California Physical Therapy Ebook Continuing Education

Nouri, A., Cheng, J. S., Davies, B., Kotter, M., Schaller, K., & Tessitore, E. (2020). Degenerative cervical myelopathy: A brief review of past perspectives, present developments, and future directions. Journal of Clinical Medicine , 9 (2), 535. https:// doi.org/10.3390/jcm9020535 Nouri, A., Tessitore, E., Molliqaj, G., Meling, T., Schaller, K., Nakashima, H., Yukawa, Y., Bednarik, J., Martin, A. R., Vajkoczy, P., Cheng, J. S., Kwon, B. K., Kurpad, S. N., Fehlings, M. G., Harrop, J. S., Aarabi, B., Rahimi-Movaghar, V., Guest, J. D., Davies, B. M., Kotter, M., … Wilson, J. R. (2022). Degenerative cervical myelopathy: Development and natural history (AO Spine RECODE-DCM Research Priority Number 2). Global Spine ournal , 12 (1Suppl), 39S-54S. https://doi. org/10.1177/21925682211036071 Obesity and Heart Disease: What You Should Know . (n.d.). 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The Medical Clinics of North America , 105 (1), 175-186. https://doi.org/10.1016/j.mcna.2020.08.019 Perez-Fernandez, T., Armijo-Olivo, S., Liébana, S., de la Torre Ortíz, P. J., Fernández-Carnero, J., Raya, R., & Martín-Pintado- Zugasti, A. (2020). A novel use of inertial sensors to measure the craniocervical flexion range of motion associated to the craniocervical flexion test: An observational study. Journal of Neuroengineering and Rehabilitation , 17 (1), 152. https://doi. org/10.1186/s12984-020-00784-1 Perry, J. J., Sivilotti, M., Sutherland, J., Hohl, C. M., Émond, M., Calder, L. A., Vaillancourt, C., Thirganasambandamoorthy, V., Lesiuk, H., Wells, G. A., & Stiell, I. G. (2017). Validation of the Ottawa Subarachnoid Hemorrhage Rule in patients with acute headache. CMAJ: Canadian Medical Association Journal (journal de l’Association medicale Canadienne) , 189 (45), E1379-E1385. https://doi.org/10.1503/cmaj.170072 Pluta RM, Lynm C, Golub RM. Tension-Type Headache. 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The Journal of Manual & Manipulative Therapy , 21 (2), 113-124. https://doi.org/10.1179/2042618612Y.0000000025 Radhakrishnan, K., Litchy, W. J., O’Fallon, W. M., & Kurland, L. T. (1994). Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain: A Journal of Neurology , 117 (Pt 2), 325-335. https://doi.org/10.1093/brain/117.2.325 Rahman, S., & M Das, J. (2021). Anatomy: Head and neck, cervical spine. StatPearls . StatPearls Publishing. Raney, N. H., Petersen, E. J., Smith, T. A., Cowan, J. E., Rendeiro, D. G., Deyle, G. D., & Childs, J. D. (2009). Development of a clinical prediction rule to identify patients with neck pain likely to benefit from cervical traction and exercise. European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society , 18 (3), 382-391. https://doi.org/10.1007/s00586-008-0859-7 Range of Motion . (n.d.-b). Physiopedia. https://www.physio-pedia.com/Range_of_Motion Robins, H., Perron, V., Heathcote, L. C., & Simons, L. E. (2016). Pain neuroscience education: State of the art and application in pediatrics. Children (Basel, Switzerland) , 3 (4), 43. https://doi.org/10.3390/children3040043 Samartzis, D., Gillis, C. C., Shih, P., O'Toole, J. E., & Fessler, R. G. (2015). Intramedullary spinal cord tumors: Part I. Epidemiology, pathophysiology, and diagnosis. Global Spine Journal , 5 (5), 425-435. https://doi. org/10.1055/s-0035-1549029 Sav, M. Y., Sav, T., Senocak, E., & Sav, N. M. (2014). Hemodialysis-related headache. Hemodialysis International: International Symposium on Home Hemodialysis , 18 (4), 725-729. https://doi.org/10.1111/hdi.12171 Schimmel, K., Ali, M. K., Tan, S. Y., Teng, J., Do, H. M., Steinberg, G. K., Stevenson, D. A., & Spiekerkoetter, E. (2021). Arteriovenous malformations: Current understanding of the pathogenesis with implications for treatment. International Journal of Molecular Sciences , 22 (16), 9037. https://doi.org/10.3390/ijms22169037 Shreffler, J., & Huecker, M. R. (2022). Diagnostic testing accuracy: Sensitivity, specificity, predictive values and likelihood ratios. StatPearls . StatPearls Publishing. Side Effects of Radiation Therapy | Radiation Effects on Body . (n.d.). https://www.cancer.org/treatment/treatments-and- side-effects/treatment-types/radiation/effects-on-different-parts-of-body.html Silver, N. (2022, October 17). Does Sugar Cause Headaches? Healthline. https://www.healthline.com/health/headache/ sugar-headache Siracusa, R., Paola, R. 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Evidence-Based Nursing , 23 (1), 2-4. https:// doi.org/10.1136/ebnurs-2019-103225 Symptoms . (2018, August 1). Stanford Health Care. https://stanfordhealthcare.org/medical-conditions/blood-heart- circulation/abdominal-aortic-aneurysm/symptoms.html Tadros, A., Sharon, M., Craig, K., & Krantz, W. (2019). Characteristics and management of emergency department patients presenting with C2 cervical spine fractures. BioMed Research International , 2019 , 4301051. https://doi. org/10.1155/2019/4301051 Taso, M., Sommernes, J. H., Kolstad, F., Sundseth, J., Bjorland, S., Pripp, A. H., Zwart, J. A., & Brox, J. I. (2020). A randomised controlled trial comparing the effectiveness of surgical and nonsurgical treatment for cervical radiculopathy. BMC musculoskeletal Disorders , 21 (1), 171. https://doi.org/10.1186/s12891-020-3188-M Taylor, A., Mourad, F., Kerry, R., & Hutting, N. (2021). A guide to cranial nerve testing for musculoskeletal clinicians. 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Cureus , 13 (8), e17601. https://doi. org/10.7759/cureus.17601 Vandenbussche, N., Laterza, D., Lisicki, M., Lloyd, J., Lupi, C., Tischler, H., Toom, K., Vandervorst, F., Quintana, S., Paemeleire, K., & Katsarava, Z. (2018). Medication-overuse headache: A widely recognized entity amidst ongoing debate. The Journal of Headache and Pain , 19 (1), 50. https://doi.org/10.1186/s10194-018-0875-x Verma, S., Tripathi, M., & Chandra, P. S. (2021). Cervicogenic headache: Current perspectives. Neurology India , 69 (Supplement), S194-S198. https://doi.org/10.4103/0028-3886.315992 Villa-Forte A. (2011). Giant cell arteritis: Suspect it, treat it promptly. Cleveland Clinic Journal of Medicine , 78 (4), 265-270. https://doi.org/10.3949/ccjm.78a.10131 Vollesen, A. L., Benemei, S., Cortese, F., Labastida-Ramírez, A., Marchese, F., Pellesi, L., Romoli, M., Ashina, M., Lampl, C., & School of Advanced Studies of the European Headache Federation (EHF-SAS). (2018). 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DIFFERENTIAL DIAGNOSIS FOR HEADACHES AND CERVICAL SPINE PAIN Self-Assessment Answers and Rationales

1. The correct answer is A. Rationale: Only 1% of physical therapy cases are estimated to present as musculoskeletal injuries even though they originate from systemic or viscerogenic issues. Although this is a small per- centage, differential diagnosis to identify viscerogenic and sys- temic issues is critical to effectively evaluating physical therapy clients. 2. The correct answer is D. Rationale: Many patients with musculoskeletal injuries present with maladaptive pain coping strategies. It is not uncommon for clients to believe that their pain is a direct consequence of pro- portional tissue damage and to not understand the influence of maladaptive strategies such as catastrophizing. It is within the realm of physical therapy practice to recognize these maladaptive strategies and to provide pain neuroscience education to help the client understan d how these strategies are contributing to their pain experience. 3. The correct answer is B. Rationale: Conditions related to musculoskeletal dysfunction are almost always indicated by a change in activity or a change in position. In addition, night pain is always considered a red flag, as typically rest relieves musculoskeletal pain. Finally, sharp, knifelike pain is not often associated with musculoskeletal conditions. 4. The correct answer is A. Rationale: Night pain is considered a red flag for the possibility of both tumor and infection. As such, when night pain is present, further medical investigation and possible referral to a physician are indicated. 5. The correct answer is D. Rationale: Sensitivity is the ability of a test to correctly identify patients who have a disease or a condition. In this case, 43 of the 100 patients who actually had the disease tested positive, so the test has a sensitivity of 43%. By contrast, the second test was able to correctly identify 96% of those who did not have a disease, so the specificity of that test is 96%. 6. The correct answer is A. Rationale: Headaches that occur 15 or more times per month over a period of three months are considered chronic.

7. The correct answer is C. Rationale: Cervicogenic headaches originate from dysfunction in the upper cervical spine, including impaired muscle function and joint motion issues. These are problems that physical therapists can address and, as such, physical therapists are often effective in Rationale: Primary headaches arise from overactivity or problems with pain structures within the cranium or upper cervical spine. Primary headaches include migraine, tension-type, and cervico- genic. Secondary headaches are considered symptoms of an un- derlying disorder. Headaches that arise from a brain abscess are considered secondary headaches. 9. The correct answer is C. Rationale: Metastases to the brain are highest with lung cancer, breast cancer, and malignant melanoma. Although metastases to the brain are rare—less than 0.1%—when the patient’s history in- cludes one of these types of cancer, the physical therapist should consider whether the source of the headache pain might be can- cer metastases. 10. The correct answer is B. treating cervicogenic headaches. 8. The correct answer is A. Rationale: Headaches related to COVID-19 have been descried as moderate to severe, bilateral, with a pressing or pulsating quality. 11. The correct answer is D. Rationale: Rapid onset of severe headache is always cause for concern. According to the Ottawa Subarachnoid Hemorrhage Rule, headache related to subarachnoid hemorrhage should be suspected with age 40 years or older, neck pain or stiffness, wit- nessed loss of consciousness, onset during exertion, sudden on- set of severe headache, and limited neck flexion on examination. This rule recommends further investigation if one or more of these conditions are present. High blood pressure is not included in the Ottawa Subarachnoid Hemorrhage Rule. 12. The correct answer is B. Rationale: The new onset of tension-type headaches is most com - mon in the 20s and is rare after age 50. Infection, medication overuse, and head and neck trauma have all been identified as frequent causes of headache in persons 50 years and older.

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