Dx/Risk Factors
Patients with hip OA typically report increased pain during these activities rather than during rest.
What are weight-bearing activities such as walking, stair climbing, or standing
Aside from ROM and MMTs, what special test for hip pathology is mentioned for examination of hip OA?
FABER
Scour (Diff. Dx)
(True/False) Therapists should use bracing as an intervention for Hip OA.
False. F level evidence - Should not use.
Which of the following is considered a risk factor for developing arthritic hip pain?
A. Advanced Age (> 50)
B. Diabetes
C. High Socioeconomic Status
D. Trendelenburg Gait
A. Advanced Age >50
This unique treat, similar to Turkish Delights, was created by Armenian Immigrants in Washington in 1918.
Aplets & Cotlets
Name 3 risk factors for development of Hip OA
Age over 50
Acetabular retroversion
Higher BMI
Male
Morning stiffness < 1 hours
Low socioeconomic status
High bone mass
Reduced Hip IR and Flexion
Previous Hip injury
These functional limitations are commonly seen during the examination of patients with hip OA and reflects reduced hip mobility
What is difficulty with sit-to-stand, stair negotiation, or squatting
(True/False) There is A level evidence for Manual Therapy, including distraction and hip Mulligan techniques for anterior and posterior glides
True
You have been treating your patient with "hip OA" for 2x a week for 6 weeks and their WOMAC score has improved by 15% - based on score alone, have they made meaningful improvement based on subjective reporting?
No. MCID for WOMAC is 20-25%
This Holiday was invented in WA, in 1909, first celebrated in Spokane in 1910, and eventually recognized as a National Holiday by Richard Nixon in 1972.
Father's Day
Name 3 of the 5 clinical findings for Hip OA
Mod Anterior or latera hip pain with WB
AM stiffness < 1 hr
Hip IR < 24 deg or
IR and Hip Flex 15 deg less than non-painful side
Increased pain with Passive Hip IR
A patient diagnosed with Hip OA is performing a BERG balance scale for further objective measures. Their score is 43/56 - what is their current falls risk?
Low Falls Risk
Beyond physical therapy, clinicians should collaborate with these professionals to support weight loss in overweight or obese patients with hip OA
Nutritionists and Registered Dieticians
A 52 year old female comes into clinic with primary complaints of R hip pain. She presents with a BMI of 40, Trendelenburg gait, and Hip flexion AROM 90 deg L, 65 Deg R, Hip Extension WNL, Hip ER 45 deg L, 40 deg R, Hip IR 34 deg L, 18 deg R.
What objective measure is the most indicative of Hip OA?
Hip and IR greater than 15 deg less than non-painful side or Hip IR less than 24 deg.
What is the name of the animal bridge in Longview, WA, built specifically for the safe crossing of squirrels?
Nutty Narrows
Greater trochanteric bursitis
Gluteal Tendinopathy
SIJ pain
Labral Tear
FAI
These Outcome measures have Strong evidence to assess regarding Hip Pain with mobility deficits and OA - Name 3
WOMAC
HOOS (Hip Disability and Osteoarthritis Outcomes Score
LEFS
HHS (Harris Hip Score)
VAS
PPT (Pressure Pain Threshold)
BBT (Brief Pain Inventory)
(True/False) According to B level evidence, a therapist may use Ultrasound across the anterior, lateral and posterior hip for 5 min each, for 10 treatments over 2 weeks, without the addition of exercise or hot packs for short term pain relief.
False. US must be used in conjunction with exercise and hot packs for short term pain relief.
Anita is a 76-year-old retired school bus driver was referred to your clinic for left lateral hip pain. She says the pain started after she walked for a very long time at a flea market and now gives her difficulty with walking, lying on her side, and going up and down steps. Her lumbar clearing exam is unremarkable, and FADIR is negative. Her physical exam reveals pain with active hip abduction, pain with end range passive hip adduction, and pain with resisted hip abduction. Her single limb stance time is 17 seconds on the right and 7 seconds on the left with pain reproduction. Which ICF treatment classification is most consistent with Anita's presentation?
A. Mobility Deficit
B. Movement Coordination Impairment
C. Muscle Power Deficit
D. Radiating Pain
C. Muscle Power Deficit
What city was the home of the first gas station in the world?
Seattle
Name two congenital deformities that will likely develop early hip OA.
SCFE - Leading to Cam deformities
Developmental/acetabular dysplasia
Name 3 Functional Activity Performance Measures with Strong level evidence for Hip OA
30" STS
6min Walk Test or self paced test
TUG
Stair Measure
Four Square Step Test
What three muscle groups/directions should be the primary target for strengthening in patients with Hip OA?
Hip Abductors, extensors and ERs
A patient with Hip OA has a BERG score of 32/56, and a TUG time of 16", their goal is to get back to golfing, what should the primary intervention emphasize?
Based on C level evidence and scores indicating medium falls risk for both the BERG and TUG, this patient's POC should incorporate the following -
1. Balance training
2. Gait training
3. Functional balance and gait training oriented towards uneven surfaces, dynamic balance to allow for swinging a club and activity endurance to facilitate participation in recreational sports (ie. golf)
Place these active volcanos in order of highest to lowest elevation.
Mt. Rainier
Mt. St. Helens (post explosion)
Mt. Baker
Mt. Adams
Glacier Peak
Mt. Rainier 14,410ft
Mt. Adams 12,277ft
Mt. Baker 10,781ft
Glacier Peak 10,541ft
Mt. St. Helens 8,363ft