at the 6-month follow-up. The patient has since returned to her prior activity level, which includes skiing, motorcycle riding, and working at her consulting firm. Discussion This case report demonstrates how careful evaluation by the physical therapist indicated that signs and symptoms were not consistent with fibromyalgia, and further medical evaluation revealed the actual diagnosis of serotonin syndrome.

scholarly journals Physical Therapy Management of an Individual With Post-COVID Syndrome: A Case Report

2021 ◽  
Author(s):  
Kirby P Mayer ◽  
Angela K Steele ◽  
Melissa K Soper ◽  
Jill D Branton ◽  
Megan L Lusby ◽  
...  
Keyword(s):  
Case Report ◽  
Cognitive Function ◽  
Physical Therapy ◽  
Muscle Strength ◽  
Exercise Capacity ◽  
Cognitive Dysfunction ◽  
Clinical Presentation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Emotional Health

Abstract Objective The purpose of this case report is to present the clinical presentation and physical therapist management for a patient with post–COVID syndrome. Secondarily, the report highlights the importance of assessing cognitive and emotional health in patients with post–COVID syndrome. Methods (Case Description) A 37-year-old woman tested positive for SARS-CoV-2 and developed mild COVID-19 disease but did not require supplemental oxygen or hospitalization. The patient experienced persistent symptoms including dyspnea, headaches, and cognitive fog. On day 62, she participated in an outpatient physical therapist evaluation that revealed deficits in exercise capacity, obtaining 50% of her age-predicted 6-minute walk distance (6MWD). She had minor reductions in muscle strength and cognitive function. Self-reported quality of life (QoL) was 50, and she scored above established cut-off scores for provisional diagnosis of posttraumatic stress disorder (PTSD). Results The patient participated in biweekly physical therapist sessions for 8 weeks, which included aerobic training, strengthening exercises, diaphragmatic breathing techniques, and mindfulness training. Metabolic equivalent for task (METS) levels increased with variability over the course of the program. The patient’s muscle strength, physical function, and exercise capacity improved. 6MWD increased by 199 m, equating to 80% of her age-predicted distance. QoL and PTSD scores did not improve. At evaluation after physical therapy, the patient was still experiencing migraines, dyspnea, fatigue, and cognitive dysfunction. Conclusion This case report described the clinical presentation and physical therapist management of a person with post–COVID syndrome, a novel health condition for which little evidence exists to guide rehabilitation examination and interventions. Physical therapists should consider cognitive function and emotional health in their plan of care for patients with post–COVID syndromes. Impact This case alerts physical therapists to post–COVID syndrome—which can include debilitating symptoms of decreased aerobic tolerance, anxiety, PTSD, and cognitive dysfunction—and to the role that therapists can play in assessing these symptoms and managing these patients.

scholarly journals Dermatomyositis: Evolution of a Diagnosis

2003 ◽  
Vol 83 (10) ◽  
pp. 932-945 ◽  
Author(s):  
Joshua A Cleland ◽  
Jane Walter Venzke
Keyword(s):  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Short Form ◽  
Exercise Program ◽  
Signs And Symptoms ◽  
Care Physician ◽  
Direct Access ◽  
Home Exercise ◽  
Diagnostic Process

Abstract Background and Purpose. As direct access evolves, physical therapists will increasingly encounter patients with pathology that might have an underlying systemic origin. The purpose of this case report is to describe the diagnostic process that led a patient's physical therapist to recognize signs and symptoms of dermatomyositis. Case Description. The patient was an 18-year-old woman who was referred for physical therapy by her primary care physician on 3 occasions with 3 separate musculoskeletal diagnoses. During the third episode, the physical therapist recognized signs and symptoms that could be indicative of dermatologic disease and referred the patient to a dermatologist. Outcomes. A rheumatologist diagnosed the patient's condition as dermatomyositis and referred her for physical therapy. The physical therapy plan of care focused on strengthening and stretching, with an emphasis on a home exercise program. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) indicated that the patient continually made functional improvements over an 18-month period. Discussion. Although diagnosis of diseases such as inflammatory myopathies is not within a physical therapist's scope of practice, this case demonstrates the role a physical therapist can play in recognition of underlying systemic pathology by using the diagnostic process.

scholarly journals An investigation of screening for medical referral by Physical Therapists

2016 ◽  
Author(s):  
Heather Mount ◽  
Cecilia Graham ◽  
Diane Clark ◽  
David Morris ◽  
Kathleen Foley
Keyword(s):  
Physical Therapy ◽  
Health Care Providers ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Signs And Symptoms ◽  
Care Providers ◽  
Management Decisions ◽  
Clinical Vignettes ◽  
Outpatient Practice ◽  
Medical Referral

Screening for medical referral is essential to physical therapist practice; however, no studies have examined medical screening across physical therapy practice settings. The purpose of this study was to determine if physical therapists in a variety of practice settings, given brief clinical vignettes, would screen for medical referral in a similar manner. The Delphi Technique was implemented to establish content validity, although only 2 vignettes reached 100% consensus by the expert panel. After reviewing the vignettes, physical therapist subjects determined if they would provide intervention, provide intervention and refer, or refer before intervention. To determine which variables were associated with identified appropriate decisions in each category, 4 sets of logistic regressions were performed. A random sample of APTA members in targeted sections (n=214) completed the survey. Physical therapists with more than 23 years experience were 7 times more likely to make similar management decisions in noncritical vignettes then those with 11 years or less. Half of the participants practiced in outpatient practice settings. In critical medical vignettes, 86% of physical therapists made similar decisions. Physical therapists in this study made identified appropriate management decisions for 90% of the vignettes. Board certification, practice setting and highest earned degree were not found to be statistically significant. It is imperative not only to ensure that the client is appropriate for physical therapy intervention, but it is also vital to recognize and identify signs and symptoms that warrant evaluation by other health care providers.

scholarly journals Patient Participation in Physical Therapy Goal Setting

2001 ◽  
Vol 81 (5) ◽  
pp. 1118-1126 ◽  
Author(s):  
Susan M Baker ◽  
Helen H Marshak ◽  
Gail T Rice ◽  
Grenith J Zimmerman
Keyword(s):  
Patient Satisfaction ◽  
Physical Therapy ◽  
Elderly Patients ◽  
Goal Setting ◽  
Patient Participation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Assessment Instrument ◽  
Initial Examination ◽  
Goals And Objectives

Abstract Background and Purpose. An important part of treatment planning in physical therapy is effective goal setting. The Guide to Physical Therapist Practice recommends that therapists should identify the patient's goals and objectives during the initial examination in order to maximize outcomes. The purpose of this study was to examine whether therapists seek to involve patients in goal setting and, if so, what methods they use. Therapists' attitudes toward participation and patient satisfaction with the examination were also examined. Subjects and Methods. Twenty-two physical therapists audiotaped the initial examination of 73 elderly patients (X̄=76.4 years of age, SD=7.1, range=65–94). The audiotaped examinations were then scored using the Participation Method Assessment Instrument (PMAI) to determine the frequency of attempts made by therapists to involve patients in goal setting. Therapists and patients completed surveys following the examinations. Results. Therapists' use of participation methods during examinations ranged from a minimum of 1 to a maximum of 19 out of 21 possible items on the PMAI. The therapists stated that they believed that it is important to include patients in goal-setting activities and that outcomes will be improved if patients participate. Patients also indicated that participation is important to them. Discussion and Conclusion. In most cases, the therapists did not fully take advantage of the potential for patient participation in goal setting. Patient and therapist education is needed regarding methods for patient participation during initial goal-setting activities.

Contributions of Non-professional Local Physical Therapist In the Promotion of Community Health Activities in the Arsi Zone, Southeast Ethiopia (Preprint)

2021 ◽  
Author(s):  
Leta Melaku
Keyword(s):  
Health Promotion ◽  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Arsi Zone ◽  
Southeast Ethiopia ◽  
The Impact

BACKGROUND Physical activity is a first-line therapy and secures against persistent illnesses. Essential medical care professionals are obviously situated to advance actual action. Active recuperation mediations focused on advancement and upkeep of wellbeing, personal satisfaction, and wellness. There is, notwithstanding, a deficiency of such examination proof in Ethiopia. OBJECTIVE We planned to assess the degree of KAP of nonprofessional local physical therapists' towards wellbeing advancement in Arsi zone of Oromia, Southeast Ethiopia. METHODS Community based cross sectional study was conducted in April 2018 among 45 physical therapists. Data were collected using pre-tested, structured and self-administrative questionnaires. Participants were selected by quota sampling technique. The questionnaire was drafted specifically to test the KAP. Data were double entered and analyzed by SPSS Version 20.0 program. Descriptive statistics were used. The KAP were estimated using proportion. RESULTS In present response rate is 90.0%. Ages of respondents ranged between 24 – 87 years. 57.8% of participants got initial physical therapy knowledge from either of their parents. 53.3% of the respondents hear about health promotion from families and friends. 57.8% of them provided health promotion at their workplace. The overall percentage of all the respondents’ KAP in health promotion was 60.1%. CONCLUSIONS The respondents’ have good KAP towards health promotion. However there is still room for improvement. Also there is a lack of proper guide lines in determining the impact physical therapy.

Awareness and Perception of Physical Therapy Education, Role in Patient Management and Health Promotion Held by Senior Medical Practitioners

2020 ◽  
pp. 13-17
Author(s):  
OJS Admin
Keyword(s):  
Health Promotion ◽  
Physical Therapy ◽  
Patient Management ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Well Being ◽  
Physical Therapy Education ◽  
Health Providers ◽  
Medical Practitioners ◽  
Therapy Education

Physical therapists are integral part of health care system. In collaboration with other health providers, physical therapist can play an effective role in patient handling and well-being of individuals. The awareness and perception of senior medical practitioners is less known regarding physical therapy education, role in patient management and health promotion.

scholarly journals Value-Based Care for Musculoskeletal Pain: Are Physical Therapists Ready to Deliver?

2019 ◽  
Vol 100 (4) ◽  
pp. 621-632 ◽  
Author(s):  
Trevor A Lentz ◽  
Adam P Goode ◽  
Charles A Thigpen ◽  
Steven Z George
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Musculoskeletal Pain ◽  
Clinical Decision Making ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Great Promise ◽  
Health Care Environment ◽  
Early Physical Therapy ◽  
Analytical Approaches

Abstract Early physical therapy models hold great promise for delivering high-value care for individuals with musculoskeletal pain. However, existing physical therapist practice and research standards are misaligned with value-based principles, which limits the potential for growth and sustainability of these models. This Perspective describes how the value proposition of early physical therapy can be improved by redefining harm, embracing a prognostic approach to clinical decision making, and advocating for system-wide guideline-adherent pain care. It also outlines the need to adopt a common language to describe these models and embrace new, rigorous study designs and analytical approaches to better understand where and how early physical therapy delivers value. The goal is to define a clear path forward to ensure physical therapists are aligned within health care systems to deliver on the American Physical Therapy Association’s vision of high-value care in a rapidly changing health care environment.

scholarly journals The Revised APTA Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant: Theory, Purpose, Process, and Significance

2010 ◽  
Vol 90 (5) ◽  
pp. 803-824 ◽  
Author(s):  
Laura Lee Swisher ◽  
Peggy Hiller ◽  
Keyword(s):  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Code Of Ethics ◽  
Codes Of Ethics ◽  
Ethical Conduct ◽  
Vision 2020 ◽  
Deliberative Process ◽  
Physical Therapist Assistant ◽  
Physical Therapist Assistants

IntroductionIn June 2009, the House of Delegates (HOD) of the American Physical Therapy Association (APTA) passed a major revision of the APTA Code of Ethics for physical therapists and the Standards of Ethical Conduct for the Physical Therapist Assistant. The revised documents will be effective July 1, 2010.PurposeThe purposes of this article are: (1) to provide a historical, professional, and theoretical context for this important revision; (2) to describe the 4-year revision process; (3) to examine major features of the documents; and (4) to discuss the significance of the revisions from the perspective of the maturation of physical therapy as a doctoring profession.Process of RevisionThe process for revision is delineated within the context of history and the Bylaws of APTA.Format, Structure, and Content of Revised Core Ethics DocumentsThe revised documents represent a significant change in format, level of detail, and scope of application. Previous APTA Codes of Ethics and Standards of Ethical Conduct for the Physical Therapist Assistant have delineated very broad general principles, with specific obligations spelled out in the Ethics and Judicial Committee's Guide for Professional Conduct and Guide for Conduct of the Physical Therapist Assistant. In contrast to the current documents, the revised documents address all 5 roles of the physical therapist, delineate ethical obligations in organizational and business contexts, and align with the tenets of Vision 2020.SignificanceThe significance of this revision is discussed within historical parameters, the implications for physical therapists and physical therapist assistants, the maturation of the profession, societal accountability and moral community, potential regulatory implications, and the inclusive and deliberative process of moral dialogue by which changes were developed, revised, and approved.

scholarly journals Using a Case Report of a Patient With Spinal Cord Injury to Illustrate the Application of the International Classification of Functioning, Disability and Health During Multidisciplinary Patient Management

2010 ◽  
Vol 90 (7) ◽  
pp. 1039-1052 ◽  
Author(s):  
Alexandra Rauch ◽  
Reuben Escorpizo ◽  
Daniel L. Riddle ◽  
Inge Eriks-Hoogland ◽  
Gerold Stucki ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Case Report ◽  
Physical Therapy ◽  
Patient Management ◽  
Physical Therapists ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Cord Injury

Background and PurposePhysical therapists require a comprehensive assessment of a patient's functioning status to address multiple problems in patients with severe conditions. The International Classification of Functioning, Disability and Health (ICF) is the universally accepted conceptual model for the description of functioning. Documentation tools have been developed based on ICF Core Sets to be used in multidisciplinary rehabilitation management and specifically by physical therapists. The purposes of this case report are: (1) to apply ICF-based documentation tools to the care of a patient with spinal cord injury and (2) to illustrate the use of ICF-based documentation tools during multidisciplinary patient management.Case DescriptionThe patient was a 22-year-old man with tetraplegia (C2 level) who was 5 months postinjury. The report describes the integration of the ICF-based documentation tools into the patient's examination, evaluation, prognosis, diagnosis, and intervention while he participated in a multidisciplinary rehabilitation program for 2 months.OutcomesThe patient's comprehensive functioning status at the beginning of the program, the rehabilitation goals, the intervention plan, and his improvements in functioning following rehabilitation and the according goal achievement were illustrated with physical therapy–specific and multidisciplinary ICF-based documentation tools.DiscussionThis case report illustrates how the ICF-based documentation template for physical therapists summarizes all relevant information to aid the physical therapist's patient management and how ICF-based documentation tools for multidisciplinary care complement one another and thus can be used to enhance multidisciplinary patient management. In addition, the ICF assists in clarifying clinician roles as part of a multidisciplinary team. The case report demonstrates that the ICF can be a viable framework both for physical therapy and multidisciplinary management and for clinical documentation.

scholarly journals Physical Therapy Intervention for People With Huntington Disease

2008 ◽  
Vol 88 (7) ◽  
pp. 820-831 ◽  
Author(s):  
Monica E Busse ◽  
Hanan Khalil ◽  
Lori Quinn ◽  
Anne E Rosser
Keyword(s):  
Physical Therapy ◽  
Huntington Disease ◽  
Clinical Decision Making ◽  
Clinical Symptoms ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Clinical Care ◽  
Future Research ◽  
Therapy Intervention ◽  
Physical Therapy Intervention

Background and PurposeThe clinical symptoms of Huntington disease (HD) include progressive movement disorders, cognitive deficits, and behavioral changes, all of which affect an individual's ability to participate in activities of daily living. To date, very few quantitative or qualitative studies have been conducted to guide physical therapists working with people with HD. The objective of this study was to characterize current physical therapist practice for people with HD, thus informing the development of standardized clinical care and future research studies.Subjects and MethodsConsultation with physical therapists working with people with HD was undertaken in the form of mailed questionnaires (n=49) and semistructured interviews (n=8). The development of the interview schedule was aided by consideration of the data obtained from the questionnaires. Themes identified from the interviews were considered in light of published literature and questionnaire responses.ResultsThe main issues that emerged from the interviews were classified into 3 subthemes: (1) there is insufficient use of routine physical therapy–related outcome measures at different stages of HD, (2) there is underutilization of physical therapy services in managing HD (particularly in the early stages), and (3) the management of falls and mobility deficit progression is a key treatment aim for people with HD.Discussion and ConclusionA conceptual framework for physical therapy intervention in HD was developed on the basis of the themes that emerged from the data in this study. Such a framework has utility for complex, progressive conditions such as HD and may facilitate clinical decision making and standardization of practice and affect the development of future physical therapy trials.

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