CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
.png)
Guidelines - Patellofemoral Pain
This tool provides information to facilitate the management of patellofemoral pain (PFP) in adolescents and adults.
Focused examination
1. Patient History
-
Rule out risk factors for major structural or other pathologies. If required, refer to an appropriate healthcare provider.
-
Identify and assess other conditions and co-morbidities. Manage using appropriate care pathways.
-
Address prognostic factors that may delay recovery.
Major structural or other pathologies may be suspected with certain signs and symptoms (red flags):
-
Sharp pain, persistent nagging ache, unexplained deformity, swelling, or redness of the skin, weakness not due to pain, fever/chills/feeling ill, pain at rest
Examples of other conditions/co-morbidities:
-
Physical conditions: back pain, headache
-
Psychological conditions: depression, anxiety
-
Co-morbidities: diabetes, heart disease
Examples of prognostic factors that may delay recovery:
-
Symptoms of depression or anxiety, passive coping strategies, job dissatisfaction, high self-reported disability levels, disputed compensation claims, somatization
2. Physical Examination
-
Rule out major structural or other pathologies.
-
Assess for neurological signs.
-
Appropriately diagnose PFP.
Criteria for PFP:
-
Presence of retropatellar or peripatellar pain AND;
-
Reproduction of retropatellar or peripatellar pain with squatting, stair climbing, prolonged sitting, or other functional activities loading the patellofemoral joint (PFJ) in a flexed position AND;
-
Exclusion of all other conditions that may cause anterior knee pain including tibiofemoral pathologies
3. Management
-
Offer information on nature, management, and the course of PFP. See patient handouts for more information to provide to patients.
-
Discuss the range of effective interventions with the patient and, together, select a therapeutic intervention.
Patient Handouts
Therapeutic Management of PFP
Provide structured patient education (advice to stay active, reassurance, promote and facilitate return to work and normal activities, self-care advice) and any one of the following therapeutic interventions*:
-
Consider multimodal careᶧ
-
Cobination of hip– and knee-targeted exercise therapy and one or more of the following:
-
tailored patellar taping in combination with exercise therapy
-
prefabricated foot orthoses for those with greater than normal pronation
-
physical therapy
-
gait retraining
-
acupuncture
-
-
-
Consider load management education, body weight management (when appropriate)
-
Consider blood flow restriction plus high-repetition knee exercise therapy
-
Do not offer dry needling
-
Do not offer manual therapy including lumbar, knee, or patellofemoral manipulation/mobilization
-
Do not offer patellofemoral knee orthoses, including braces, sleeves, or straps
-
Do not offer EMG-based biofeedback on medial vastii activity to augment knee-targeted (quadriceps) exercise therapy
-
Do not offer visual biofeedback on lower extremity alignment during hip- and knee-targeted exercises
-
Do not offer biophysical agents, including ultrasound, cryotherapy, phonophoresis, iontophoresis, electrical stimulation, and therapeutic laser
*Interventions are recommended if guidelines used terms such as ‘recommended for consideration’ (e.g., ‘offer’, ‘consider’), ‘strongly recommended’, ‘recommended without any conditions required’, or ‘should be used’. Recommendations from low-quality evidence are not listed.
ᶧMultimodal care: treatment involving at least two distinct therapeutic modalities, provided by one or more health care disciplines.
Care Pathway for the management of patellofemoral pain
4. Reevaluation and Discharge
-
Reassess the patient at every visit to determine if: (1) additional care is necessary; (2) the condition is worsening; or (3) the patient has recovered.
-
Monitor for any emerging factors that may delay recovery.
5. Referrals and Collaboration
-
Refer the patient to an appropriate healthcare provider for further evaluation at any time during their care if they develop worsening symptoms and new physical or psychological symptoms.