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Picture

What do you consider a successful treatment? 

12/9/2012

3 Comments

 
Picture
This post come to us from in touch physical therapy blog. The author highlights 3 important components of every successful treatment session. 

1) Decrease the patients pain or symptoms rating.
He says a clinically meaningful change in pain is 2 points (for example changing pain from a 7/10 to a 5/10). It is also important to consider the pain during movement, and not while the patient is at rest. 
2) Patient understands how to manage their symptoms
One of our teachers consistently told us in class, "Your manual skills and treatment sessions are only as good as your home exercise program." She is correct. It is great if we can reduce the patient's pain, but if the patient cannot sustain that reduction in symptoms, what good have we really done? Providing good education and a strong home exercise is crucial to the patient's success. 
3) Know that the patient's time and money was well spent
A happy patient will hopefully be a compliant patient. It is important to remember that the patient is choosing to come see you. Many of them have high co-pays as well. As therapists we need to respect their time and money. Go above and beyond for them, and I am sure you will see positive results. 

3 Comments
Eric Lehman
12/9/2012 11:40:48 pm

Great post! I love keeping up with the posts on this site and I think this is an extremely important aspect to consider.

Was this episode of care meaningful to my patient? I like what you say above, decreasing pain is always a good thing and self-management is absolutely key.

One outcome that I love to use with patients is the "patient-specifc functional scale."

http://www.tac.vic.gov.au/media/upload/patient-specific.pdf

Above just the reduction in pain, have you considered from the beginning what the patient is not able to do due to the present condition, that he or she MOST desires to get back to.

If at a follow-up visit your patient says he is able to do what he wants to do again, what better outcome is there? I think pain is good to get rid of but I often find myself asking my patients "have you noticed over the past week that you are able to (insert functional activity) that you were not able to do when you first started?" Even if it was able to initiate the activity without onset of symptom, or walk for 5 minutes before onset instead of 3, I focus on functional gain. I tend to not ask, "what's your pain 0-10 today?"

Let me know your thoughts on this scale. Have you used it before? I find myself using it rather informally, without the actually sheet in front of me. Regardless, I think the idea behind it has huge implications.

Guys, keep up the awesome work. I really enjoy your posts and particularly think this post carries significant meaning.

Thanks!!

Eric Lehman

Reply
Jim Heafner
12/10/2012 05:05:11 am

Hey Eric,
No I have not seen that scale before, but I am definitely going to implement it on my next clinical rotation. I agree with what you said as well. From what I have seen thus far, as a profession we are much too focused on pain. Pain is a natural occurrence to any unpleasant sensory or emotional stimuli. We will not be able completely get rid of every patient's pain, so objectifying pain as the sole determinant of a successful treatment would be foolish. Unfortunately Medicare still heavily focuses on the numeric value as an outcome measure. While the VAS may be an important component psychologically, I agree that we should not discredit functional gains.

Thanks for your input,

Jim

Reply
medicare education link
2/3/2013 05:32:59 pm

On average, Medicare covers about 48 percent of health care costs for enrollees, and the enrollee must then cover the rest of the costs.

Reply



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  • Home
  • About Us
  • Insider Access
    • About Insider Access
  • Online Courses
    • Hooper's Knee
    • Physical Therapist Entrepreneur Course
    • Physical Therapist Consultant Course
    • Orthopedic Management of the Cervical Spine
    • Return to Sport Essentials Course
  • Resources
    • Newsletter
    • Business Minded Sports Physio Podcast
    • Day in the Life of a Sports PT
    • Residency Corner
    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test