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.
This course series will help the learner make accurate judgments on the patient with knee OA, like 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.
This installment will help the learner take information derived from the patient interview and manual examination to plan and execute an appropriate and well-tolerated intervention. Participants will develop clinical reasoning strategies to plan, prioritize, and execute a well-tolerated manual physical therapy intervention. Specific topics covered include prescription of exercise to enforce manual treatment, employing maintenance or tune-up physical therapy sessions, and prescribing and fitting a stationary bicycle.
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 guideline panel member, and experienced researcher on physical therapy treatment for osteoarthritis of the knee. His earned professional degrees include a BSc from the University of Nebraska at Kearney, a Master of Physical Therapy from Baylor University, a Doctor of Physical Therapy from Creighton University, and a Doctor of Science in Physical Therapy from Andrews University. He is board certified in Orthopaedics and he is a Fellow of the American Academy of Orthopaedic Manual Physical Therapists. Dr. Deyle has received outstanding researcher awards from the Texas Physical Therapy Association, The American Academy of Orthopaedic Manual Physical Therapists, and the Geriatric Specialty Section. He has twice received the Rose Research Award from the Orthopaedic Specialty Section. He is the recipient of the Hartgraves Award for Teaching Excellence from Rocky Mountain University of Health Professions, and the Freddy Kaltenborn “Teach I must” and the Distinguished Lecturer Awards from the American Academy of Orthopadic Manual Physical Therapists. He has also received the Outstanding Alumni Award from the Army-Baylor Doctor of Physical Therapy Program Alumni Association. He continues to be actively involved with clinical practice and research, and teaching in numerous academic and clinical settings.
This chapter details how to utilize examination findings to plan, prioritize, and execute a likely to be well-tolerated intervention. This chapter includes demonstrations of techniques with a patient.
This chapter details how to utilize examination findings to plan, prioritize, and dose likely to be well-tolerated exercises to augment and reinforce manual therapy intervention.
The final chapter of this course details how to utilize stationary bike exercise as a low impact physical activity to initiate and sustain a variety of beneficial effects for the patient with knee OA. This chapter includes a video demonstration of bike fitting with a patient.