Academy of Orthopaedic Physical Therapy

American Physical Therapy Association (APTA)

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25.1 Orthopaedic Care In Auto Injury
Table of Contents

EVALUATION AND TREATMENT STRATEGIES FOR CARE OF THE INJURED CERVICAL AND UPPER THORACIC SPINE

Abstract:

CONTENT: This monograph that will enable physical therapists to appreciate the unique aspects involved in the evaluation and treatment of patients involved in motor vehicle accident trauma. With very little information specifically addressing this topic, the registrant will gain valuable insight into this challenging patient population. The monograph begins with a review the relationship between acceleration/deceleration trauma from a motor vehicle accident and cervical and thoracic spine injuries. The focus is on the structures involved (eg, bone soft tissue, neuromuscular tissue) and the clinical manifestations that may be present, otherwise known as Whiplash-Associated Disorders. Select tissue responses to crash kinematics are detailed with an emphasis on current research findings. An important section on central sensitization, or the hyperexcitability of central nociceptive pathways as a result of a motor vehicle accident is included. Strategies for treating cervical and upper thoracic spine injuries are then covered. The clinical decision making process is the focus, with specific applications to unique symptoms to be screened for in the MVA patient critical to the posttraumatic patient. Chronic pain management and the role of modalities, bracing, rest, and active rest are reviewed. Manual therapy, exercise, sensorimotor and dizziness treatments, and neuromuscular re-education and strengthening are cited as well. CASE ANALYSES: A “best practice” summary precludes two case studies. The first case involves a 34-year-old woman who complained of neck and thoracic pain and accompanying, suboccipital headaches following a rear-end accident 6 months post. The second case describes a 23-year-old male who complained of neck pain and occasional dizziness after being involved in a slow speed auto accident.

Keywords:​

auto injury, rehabilitation, physical therapy

References:​

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EVALUATION AND TREATMENT STRATEGIES FOR CARE OF THE INJURED LUMBAR SPINE AFTER A MOTOR VEHICLE ACCIDENT

Abstract:

CONTENT: Treatment for patients suffering from vehicle accident trauma remains elusive. This monograph is dedicated to the effective management of this patient population. The author first reviews clinical anatomy of the lumbar spine and also common injuries. The biopsychological approach to clinical management and consideration of the psychological factors are introduced along with proper examination of the patient following a motor vehicle accident. Critical components of the exam are highlighted including verbal communication, screening for red flags, and the role of radiological findings. Physical exam screening is discussed and supplemented with helpful video clips that can be accessed online. Specific exam portions also include assessment of the hip and thoracolumbar regions. Outcomes in relation to biomechanical findings are also covered in accordance with key findings. Treatments address parameters for designing interventions with novel topics on graded motor imagery, algorithmic-based therapy, and considerations for improving core motor control and neural mobility. Self-management strategies and manual therapy are also covered and functional progressions are reviewed. CASE ANALYSES: Two cases are discussed. The first case involves a 55-year-old male referred to physical therapy for examination and treatment after a motor vehicle accident. The second case describes a 32-year-old female with complaints of low back and posterior hip pain 6 months after being involved in a motor vehicle accident.

Keywords:​

sensors, robots, orthopaedic physical therapy

References:​

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MANAGEMENT OF AUTO INJURIES: LEGAL AND DOCUMENTATION PERSPECTIVES

Abstract:

CONTENT: This monograph prepares the physical therapist to effectively interact successfully and professionally with auto injury patients while safeguarding their legal positions and rights. Legal liabilities of the physical therapist in dealing with the auto-injured client are specifically covered. The author uses a case-based approach throughout the monograph to allow the user to readily apply legal concepts. A total of 6 cases are presented and accompanied by the author's suggested problem-solving guidance. This professional insight allows the reader to glean the important aspects of each case. A brief section on the varied requirements of workers' compensation systems across states is then reviewed. The final section of the monograph addresses legal aspects of auto accident patient-client care documentation. Specific topics in this section include risk management strategies, informed consent, and HIPAA and also special reimbursement issues. CASE ANALYSES: Six cases analyses are included. The first two cases address malpractice scenarios. The third case deals with patient allegations of sexual assault and battery. Case 4 discusses the topic of compliance with mandatory reporting requirements, specifically the issue of domestic abuse. Prior to presenting cases 5 and 6, Scott details the duties and responsibilities of physical therapists giving testimony as expert, party, and percipient witnesses.

Keywords:​

tort, physical therapy, risk management

References:​

Click here.

Orthopaedic Care in Auto Injury

This series addresses the unique aspects of evaluating and treating the patient following an automobile accident.

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