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181. AIM Clinical Appropriateness Guidelines for Joint Surgery

due to osteoarthritis, inflammatory disease or other chronic condition when all of the following requirements have been met: o Imaging evidence of significant joint destruction and cartilage loss, defined as Tönnis grade 3, modified Outerbridge grade III – IV, or Kellgren-Lawrence grade 3 – 4 o Limited range of motion, antalgic gait and disabling pain of at least three (3) months’ duration o Pain with passive internal or external rotation o Failure of at least three (3) months of non-surgical (...) removal of prosthesis due to infection or catastrophic failure ? Progressive and substantial bone loss ? Recurrent disabling pain or significant functional disability that persists despite at least three (3) months of conservative management in conjunction with either of the following: o Antalgic gait o Abnormal findings confirmed by plain radiography or imaging studies such as implant malposition or impingement Contraindications Total hip arthroplasty is contraindicated when any of the following

2019 AIM Specialty Health

182. Spine imaging

Rationale Neck pain is the fourth leading cause of global disability and has an annual prevalence rate exceeding 30%. 33-35 A majority (approximately 70%) of patients with neck pain improve with conservative/medical management alone. 36 Imaging of the Spine Copyright © 2019. AIM Specialty Health. All Rights Reserved. 18 Agreement exists among several high-quality guidelines that patients with progressive neurological deficits should undergo MRI, 37, 38 and that patients with major neurologic deficits (...) that neck/upper extremity strengthening exercises reduce neck pain in the near term; the average duration of the exercise programs in this review was approximately 12 weeks. 41 Several randomized controlled trials have shown that a multimodal approach to conservative management is better than a unimodal one: ? Exercise and education are better than education alone. 42 ? Multimodal exercises and cognitive behavioral therapy result in less disability from neck pain at 1 year when compared to general

2019 AIM Specialty Health

183. Hip pain and mobility deficits&mdash

, McDonough CM. Hip pain and mobility deficits-hip osteoarthritis: revision 2017. J Orthop Sports Phys Ther. 2017 Jun;47(6):A1-A37. [77 references] This is the current release of the guideline. This guideline updates a previous version: Cibulka MT, White DM, Woehrle J, Harris-Hayes M, Enseki K, Fagerson TL, Slover J, Godges JJ. Hip pain and mobility deficits--hip osteoarthritis: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from (...) guidelines on "Hip Pain and Mobility Deficits – Hip Osteoarthritis" for literature reviewed prior to 2009. Diagnosis/Classification Clinicians should use the following criteria to classify adults over the age of 50 years into the International Statistical Classification of Diseases and Related Health Problems (ICD) category of coxarthrosis and the associated International Classification of Functioning, Disability and Health (ICF) impairment-based category of hip pain (b28016 Pain in joints) and mobility

2017 National Guideline Clearinghouse (partial archive)

184. Chronic pain disorder medical treatment guideline.

evaluation and diagnostic procedures for patients with chronic pain disorders and for further descriptions of the therapies discussed below. The grades of recommendations ( Some, Good, Strong ) are defined at the end of the Major Recommendations field. Therapeutic Procedures—Non-operative Non-operative therapeutic rehabilitation is applied to patients with chronic and complex problems of de-conditioning and functional disability. Treatment modalities may be utilized sequentially or concomitantly (...) that include screening for psychological issues, identification of fear-avoidance beliefs and treatment barriers, and establishment of individual functional and work goals will improve function and decrease disability (Design: Cluster randomized trial, randomized clinical trial ). Multidisciplinary rehabilitation (physical therapy and either psychological, social, or occupational therapy) shows small effects in reducing pain and improving disability compared to usual care, and multidisciplinary

2017 National Guideline Clearinghouse (partial archive)

185. VA/DoD clinical practice guideline for diagnosis and treatment of low back pain.

limited approaches, we suggest offering a multidisciplinary or interdisciplinary rehabilitation program which should include at least one physical component and at least one other component of the biopsychosocial model (psychological, social, occupational) used in an explicitly coordinated manner. ( Weak for; Reviewed, New-replaced ) Definitions The relative strength of the recommendation is based on a binary scale, "Strong" or "Weak." A strong recommendation indicates that the Work Group is highly (...) ). The following algorithms are provided in the original guideline document: Module A: Initial Evaluation of Low Back Pain Module B: Management of Low Back Pain Acute, subacute, or chronic axial/non-radiating low back pain Diagnosis Evaluation Management Treatment Chiropractic Internal Medicine Neurology Orthopedic Surgery Physical Medicine and Rehabilitation Radiology Rheumatology Sports Medicine Advanced Practice Nurses Chiropractors Health Care Providers Nurses Pharmacists Physical Therapists Physician

2017 National Guideline Clearinghouse (partial archive)

186. Complex regional pain syndrome/reflex sympathetic dystrophy medical treatment guideline.

guideline document for time to produce effect, frequency, and optimum and maximum durations. Evidence Statements Regarding Interdisciplinary Rehabilitation Programs Good Evidence Interdisciplinary programs that include screening for psychological issues, identification of fear-avoidance beliefs and treatment barriers, and establishment of individual functional and work goals will improve function and decrease disability (Design: Design: Cluster randomized trial, randomized clinical trial (...) ). Multidisciplinary rehabilitation (physical therapy and either psychological, social, or occupational therapy) shows small effects in reducing pain and improving disability compared to usual care, and multidisciplinary biopsychosocial rehabilitation is more effective than physical treatment for disability improvement after 12 months of treatment in patients with chronic low back pain. Patients with a significant psychosocial impact are most likely to benefit (Design: Meta-analysis of randomized clinical trials

2017 National Guideline Clearinghouse (partial archive)

187. Knee stability and movement coordination impairments: knee ligament sprain revision 2017.

, and Injury to multiple structures of knee, and the associated International Classification of Functioning, Disability and Health (ICF) impairment-based categories of knee instability (b7150 Stability of a single joint) and movement coordination impairments (b7601 Control of complex voluntary movements), using the following history and physical examination findings: mechanism of injury, passive knee laxity, joint pain, joint effusion, and movement coordination impairments. ( Grade of Recommendation (...) should administer appropriate clinical or field tests, such as single-legged hop tests (e.g., single hop for distance, crossover hop for distance, triple hop for distance, and 6-meter timed hop), that can identify a patient's baseline status relative to pain, function, and disability; detect side-to-side asymmetries; assess global knee function; determine a patient's readiness to return to activities; and monitor changes in the patient's status throughout the course of treatment. ( Grade

2017 National Guideline Clearinghouse (partial archive)

188. Neck pain: revision 2017.

. [247 references] This is the current release of the guideline. This guideline updates a previous version: Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, Sopky BJ, Godges JJ, Flynn TW, American Physical Therapy Association. Neck pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2008 Sep;38(9):A1-34. [185 (...) of Recommendation: A ) Examination Outcome Measures Clinicians should use validated self-report questionnaires for patients with neck pain, to identify a patient's baseline status and to monitor changes relative to pain, function, disability, and psychosocial functioning. ( Grade of Recommendation: A ) Activity Limitations and Participation Measures Clinicians should utilize easily reproducible activity limitation and participation restriction measures associated with the patient's neck pain to assess

2017 National Guideline Clearinghouse (partial archive)

189. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians.

Massage Acupuncture Spinal manipulation Exercise Multidisciplinary rehabilitation Mindfulness-based stress reduction Tai chi Yoga Motor control exercise (MCE) Progressive relaxation Electromyography biofeedback Low-level laser therapy (LLLT) Operant therapy Cognitive behavioral therapy Reduction or elimination of low back pain (including related leg symptoms) Improvement in back-specific and overall function Improvement in health-related quality of life Reduction in work disability Return to work (...) low back pain, and the committee recommends against these drugs for treatment of acute low back pain. Recommendation 2 : For patients with chronic low back pain, clinicians and patients should initially select nonpharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction ( moderate-quality evidence ), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy

2017 National Guideline Clearinghouse (partial archive)

190. Final recommendation statement: adolescent idiopathic scoliosis: screening.

children and adolescents with scoliosis do not have symptoms. Generally, smaller spinal curvatures remain stable, while larger curvatures tend to progress in severity. Pulmonary dysfunction can be clinically significant in patients with spinal curvatures greater than 100°; however, curvatures of that severity are rare. Back pain is more common, but its effect on functioning or disability is unclear. Current evidence suggests that the presence of back pain does not necessarily correlate with the degree (...) on Scoliosis Orthopaedic and Rehabilitation Treatment. The type of evidence supporting the recommendations is not specifically stated. Benefits of Early Detection and Intervention or Treatment The U.S. Preventive Services Task Force (USPSTF) found no direct evidence regarding the effect of screening for adolescent idiopathic scoliosis on patient-centered health outcomes. The USPSTF found inadequate evidence on the treatment of idiopathic scoliosis (Cobb angle <50° at diagnosis) in adolescents with exercise

2018 National Guideline Clearinghouse (partial archive)

191. Mental health of adults in contact with the criminal justice system.

, diversion and street triage services; remanded on bail; remanded in prison; who have been convicted and are serving a prison or community sentence; released from prison on licence; and released from prison and in contact with a community rehabilitation company (CRC) or the probation service. Specific consideration will be given to people with neurodevelopmental disorders (including learning disabilities), women, older adults (aged 50 years and over), young black men, and young adults that have (...) of a learning disability or any acquired cognitive impairment Other communication difficulties (for example, language, literacy, information processing or sensory deficit) The nature of any coexisting mental health problems (including substance misuse) Limitations on prescribing and administering medicine (for example, in-possession medicine) or the timing of the delivery of interventions in certain settings (for example, prison) The development of trust in an environment where health and care staff may

2017 National Guideline Clearinghouse (partial archive)

192. Parkinson's disease in adults.

professional should spend more time considering and discussing the options with the patient. A National Institute for Health and Care Excellence (NICE) pathway titled "Parkinson's disease overview" is provided on the . Parkinson's disease Diagnosis Evaluation Management Treatment Geriatrics Neurological Surgery Neurology Nursing Physical Medicine and Rehabilitation Psychiatry Speech-Language Pathology Advanced Practice Nurses Allied Health Personnel Health Care Providers Hospitals Nurses Occupational (...) 39 [PDQ-39], EQ5D) Disease severity (Unified Parkinson's Disease Rating Scale [UPDRS], Webster disability score) Non-motor features (Non-motor symptoms questionnaire [NMS Quest], Parkinson's disease sleep scale [PDSS2]) Carer-related Outcomes Impact on carer (Family Burden Interview, Caregiver Burden Inventory) Need for respite care Resilience (Dispositional Resilience Scale, Resilience Scale) Communication between carers and healthcare staff (Decision Making Involvement Scale) Family-related

2017 National Guideline Clearinghouse (partial archive)

193. Shoulder Conditions Diagnosis and Treatment Guideline

. Diagnostic arthroscopy 26 VII. Post-Operative Treatment and Return to Work 26 VIII. Specific Shoulder Tests 26 IX. Functional Disability Scales for Shoulder Conditions 28 REFERENCES 31 Acknowledgements 36 Washington State Department of Labor and Industries Medical Treatment Guideline for Shoulder Diagnosis and Treatment –updated May 2018 I. Review Criteria for Shoulder Surgery A request may be appropriate for If the patient has AND the diagnosis is supported by these clinical findings: AND this has been (...) as an educational resource for health care providers who treat injured workers in the Washington workers’ compensation system under Title 51 RCW and as review criteria for the department’s utilization review team to help ensure treatment of shoulder injuries is of the highest quality. The emphasis is on accurate diagnosis and treatment that is curative or rehabilitative (see WAC 296-20-01002 for definitions). This guideline, focusing on work-related shoulder conditions, was developed in 2013 by a subcommittee

2018 Washington State Department of Labor and Industries

194. Hearing loss in adults: assessment and management

, or recurs abnormal appearance of the outer ear or the eardrum, such as: inflammation polyp formation perforated eardrum abnormal bony or skin growths swelling of the outer ear blood in the ear canal a middle ear effusion in the absence of, or that persists after, an acute upper respiratory tract infection. Adults with suspected or diagnosed dementia, mild cognitiv Adults with suspected or diagnosed dementia, mild cognitive impairment or a e impairment or a learning disability learning disability 1.1.8 (...) Consider referring adults with diagnosed or suspected dementia or mild cognitive impairment to an audiology service for a hearing assessment because hearing loss may be a comorbid condition. 1.1.9 Consider referring adults with diagnosed dementia or mild cognitive impairment to an audiology service for a hearing assessment every 2 years if they have not previously been diagnosed with hearing loss. 1.1.10 Consider referring people with a diagnosed learning disability to an audiology service

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

195. Dementia: assessment, management and support for people living with dementia and their carers

with learning disabilities, see the NICE guideline on mental health problems in people with learning disabilities. Diagnosis in specialist dementia diagnostic services Diagnosis in specialist dementia diagnostic services 1.2.9 Diagnose a dementia subtype (if possible) if initial specialist assessment (including an appropriate neurological examination and cognitive testing) confirms cognitive decline and reversible causes have been ruled out. 1.2.10 If Alzheimer's disease is suspected, include a test (...) accessible Making services accessible 1.3.6 Service providers should design services to be accessible to as many people living with dementia as possible, including: people who do not have a carer or whose carer cannot support them on their own people who do not have access to affordable transport, or find transport difficult to use people who have other responsibilities (such as work, children or being a carer themselves) people with learning disabilities, sensory impairment (such as sight or hearing

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

196. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

protocols for different pain procedures. One hundred twenty-four active participants attended the open forum. Responses were collected using an audience response system. Eighty-four percent of respondents were anesthesiologists, and the remainders were physical medicine and rehabilitation physicians, neurologists, orthopedic surgeons, and neurological surgeons. The vast majority of respondents (98%) followed ASRA regional anesthesia guidelines for anticoagulants but not for antiplatelet agents. Two

2018 American Society of Regional Anesthesia and Pain Medicine

197. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain

, with higher dosages and more frequent infusions associated with greater risks. Larger studies, evaluating a wider variety of conditions, are needed to better quantify efficacy, improve patient selection, refine the therapeutic dose range, determine the effectiveness of nonintravenous ketamine alternatives, and develop a greater understanding of the long-term risks of repeated treatments. From the * Departments of Anesthesiology & Critical Care Medicine, Neurology, and Physical Medicine & Rehabilitation (...) presented to nor approved by either the American Society of Anesthesiologists Board of Directors or House of Delegates, it is not an official or approved statement or policy of the Society. Variances from the recommendations contained in the document may be acceptable based on the judgment of the responsible anesthesiologist. S.P.C. is funded in part by a Congressional Grant from the Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences, Bethesda, MD (SAP

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2018 American Society of Regional Anesthesia and Pain Medicine

198. Brain tumours (primary) and brain metastases in adults

for brain metastases and how they might affect practice, see rationale and impact. 1.9 Care needs of people with brain tumours 1.9.1 Be aware that the care needs of people with brain tumours represent a unique challenge, because (in addition to physical disability) the tumour and treatment can have effects on: behaviour cognition Brain tumours (primary) and brain metastases in adults (NG99) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

199. Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

patients has serious asso- ciated risks. 2,5,38,43,45,47,48,62,63,71,83,85,88–105, 107–138 These adverse re- sponses during and after sedation for a diagnostic or therapeutic procedure may be minimized, but not completely eliminated, by a careful preprocedure review of the patient’s underlying medical conditions and consideration of how the sedation pro- cess might affect or be affected by these conditions: for example, children with developmental disabilities have been shown to have a threefold (...) increased incidence of desaturation compared with children without developmental disabilities. 74,78,103 Appropriate drug selection for the intended procedure, a clear understanding of the sedating medication’s pharmacokinetics and pharmacodynamics and drug interactions, as well as the presence of an individual with the skills needed to rescue a patient from an adverse response are critical. 42, 48,62,63,92,97,99,125–127, 132,133,139–158 Appropriate physiologic monitoring and continuous observation

2016 American Academy of Pediatric Dentistry

200. Back Pain

pain and disability in both the short and long term. The studies assessing the long-term effect were of moderate quality. However, no statistically difference was found in terms of work status/return to work. In addition, multidisciplinary rehabilitation may improve quality of life on the short term. Compared to physical therapy, the same systematic review showed that multidisciplinary rehabilitation was more effective in reducing pain and disability in the long and short terms. Nevertheless (...) , the evidence was of low quality. Compared to no multidisciplinary rehabilitation, multidisciplinary rehabilitation was effective in reducing pain and disability in the short term. Overall, low- to moderate-quality evidence shows that multidisciplinary rehabilitation is more effective than usual care, physical therapy, and no multidisciplinary rehabilitation in reducing pain and disability in the short and long term among patients with nonspecific chronic low back pain. Early physical therapy One RCT (Fritz

2017 Kaiser Permanente Clinical Guidelines

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