Evidence and Interview of the Patient with Osteoarthritis of the Knee

Presented by Gail Deyle

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Why the focus on treating osteoarthritis of the knee? Osteoarthritis (OA) is one of the most rapidly growing conditions worldwide with knee osteoarthritis (knee OA) being one of the most prevalent forms. Patients with knee OA have a wide variety of presentations making it a disorder that is best addressed with strong clinical reasoning and high differential diagnosis skills. Despite a compelling body of literature for physical therapy directed exercise programs and growing evidence that manual therapy combined with exercise increases the level of symptom relief and functional benefit, most patients do not receive physical therapy treatment prior to total joint replacement. There is also a concerning lack of consistency in physical therapy treatment approaches with many physical therapists still reaching for their favorite modalities.

This course will help the learner make accurate judgments on the patient with knee OA's likely tolerance for examination and treatment while identifying key impairments to strength, range of motion, flexibility, gait, and balance that can be addressed with manual therapy and exercise. This clinical reasoning-based process facilitates highly focused treatment strategies that are typically well tolerated by the patient.

Although patients with knee OA can be challenging to treat, focusing on the concepts presented in this course will enhance your ability to provide well-tolerated treatment strategies that are consistent with the best research evidence, and that consistently produce highly satisfying outcomes for both the patient and the treating physical therapist.

Meet your instructor

Gail Deyle

Gail Deyle is a Professor with Baylor University Graduate School and the founder and senior faculty member of the Army-Baylor University Doctoral Fellowship in Orthopaedic Manual Physical Therapy, located at Brooke Army Medical Center in San Antonio, Texas. He is an internationally recognized expert, frequent national…

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Chapters & learning objectives

Physical Therapy Evidence for Patients with Knee OA

1. Physical Therapy Evidence for Patients with Knee OA

In this chapter, Dr. Deyle presents the current evidence for physical therapy interventions for knee OA. He also compares and contrasts the risk to benefit of physical therapy strategies to other treatment options for this disorder and highlights the percentage of patients who receive physical therapy versus other treatments.

Comparative Risk to Benefit and Relative Medical Utilization of Physical Therapy Versus Other Treatment Options

2. Comparative Risk to Benefit and Relative Medical Utilization of Physical Therapy Versus Other Treatment Options

This chapter provides perspective with respect to the associated risk and relative benefit of physical therapy interventions for the patient with knee OA. This chapter also provides insight into overall health care system utilization of physical therapy services for knee OA.

The Knee OA Patient Interview Part 1: Determining The Profile, Symptom Map, and the Reason For Seeking Physical Therapy Consultation

3. The Knee OA Patient Interview Part 1: Determining The Profile, Symptom Map, and the Reason For Seeking Physical Therapy Consultation

This chapter covers how to conduct the initial part of the patient interview, which is the basis for early hypothesis formation. It is essential to accurately determine the location, quality, severity and intensity of symptoms at the knee and in areas that could be related to the knee. This information must be carefully documented onto a body chart or symptom map which then serves as an important part of the baseline from which to plan the examination and to ultimately determine change with intervention. The early interview determines the patient’s typical activities and the impact their symptoms is having on their life. The early interview should also very carefully determine goals and expectations for seeking physical therapy consultation.

The Knee OA Patient Interview Part 2: Behavior of symptoms, Current and Previous History

4. The Knee OA Patient Interview Part 2: Behavior of symptoms, Current and Previous History

This chapter covers how to conduct the second part of the interview testing initial hypotheses by determining symptom behavior over the course of the typical day and with typical activities. It also covers how to obtain relevant details of the current episode of care as well as previous episodes of care while integrating relevant health screening.