Nov 2, 2012

Top 5 Fridays! 5 Reasons Why History Matters


Robin McKenzie's wisdom tells us that we should listen to the patient, because they have the answer. Here are 5 Reasons Why History Matters.



1) Patients tell you what makes them better and what makes them worse
  • this often leads to telling you what the directional preference of movement may be
  • in turn, it tells you what movements or positions they should avoid
2) The Sx behavior
  • Sx behavior lets you set goals
  • A patient may not thing they have improved, thus perpetuating anxiety about their condition
  • further history taking on follow up should lead you to ask about Sx frequency and duration
    • the patient often states it does not last as long, or it is happening less or both
    • they then realize they have improved and do not focus on the intensity as much
3) The Sx location
  • peripheralization and centralization
  • centralization was recently found again in a meta-analysis to be predictive of successful outcomes
  • the patient may think their back feels better, but their foot Sx are worse, that is not indicative of progression if nothing actually happened to the distal part
4) Older injuries/surgeries they forgot to mention
  • Check this case for an example of this
  • it's not mandatory you look that far away, unless the patient is 
    • not getting better or plateauing
    • keeps coming back with recurrent injuries
5) Red flags
  • always remember to ask for red flags
  • anything resembling Stoddard's warning signs
  • don't only ask for "loss" of bowel and bladder, patient's do not think of frequency or urgency of issues
I hope everyone has a great weekend! I'll be on my way to far off London, ON for my first international course!

1 comment:

Alison Cupini McLean said...

So important!! In fact I keep up with the history during every tx, as part of the Reass... It's amazing if something is not clearing up the way you thought, what comes out in a patient's history past or current, that is effecting the outcome.

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