REE PCE Clinical Practice and Patient Management Flashcards

What is the first step in assessing a patient with a suspected musculoskeletal injury?

Answer: Taking a detailed patient history

Before any physical assessment, gathering a detailed patient history is the crucial first step. This involves asking about the mechanism of injury, onset of symptoms, pain characteristics, aggravating/alleviating factors, past medical history, and functional limitations. This information guides the physiotherapist in forming a hypothesis, identifying red flags, and tailoring the subsequent physical examination.

Which treatment is most appropriate for a patient with acute low back pain?

Answer: Application of cold packs and staying active

For acute low back pain, current evidence-based guidelines recommend staying active and avoiding prolonged bed rest, as inactivity can worsen symptoms and delay recovery. Applying cold packs can help reduce inflammation and pain in the initial acute phase. A combination of gentle activity, pain management, and education is generally the most effective approach.

What is the goal of gait training in a post-stroke patient?

Answer: Restore functional walking ability

Gait training for a post-stroke patient focuses on re-educating the nervous system and muscles to achieve a safe, efficient, and independent walking pattern. This involves addressing issues like balance, coordination, strength, and spasticity that impact their ability to walk. The ultimate goal is to improve mobility and enable the patient to participate in daily activities.

What is the most appropriate action for a patient with signs of deep vein thrombosis (DVT)?

Answer: Refer the patient for immediate medical evaluation

Deep vein thrombosis (DVT) is a serious medical condition where a blood clot forms in a deep vein, often in the leg. If suspected, a physiotherapist must immediately refer the patient for medical evaluation, as DVT can lead to life-threatening pulmonary embolism. Physical activity or massage could dislodge the clot, making prompt medical diagnosis and treatment essential.

What is the main focus of rehabilitation for a patient recovering from a total hip replacement?

Answer: Avoiding hip dislocation while restoring mobility

After a total hip replacement, the primary focus of rehabilitation is to restore mobility and strength while strictly adhering to hip precautions to prevent dislocation of the new joint. Physiotherapists guide patients through exercises that strengthen surrounding muscles and educate them on movements to avoid, such as extreme flexion, adduction, and internal rotation, depending on the surgical approach. This balance ensures safe recovery and optimal function.

Which exercise is most appropriate for a patient with weak quadriceps muscles?

Answer: Straight leg raises

Straight leg raises are an effective exercise for strengthening the quadriceps muscles, particularly the vastus medialis obliquus, without placing excessive stress on the knee joint. This exercise involves lifting the leg straight up while keeping the knee extended, directly engaging the quadriceps. It is often used in early rehabilitation stages when full weight-bearing or deep knee flexion is contraindicated.