Clinical Predication Rules - A Physical Therapy Reference Manual by Paul E. Glynn P Cody

Clinical Paul E. Glynn P Cody Weisbach Prediction Rules A Physical Therapy Reference Manual --�, /�.(\\t,/I CONTEMPORARY ISSUES IN PHYSICAL THERAPY AND REHABILITATION MEDICINE SERIES \\'. / The first and only textbook focused on clinical prediction rules for physical \" .. therapy practice. To leam more about the Series and forthcoming titles, visit CONTfMPonAn'lSSlIfS '.. PHYSI(Al TH'�\"\"PT AND www.jbpub.com/healthprofessions/physicaltherapy/series AfHAfllllf\"',\"ON \"\"lOIC\"\", Clinical Prediction Rules: A Pllysicall1lerapy Reference Manual focuses on clinical prediction rules (CPRs) and their relationship to physical therap) practice. From the de\\'e1opment and evolution of CPRs to a discussion of their strengths and weaknesses, no other book offers this level of detail. Appropriate for e11try-le\\el physical therapists, post-professional physical therapy programs, and practicing clinicians, this full-color text senes as a valuable reference manual. It helps indidduals build a strong working knowledge or how CPRs are used in conjunction \\\\ith existing research and personal experience to impact decision making. The book's intuiti\\'e layout enables the reader to easily access detailed CPR descriptions and apply material to actual patient scenarios. Chapters address musculoskeletal CPRs organized by body region, allO\\\\ing Clinical Prediction Ru.les: A Physical T herapy Reference Manual to be utilized across multiple academic courses. Features • Presents detailed descriptions, full-color photos and illustrations, and case studies for increased comprehension • Offers patient characteristics and screening tools to help make accurate diagnoses and treatment plans • Prmides a valuable reference tool to cffccti\\ely apply CPRs in day-to-day practice Other Titles in Jones and Bartlett's Contemporary Issues in Physical 111erap) and Rehabilitation IVIediciHe Series Orthopaedic Manual TIlerapy Diagnosis Tension-Type and Cervicogenic Headache Wellness and Pll}sical11e1 rapy M)'ofascial Trigger Points ISBN 978-0-7637-7518-6 90000 Jones and Bartlett Publishers 9 780763 77518 6 www.jbpub.com



Jones and Bartlett's Contemporary Issues in Physical Therapy and Rehabilitation Medicine Series Series Editor Peter A. Huijbregts, PT, MSc, MHSc, OPT, OCS, FAAOMPT, FCAMT Books in the Series Now Available Tension- Type and Cervicogenic Headache: Pathophysiology, Diagnosis, and Management Cesar Fernandez-de-las-Penas, PT, �O, PhD Lars Arendt-Nielsen, OMSc, PhD Robert O. Gerwin, MO Myofoscial Trigger Points: Pathophysiology and Evidence-Informed Diagnosis and Management Jan Oommerholt, PT, DPT, MPS, OAAPM Peter A. Huijbregts, PT, MSc, MHSc, OPT, OCS, FAAOMPT, FCAMT Wellness and Physical Therapy Sharon Elayne Fair, PT, MS, PhD Orthopaedic Manual Therapy Diagnosis: Spine and Temporomandibular Joints Aad van der El, BPE, BSc, PT, Dip. MT, Dip. Acupuncture Coming Soon Post-Surgical Rehabilitation After Artificial Disc Replacement: An Evidenced-Based Guide to Comprehensive Patient Care John N. Flood, �O, FACOS, FAOAO Roy Bechtel, PT, PhD Scott Benjamin, PT, OScPT

Clinical . Prediction . Rules A Physical Therapy Reference Manual Paul E. Glynn, PT, OPT, OCS, FAAOMPT Supervisor of Staff Development and Clinical Research Rehabilitation Department Newton-Wellesley Hospital Newton, Massachusetts P. Cody Weisbach, PT, OPT Physical Therapist Rehabilitation Department Newton-Wellesley Hospital Newton, Massachusetts JONES AND BARTLETT PUBLISHERS Sudbury, Massachusetts BOSTON TORONTO LONDON SINGAPORE

World Headquarters Jones and Barden Publishers Canada Jones and Barden Publishers International 6339 Ormindale Way Barb House, Barb Mews Jones and Bartlen Publishers Mississauga, Ontario L5V IJ2 London W6 7PA 40 Tall Pine Drive Canada United Kingdom Sudbury, MA 01776 978-443-5000 [email protected] www.jbpub.com Jones and Barden's books and products are available through mOSt bookstores and online booksellers. To contact Jones and Barden Publishers direcdy, call 800-832-0034, fax 978-443-8000, or visit our website, www.jbpub.com. Substantial discounts on bulk quantities of Jones and Barden's publications are available to corporations, professional associarions, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones and Barden via the above contact informarion or send an email to [email protected]. Copyrighr © 2011 by Jones and Barden Publishers, LLC All rights reserved. No part of the material prorected by this copyrighr may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any informarion storage and retrieval system, withour wrinen permission from the copyright owner. The authors, editor, and publisher have made every effort to provide accurare information. However, rhey are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibiliry for the use of rhe ptoducts and procedures described. Treat­ ments and side effects described in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect that is nOt described herein. Drugs and medical devices are discussed that may have limited availabiliry controlled by the Food and Drug Administra­ tion (FDA) for use only in a research study or clinical trial. Research, clinical practice, and government regulations ofren change the accepted standard in this field. W hen consideration is being given to use of any drug in the clinical sening, the health care ptovider or reader is responsible for determin­ ing FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations on dose, pre­ cautions, and contraindications, and determining the appropriate usage for the ptoduct. This is especially important in the case of drugs that are new or seldom used. Production Credits Production Assistant: Jessica Steele Newfell Marketing Manager: Grace Richards Chief Executive Officet: Clayton Jones Manufacturing and Inventory Control Supervisor: Amy Bacus Chief Operating Officer: Don W. Jones, Jr. Interior Design and Composirion: Shawn Girsberger President, Higher Education and Professional Publishing: Robert W. Holland, Jr. Cover and T ide Page Design: Kristin E. Parker v.r., Sales: W illiam J. Kane Cover Image: © Gary Cookson/ShutterStock, Inc. V.r., Design and Production: Anne Spencer V.r., Manufacturing and Inventory Control: Therese Connell Printing and Binding: Replika Press Cover Printing: Replika Press Publisher: David Cella Associate Editor: MaI'O Gartside Production Manager: Julie Champagne Bolduc Library of Congress Cataloging-in-Publication Data Glynn, Paul E. Clinical prediction rules : a physical therapy reference manual I Paul E. Glynn, I' Cody Weisbach. p.; em. Includes bibliographical references and index. ISBN 978-0-7637-7518-6 (pbk. : a1k. paper) I. Physical therapy-Handbooks, manuals, etc. 2. Medical protocols-Handbooks, manuals, etc. I. Weisbach, I' Cody (Philip Cody) II. Title. [DNLM: 1. Musculoskeletal Diseases-rehabilitation-Adult-Handbooks. 2. Decision Support Techniques-Adult-Handbooks. 3. Physical ll,erapy Modalities-Adult-Handbooks. WE 39 G568c 20 I 0] RM70l.G57 2010 615.8'2-dc22 2009031528 6048 10 9 8 7 6 5 4 3 2 I Printed in India 13 12 I I 10 09

To my wife, Buquet, and my daughter, Emma­ thank youfor your love, support, and patience. You mean the world to me. PC For Cara . . . myfavorite. CW

BRIEF CONTENTS Chapter .!\"� # 1 1 19 2 Introd,ul-ction 23 3 35 4 . :r 93 5 119 How to Use iThis 1 45 179 � It!.!3 21 5 Statistics 237 -:;'� 238 240 \"I 241 242 Screentng , ,1� vii ' �* Cervic�thoracic Region ' 6 Upper.�xtremities . �'{f\" �'tl'f'l4 7 Lumbopelvic \"'\"' :qk'\" 8 Lower Extremities _a l,,#\"\\'.•t: • 9 Case'studies �t �� Appendix

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CONTENTS Foreword xxi Acknowledgments xxiii Introduction by the Series Editor About the Authors xxv f11 Introduction -,' xxix 1 Definition 2 CPR Development 2 3 Derivation 5 Validation 6 Impact Analysis 7 Summary 7 Common Methodological Shortcomings of CPR Derivation Studies 7 Study Design 8 Sample 8 Variable Selection 9 Blinding 9 Outcome Measurement 10 Statistical Reporting 10 Reliability of Predictor Tests and Measures 11 CPR Quality Assessment 19 , 2 How to Use ThislBool( 3 Statistics \\', 23 ,:, \"'y 24 24 tv. 26 29 Common Statistical Parameters in Diagnostic Accuracy Studies 30 30 Sensitivity and Specificity 30 31 Likelihood Ratios 31 Confidence Intervals Reliability Statistics Used in CPR Derivation T-Test and Chi-Square Receiver Operating Characteristic Curve Multivariate Analysis ix