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121. Assessing Fitness to Drive

of Rehabilitation Medicinevi Assessing Fitness to Drive 2016 Acknowledgements Setting these standards involved extensive consultation across a wide range of stakeholders including regulators, employers and health professionals. The NTC and Austroads gratefully acknowledge all contributors including the members of the Maintenance Advisory Group and various working groups, and the project team and consultants. In particular, the contributions of various health professional organisations and individual health (...) conditions, progressive disorders and undifferentiated illness - the effects of prescription and over-the-counter drugs - the role of practical driver assessments and driver rehabilitation • the roles and responsibilities of drivers, licensing authorities and health professionals • what standards to apply (private or commercial) for particular driver classes • the application of conditional licences, and • the steps involved in assessing fitness to drive. Part B comprises a series of chapters relating

2016 Cardiac Society of Australia and New Zealand

122. Reducing Risk in Heart Disease

of the goals of treatment. All treatments should be personalised according to the patient’s prognosis, comorbidities, drug tolerance, lifestyle/living circumstances and wishes. • This guide can be used by health professionals across the continuum of CHD care, including in acute settings, general practice, primary care, cardiac rehabilitation, and community and allied health services. • General practitioners (GP) can use Chronic Disease Management (CDM) Medicare items to access rebates for planning (...) physical activity. • Incidental physical activity is also important to keep patients moving as often, and in as many ways, as possible. Encourage patients to sit less and move more throughout the day. • Refer patients to a cardiac rehabilitation program and/or an exercise physiologist where appropriate and available. • A structured rehabilitative physical activity program, supervised by qualified fitness personnel, should be considered. Examples include the Heart Foundation’s Heartmoves program

2012 Cardiac Society of Australia and New Zealand

123. Plantar fasciitis

around their foot, and pull it with the knees straight, causing dorsiflexion, and hold this position for 30 seconds. Repeat three times for each foot. Wall push-up or stretches for the Achilles tendon. Advise the person to place both hands (at shoulder height) on a wall, with staggered feet (one foot in front of the other). The front foot should be approximately 30 cm (12 inches) from the wall. With the front knee bent and the back knee straight, the person should lean towards the wall, until (...) . [ ] Foye,P.M. ( 2013 ) Physical medicine and rehabilitation for plantar fasciitis. eMedicine. Medscape. . [ ] Goff,J.D. and Crawford,R. ( 2011 ) Diagnosis and treatment of plantar fasciitis. American Family Physician. 84 ( 6 ), 676 - 682 . [ ] Hawke,F., Burns,J., Radford,J.A. and du Toit,V. ( 2008 ) Custom-made foot orthoses for the treatment of foot pain (Cochrane Review). The Cochrane Library. John Wiley & Sons, Ltd . [ ] Hyland,M.R., Webber-Gaffney,A., Cohen,L. and Lichtman,P.T. ( 2006 ) Randomized

2015 NICE Clinical Knowledge Summaries

124. Pre-conception - advice and management

. Macrosomia and shoulder dystocia. Preterm delivery. Birth trauma. Caesarean delivery. Postpartum complications (for example haemorrhage, thrombosis and infection). Stillbirth. Congenital anomalies (for example neural tube defects, cardiovascular anomalies, cleft palate, limb reduction, anorectal atresia, hydrocephaly). Advise and encourage women who are obese (BMI of 30 kg/m 2 or more) to lose weight before becoming pregnant. Women should be informed that losing 5–10% of their weight (a realistic target (...) as appropriate to a treatment centre or higher level care [ ] . The US Centers for Disease Control and Prevention also recommend, as part of a pre-conception risk assessment, referral to a programme providing abstinence support and rehabilitation for women using illicit substances [ ]. Offering contraceptive advice This recommendation is based on expert opinion in a factsheet from the Centers for Disease Control and Prevention on Preconception clinical care for women: Exposures which indicates the importance

2017 NICE Clinical Knowledge Summaries

125. Stroke and TIA

up should be arranged to optimize secondary prevention lifestyle and drug strategies. Have I got the right topic? Have I got the right topic? From age 16 years onwards. This CKS topic is largely based on the clinical guidelines Stroke rehabilitation in adults [ ] and National clinical guideline for stroke prepared by the Intercollegiate Stroke Working Party [ ]. This CKS topic covers the primary care assessment and management of adults presenting with suspected acute stroke or transient ischaemic (...) serious interaction between proton pump inhibitors and protease inhibitors (atazanavir and saquinavir) has also been added. Issued in January 2012. September 2011 — minor update. Text added to include recommendations from the Scottish Intercollegiate Guidelines Network national clinical guideline 119 Management of patients with stroke: identification and management of dysphagia and national clinical guideline 118 Management of patients with stroke: Rehabilitation, prevention and management

2017 NICE Clinical Knowledge Summaries

126. Carpal tunnel syndrome

or altered sensation and burning or pain in the distribution of the median nerve (the thumb, index finger, middle finger, and radial half of the ring finger). Symptoms are often worse at night and can disrupt sleep. Symptoms may affect one or both hands. Pain in the hand may radiate up the arm into the wrist or as far as the shoulder. The person may complain of loss of grip strength, clumsiness and reduced manual dexterity for example when doing up buttons. Some people may present atypically, for example (...) . Royal College of Physicians. . [ ] RCS ( 2013 ) Commissioning guide: Treatment of painful tingling fingers. Royal College of Surgeons . [ ] Wainner, R., Fritz, J., Irrgang, J. and et al. ( 2005 ) Development of a clinical prediction rule for the diagnosis of carpal tunnel syndrome. Archives of Physical Medicine and Rehabilitation. 86 ( 4 ), 609 - 618 . [ ] Washington State Department of Labour and Industries ( 2014 ) Work-Related Carpal Tunnel Syndrome Diagnosis and Treatment Guideline. Washington

2016 NICE Clinical Knowledge Summaries

128. Standardization of Spirometry

and recovery from exacerbations To monitor people for adverse effects of exposure to injurious agents To watch for adverse reactions to drugs with known pulmonary toxicity Disability/impairment evaluations To assess patients as part of a rehabilitation program To assess risks as part of an insurance evaluation To assess individuals for legal reasons Other Research and clinical trials Epidemiological surveys Derivation of reference equations Preemployment and lung health monitoring for at-risk occupations (...) ( ). Testing should preferably occur in a quiet and comfortable environment that is separated from the waiting room and other patients being tested. Drinking water should be available. Tissues or paper towels should be offered to help patients deal with secretions. The patient should be seated erect, with shoulders slightly back and chin slightly elevated. A chair with arms (to prevent falling sideways should syncope occur), without wheels, and with a height adjustment so that the feet are flat

2019 American Thoracic Society

129. Pelvic Girdle Pain in the Antepartum Population: Physical Therapy Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health From the Section on Women's Health and the Orthopaedic Section of the American Full Text available with Trip Pro

. The organization and classification of the document can guide research to address the paucity of evidence especially in the interventions with this population. 1 Embody Physiotherapy & Wellness, LLC, Sewickley, Pennsylvania ; Department of Physical Therapy , University of Pittsburgh, Pittsburgh, Pennsylvania; and Department of Physical Therapy , Chatham University, Pittsburgh, Pennsylvania. 2 Oncology Rehab, Centennial, Colorado. 3 Department of Physical Therapy , Chatham University, Pittsburgh, Pennsylvania (...) as reviewers of the first draft of this CPG: ACOG guidelines Coding Manipulative therapy Obstetric physical therapy Orthopedic physical therapy rehabilitation Outcomes research Pain science PGP rehabilitation Physical therapy academic education Women's health physical therapy education Comments from these reviewers were utilized by the authors to edit this CPG prior to submission to the Journal of Women's Health Physical Therapy and the Journal of Orthopaedic & Sports Physical Therapy . In addition

2017 American Physical Therapy Association

130. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain Full Text available with Trip Pro

soft tissue structures, such as those associated with knee extension range-of-motion loss. Interventions – Cryotherapy Clinicians should use cryotherapy immediately after ACL reconstruction to reduce postoperative knee pain. Interventions – Supervised Rehabilitation Clinicians should use exercises as part of the in-clinic supervised rehabilitation program after ACL reconstruction and should provide and supervise the progression of a home-based exercise program, providing education to ensure (...) , including how directly the studies addressed the question on knee stability and movement coordination impairments/knee ligament sprain population. In developing their recommendations, the authors considered the strengths and limitations of the body of evidence and the health benefits, side effects, and risks of tests and interventions. Guideline Review Process and Validation Identified reviewers who are experts in knee ligament injury management and rehabilitation reviewed the content and methods

2017 American Physical Therapy Association

131. Angina

guidelines SIGN (2017) Cardiac rehabilitation . Scottish Intercollegiate Guidelines Network. [ ] SIGN (2017) Risk estimation and the prevention of cardiovascular disease . Scottish Intercollegiate Guidelines Network. [ ] SIGN (2018) Management of stable angina . Scottish Intercollegiate Guidelines Network. [ ] HTAs (Health Technology Assessments) No new HTAs since 1 January 2017. Economic appraisals No new economic appraisals relevant to England since 1 January 2017. Primary evidence No new randomized (...) ) in the chest, in the neck, shoulders, jaw, or arms caused by an insufficient blood supply to the myocardium. Angina is usually caused by coronary artery disease — atherosclerotic plaques in the coronary arteries cause progressive narrowing of the lumen, and symptoms occur when blood flow does not provide adequate amounts of oxygen to the myocardium at times when oxygen demand increases (such as during exercise). Less commonly, angina is caused by valve disease (for example aortic stenosis), hypertrophic

2018 NICE Clinical Knowledge Summaries

132. Care and Maintenance to Reduce Vascular Access Complications

Program, Thunder Bay, Ontario Marg Poling, RN, BScN, PHCNP Palliative Care Nurse Practitioner, Palliative Care Advisor, Victorian Order of Nurses, Thunder Bay and District, Thunder Bay, Ontario Wendy L. Pomponio, RN, BScN Nurse Clinician, Medical & Rehabilitation Services, Brant Community Healthcare System, Brantford, Ontario Donna Prenger, RN, ONA Registered Nurse (Oncology), Thunder Bay Regional Health Science Centre, Thunder Bay, Ontario Christina Purdon, RN, BScN Clinical Educator, Thunder Bay

2005 Registered Nurses' Association of Ontario

133. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Full Text available with Trip Pro

return to activity depending on the type of articular cartilage surgery. Interventions — Supervised Rehabilitation 2018 Recommendation Clinicians should use exercises as part of the in-clinic supervised rehabilitation program after arthroscopic meniscectomy and should provide and supervise the progression of a home-based exercise program, providing education to ensure independent performance. Interventions — Therapeutic Exercises 2018 Recommendation Clinicians should provide supervised, progressive (...) . The authors of this guideline revision worked with the CPG Editors and medical librarians for methodological guidance. The research librarians were chosen for their expertise in systematic review rehabilitation literature search, and to perform systematic searches for concepts associated with meniscus and articular cartilage injuries of the knee in articles published from 2008 related to classification, examination, and intervention strategies consistent with previous guideline development methods related

2018 American Physical Therapy Association

134. Sprains and strains

and overuse can cause the bursa in the shoulder, elbow, hip, knee, or ankle to swell. See the CKS topics on , , and for more information. Tendon rupture — indicated by an inability to effect movement served by that tendon's muscle and/or a palpable gap in the tendon. Meniscus injury — often affects the knee and involves a twisting injury with a tearing sensation, followed by severe pain. Mild to moderate swelling is expected within 24 hours. There may be locking of the joint. Achilles tendinopathy (...) . CKS has not recommended referral of all muscle strains, because conservative management will result in a good outcome in most cases [ ]. However, the expert opinion of previous reviewers of this CKS topic is that appropriate rehabilitation reduces the likelihood of a further strain and/or residual symptoms, so referral to physiotherapy may be justified. Prevention of further strains and sprains What should I advise on preventing further strains and sprains? Advise that the person should: Take care

2016 NICE Clinical Knowledge Summaries

135. European Society of Endocrinology Clinical practice guidelines for the care of girls and women with Turner syndrome

in Turner syndrome R 4.1. We recommend that an infant or child is examined with transthoracic echocardiography (TTE) at the time of diagnosis, even if the fetal echocardiogram or postnatal cardiac examination was normal (⨁⨁◯◯). R 4.2. We recommend that girls or women with aortic dilatation and/or bicuspid aortic valve be counseled to seek prompt evaluation if they are experiencing acute symptoms consistent with AoD, such as chest, neck, shoulder, back or flank discomfort, particularly if it is sudden (...) recommend a formal audiometric evaluation every 5 years regardless of the initial age at diagnosis, initial hearing threshold levels, karyotype and/or presence of a mid-frequency sensorineural hearing loss, to assure early and adequate technical and other rehabilitative measures (⨁⨁◯◯). R 6.2. We recommend aggressive treatment of middle-ear disease and otitis media (OM) with antibiotics and placement of myringotomy tubes as indicated (⨁⨁◯◯). R 6.3. We recommend screening for hypothyroidism at diagnosis

2017 European Society of Endocrinology

136. Acute Pain Management: Scientific Evidence

— the International Association for the Study of Pain (IASP), the Royal College of Anaesthetists and its Faculty of Pain Medicine, the Australian Pain Society, the Australasian Faculty of Rehabilitation Medicine, the College of Anaesthesiologists of the Academies of Medicine of Malaysia and Singapore, the College of Intensive Care Medicine of Australia and New Zealand, the Faculty of Pain Medicine of the College of Anaesthetists of Ireland, the Hong Kong College of Anaesthesiologists, the Hong Kong Pain Society (...) pain management 280 8.1.3 Acute rehabilitation after surgery, “fast-track” surgery and enhanced recovery after surgery 281 8.1.4 Risks of acute postoperative neuropathic pain 282 8.1.5 Acute postamputation pain syndromes 283 8.1.6 Other postoperative pain syndromes 285 8.1.7 Day-stay or short-stay surgery 288 8.1.8 Cranial neurosurgery 294 8.1.9 Spinal surgery 297 8.2 Acute pain following spinal cord injury 298 8.2.1 Treatment of acute neuropathic pain after spinal cord injury 299 8.2.2 Treatment

2015 Clinical Practice Guidelines Portal

137. Positioning Tests

down, their shoulders will be level with the end of the couch. Ask them to turn their head 45° towards the test ear. 6 6 An assumption is made that 45° places the posterior canal in the plane of maximal stimulation, and that then if the head is turned either more than 45° or less than 45° the sensitivity of the test may be significantly decreased. There is Recommended Procedure Positioning Tests BSA 2016 © BSA 2016 Page11 There are two possible test positions for the Dix-Hallpike test (...) : 185-9. Dix MR, Hallpike CS. The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Proc Royal Soc Med 1952; 45: 341-54. Galgon AK. It’s time to consider other signs and tests to determine side of involvement in Horizontal Canal BPPV! Vestibular Rehabilitation Special Interest Group Newsletter: BPPV Special Edition, American Physical Therapy Association / Neurology Section 2012. Gans R, Harrington-Gans P. Treatment efficacy of benign paroxysmal positional

2016 British Society of Audiology

138. Visual Reinforcement Audiometry for Infants

at the waist and facing forward. In some cases it may be useful for the child to be supported by the parent’s hands underneath the arms around the side of the body and facing forward, the thumbs resting on the shoulder blades and the remaining fingers on the child’s chest. Here, the parent’s hands actively support the upright sitting of the body, thus enabling even the younger infant to spend their effort in turning rather than maintain the body’s upright position. Alternatively, the infant may be placed (...) Society of Audiology, Reading. British Society of Audiology (2011b). Recommended Procedure. Pure-tone air- conduction and bone-conduction threshold audiometry with and without masking. British Society of Audiology, Reading. Coninx F, Lancioni GE (Eds) (1995). Hearing assessment and aural rehabilitation of multiply handicapped deaf children. Scand Audiol 24: Suppl 41. Day J, Bamford J, Parry G, Shepherd M, Quigley A (2000). Evidence on the efficacy of insert earphone and sound-field VRA with young

2014 British Society of Audiology

139. Canadian cardiovascular society guidelines for the diagnosis and management of stable ischemic heart disease

as a dull retrosternal discomfort/ ache/heaviness that might or might not radiate to the jaw, neck, shoulders or arms, is provoked by exertion or emotional stress,andisrelievedwithin5minutesofrestornitroglycerine use. 2 However, nonclassical symptoms are common, partic- ularly among diabetic patients, and even response to nitro- glycerinemightbemisleading. 17-19 Accordingly,thecontextis important and all risk factors should also be considered (Table 1). Although the physical examination has low sensi (...) . Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2013;37(suppl 1):S1-212. 13. Canadian Hypertension Education Program (CHEP). 2014 Recom- mendations. Available at: http://www.hypertension.ca/images/CHEP_ 2014/2014_CompleteCHEPRecommendations_EN_HCP1009.pdf. Accessed February 11, 2014. 14. Stone J, ed. Canadian Guidelines for Cardiac Rehabilitation and Car- diovascular Disease Prevention. 3rd ed. Winnipeg, Manitoba

2014 CPG Infobase

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