- #Icd 10 imuscle sprain mid thoracic back manual
- #Icd 10 imuscle sprain mid thoracic back professional
27, 28 This suggests a natural sequencing for the progression of treatment interventions throughout the episode of care. As physical therapists we understand that mobility, stability, mobility on stability, and skill are motor task requirements of all functional movements. One approach to developing a physical therapy treatment plan is to incorporate our understanding of motor task requirements of functional movement into the clinical reasoning process for treatment planning. It encourages physical therapists, as experts of the movement system, to design treatment plans that ultimately assist patients in returning to their desired level of pain-free function and skill. The American Physical Therapy Association (APTA) has recently proposed a new mission statement centered around the human movement system, 25, 26 that facilitates the expansion of an approach that guides the sequencing of interventions during patient management. In order for clinicians to provide effective management strategies throughout the episode of care, the clinical reasoning paradigm must shift its focus from differential diagnosis to treatment planning.
#Icd 10 imuscle sprain mid thoracic back manual
24 An assumed understanding among clinicians that interventions progress from manual therapy, to neuromuscular re-education, to therapeutic exercise fails to take into account the complex procedural reasoning strategies necessary for the development of an appropriate treatment plan. However, the majority, if not all identified clinical reasoning approaches are strongly concentrated on the examination and differential diagnosis process.
#Icd 10 imuscle sprain mid thoracic back professional
A thorough treatment plan must be based on a sound clinical reasoning framework that goes beyond mobility issues to address all aspects of the movement system.Ībbreviations: AROM, active range of motion PIVM, passive intervertebral motion ULND, upper limb neurodynamic.Ĭlinical reasoning has most recently been defined as “a reflective process of inquiry and analysis carried out by a health professional in collaboration with a patient with the aim of understanding the patient, their context, and their clinical problem in order to guide evidence-based practice.” 23 Several clinical reasoning approaches-including the most frequently considered models: deductive reasoning (hypothetico-deductive model) and inductive reasoning (pattern recognition) 24-have been thoroughly discussed in the literature and are commonly implemented in clinic practice. 22 However, while this impairment-based classification system is a good first step in the clinical management of individuals with primary complaints of thoracic pain, it does not provide the clinician with a comprehensive plan of care. An alternative method for diagnosis is through the implementation of Olson's impairment-based classification system, 22 which breaks down thoracic disorders into several categories based on examination findings and provides suggestions for treatment interventions ( Table 1). Moreover, pathoanatomical diagnoses do not necessarily provide clinicians with relevant information in the clinical decision making process for treatment planning. Similar to the cervical and lumbar spine, it often is not feasible to identify pathoanatomical diagnoses as a specific cause of pain in the thoracic spine. 17- 21 However, optimal interventions for the management of primary thoracic pain have yet to be determined. 6- 16 Previous authors of low-level evidence have suggested a combination of manual therapy and exercise in the treatment of individuals with thoracic spine pain. 5 While specific mechanisms for the benefits of manual therapy remain unclear, substantial evidence suggests that manual therapy interventions directed at the thoracic spine can lead to a decrease in pain and improvement in function in the thoracic spine and adjacent regions. 4 As a result of the anatomical proximity of the thoracic spine to the cervical, lumbar, and shoulder regions, dysfunction in the thoracic spine and/or rib cage can influence pain, mobility, and stability in these areas.
2, 3 The point prevalence for thoracic spine pain in the adult working population ranges from 3% to 70% with 10% to 38% for one-month prevalence, 13% to 39% for three-month prevalence, and 25% to 55% for one-year prevalence. While primary thoracic pain has been cited as occurring less frequently than neck or low back pain, 1 it can be equally disabling.
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