Autumn 2017 - Joint dysfunction

Contents

Finding spinal 'dysfunction' : frailties of testing, the tester or the test? Is it time to reframe our desctiptions?

This paper explores the relevancy of manual testing in the spine and how this may contribute to the notion of “dysfunction”. It looks critically at positional palpation, motion testing, and pain provocation. Clinical reasoning and how this the can be applied to the patients barriers to recovery is highlighted with reference to a model that attempts to capture a sensible, clinical, critical approach to the choice of testing enabling clinicians to generate clear rational decisions in the use of spinal testing

Neil Langridge 

Read Neil's article here.

 

Patellofemoral pain: evidence-based updates on rehabilitation of patellofemoral joint dysfunction

Patellofemoral pain, typically presenting as diffuse anterior knee pain aggravated by activities that load the patellofemoral joint, is common in active individuals across their lifespan. Patellofemoral pain is unlikely to spontaneously recover. Best available evidence suggests that patellofemoral pain and patellofemoral osteoarthritis exist on a continuum and are often a sequel to acute knee trauma, such as anterior cruciate ligament injury. Exercise-therapy is the cornerstone of patellofemoral pain management, with the greatest evidence for graduated hip and quadriceps focused muscle strengthening. Tailored education on symptoms and management of exercise loads should also be a primary component of patellofemoral pain rehabilitation

Kay M Crossley, Adam G Culvenor & Christian Barton

Joint dysfunction related to Rheumatoid Arthritis

Rheumatoid Arthritis (RA) can have a seriously deleterious effect on joint function and, while medical advances have made good strides in improving function and quality of life over the long term, for people diagnosed management of these dysfunctions remains a necessity. Physiotherapists can play a pivotal role in providing education and interventions to manage joint dysfunction as part of the multidisciplinary team

Jack March

On the road to embracing endogenous pain modulation systems

It is imperative for private practice practitioners to be able to demonstrate the ability to deliver high quality interventions and excellent clinical outcomes to internal and external stakeholders. The vehicle to do this for the private practitioner is via the Data for Impact tool which is run in conjunction with the University of Brighton. The inputted data is independently analysed and once certain benchmarks are achieved the practitioner is awarded the Quality Assured Practitioner status. This article will help guide practitioners on how to enhance their clinical outcomes by educating them on how to harness the potential of the placebo effect in everyday clinic, as well as highlighting the complexity of the placebo effect and empowering practitioners to defend its use to peers, purchasers of their service and the public. The improved clinical outcomes will not only raise the practitioner’s individual standing, but also that of the whole QAP scheme to demonstrate through data the efficacy of the physiotherapy profession

Tobias Bremer

Cartilage - can it repair?

Cartilage is a connective tissue made up of specialised cells called chondrocytes which produce an extracellular matrix of collagen fibres, proteoglycan, and elastin fibres. This article focuses on joint cartilage, specifically in the knee. It will discuss how damaged cartilage affects pain and the latest research into cartilage repair.

Nicky Snazell

Quality, quality assurance, and quality assured practitioners

The need for consumers to differentiate competing products on the grounds of quality has been around since ancient times and, over the centuries various bodies have been formed with the aim of ensuring consumer confidence in the quality of the goods and services being traded. The goal of standardising the measurable quality of healthcare also has historical precedence and, in more recent times, the requirement for continuing medical education that has now evolved to continuing professional development, is recognised by healthcare professionals as an essential part of enhancing and maintaining their quality of practice. Physio First has continually expanded on this national requirement by championing evidence-based practice, initially through encouraging members to participate in data collection, and most recently in the option, through the analysis of this collected data, of obtaining the status of Quality Assured Practitioner (QAP)

George WJ Olivier, Liz Bryant & Shemane Murtagh

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