Decision Making for a Painful Hip: A Case Requiring Referral

Browder, David A.; Erhard, Richard E.

doi:10.2519/jospt.2005.35.11.738

Cited by 11 publications

(3 citation statements)

References 31 publications

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“…PTs have recognized skills in treating musculoskeletal conditions which generally present as ATS Categories 4 or 5, including differential diagnosis of non-musculoskeletal conditions that may “masquerade” as musculoskeletal conditions (for instance deep vein thrombosis or referred visceral pain). 26 – 28 …”

Section: Introductionmentioning

confidence: 99%

Evaluation of performance quality of an advanced scope physiotherapy role in a hospital emergency department

Morris¹,

Vine²,

Grimmer³

2015

PROM

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BackgroundPhysiotherapists working in advanced and extended scope roles internationally make a difference to workflow, performance targets, and patient satisfaction in areas traditionally served by medicine and nursing.AimTo assess the impact of an advanced scope of practice physiotherapist (ASoP-PT) service in a large Australian hospital emergency department (ED) by measuring national service and triage category indicators, patient and staff satisfaction.MethodsConsecutive patients consulting the ASoP-PT were recruited over 53 weeks following service inception. Descriptions of ASoP-PT activities and patients were collected. Performance was assessed against national ED indicators for length of stay and wait. Patient and staff perspectives were assessed independently by semi-structured interviews. The physiotherapist was formally trained to extended scope of practice including competency in medicines, prescription and application. The legislation prevented him from applying these skills, therefore he worked in an ASoP-PT role in ED.ResultsThe ASoP-PT treated on average, 72 patients per month in ten shifts per fortnight, consulting patients aged from 1 to 88 years. Patients largely presented with musculoskeletal problems in triage Categories 4 and 5. There were shorter length of wait and length of stay, when the ASoP-PT was on shift. However overall compliance with national performance targets was similar with and without the ASoP-PT. Staff and patient satisfaction was high, particularly valuing the ASoP-PT’s expertise in musculoskeletal injuries.ConclusionThe ASoP-PT performed at least as well as other ED health care providers in meeting national triage targets. Had the legislation permitted his independent prescription of medicines, the ASoP-PT could have worked in an extended scope role, and his performance in meeting targets may have been better.

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Section: Introductionmentioning

confidence: 99%

Evaluation of performance quality of an advanced scope physiotherapy role in a hospital emergency department

Morris¹,

Vine²,

Grimmer³

2015

PROM

View full text Add to dashboard Cite

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“…Additional diagnostic laboratory or imaging may be necessary to determine the exact cause of symptoms. 10,74 …”

Section: Summary Of Study Findings Characteristics Of Subjectsmentioning

confidence: 99%

Acetabular Labral Tears of the Hip: Examination and Diagnostic Challenges

Martin¹,

Enseki²,

Draovitch³

et al. 2006

J Orthop Sports Phys Ther

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The purpose of this clinical commentary is to provide an evidence-based review of the examination process and diagnostic challenges associated with acetabular labral tears of the hip. Once considered an uncommon entity, labral tears have recently received wider recognition as a source of symptoms and functional limitation. Information regarding acetabular labral tears and their association to capsular laxity, femoral acetabular impingement (FAI), dysplasia of the acetabulum, and chondral lesions is emerging. Physical therapists should understand the anatomical structures of the hip and recognize how the clinical presentation of labral tears is difficult to view isolated from other hip articular pathologies. Clinical examination should consider lumbopelvic and extra-articular pathologies in addition to intra-articular pathologies when assessing for the source of symptoms and functional limitation. If a labral tear is suspected, further diagnostic testing may be indicated. Although up-and-coming evidence suggests that information obtained from patient history and clinical examination can be useful, continued research is warranted to determine the diagnostic accuracy of our examination techniques.

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“…Deviations from normal hip and pelvic motion were recorded individually, with attention to a visible Trendelenburg sign, antalgic gait, or an altered step length. 9,66 Outcome Measures PROM, numeric pain rating score (NPRS), and a measure of disability (HHS) was collected at baseline. PROM and pain scores were included because these factors have been shown to be significantly associated with the disability experienced by those with hip OA.…”

Section: Examinationmentioning

confidence: 99%

Clinical Outcomes Following Manual Physical Therapy and Exercise for Hip Osteoarthritis: A Case Series

MacDonald¹,

Whitman²,

Cleland³

et al. 2006

J Orthop Sports Phys Ther

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Study Design: Case series describing the outcomes of individual patients with hip osteoarthritis treated with manual physical therapy and exercise. Case Description: Seven patients referred to physical therapy with hip osteoarthritis and/or hip pain were included in this case series. All patients were treated with manual physical therapy followed by exercises to maximize strength and range of motion. Six of 7 patients completed a Harris Hip Score at initial examination and discharge from physical therapy, and 1 patient completed a Global Rating of Change Scale at discharge. Outcomes: Three males and 4 females with a median age of 62 years (range, 52-80 years) and median duration of symptoms of 9 months (range, 2-60 months) participated in this case series. The median number of physical therapy sessions attended was 5 (range, 4-12). The median increase in total passive range of motion of the hip was 82°(range, 70°-86°). The median improvement on the Harris Hip Score was 25 points (range, 15-38 points). The single patient who completed the Global Rating of Change Scale at discharge reported being ''a great deal better.'' Numeric pain rating scores decreased by a mean of 5 points (range, 2-7 points) on 0-to-10-point scale. Discussion: All patients exhibited reductions in pain and increases in passive range of motion, as well as a clinically meaningful improvement in function. Although we cannot infer a cause and effect relationship from a case series, the outcomes with these patients are similar to others reported in the literature that have demonstrated superior clinical outcomes associated with manual physical therapy and exercise for hip osteoarthritis compared to exercise alone.

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Decision Making for a Painful Hip: A Case Requiring Referral

Cited by 11 publications

References 31 publications

Evaluation of performance quality of an advanced scope physiotherapy role in a hospital emergency department

Evaluation of performance quality of an advanced scope physiotherapy role in a hospital emergency department

Acetabular Labral Tears of the Hip: Examination and Diagnostic Challenges

Clinical Outcomes Following Manual Physical Therapy and Exercise for Hip Osteoarthritis: A Case Series

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