Physiotherapy Management of Lumbar Radiculopathy with Hamstring Injury (Grade-II) Patient by Using Different Clinical Reasoning Process: A Case Report
Background: Clinical reasoning is a thinking and decision making procedure which helps the clinician to interact with the patient and their family members and other health care professionals in daily practice. During this process RPS-form (rehabilitation problem solving) can provide beneficial and also serve as linguistic tools between health professionals. The purpose of this study was to manage a case with lumbar radiculopathy with hamstring injury patient by using different clinical reasoning process and to deepen the clinician existing knowledge about CR.
Method:A case based study which was solved by using hypothetico-deductive and narrative reasoning. Also other reasoning process has to use. RPS tools help to solve the problem both from patient and therapist perspectives.
Result:After 21 session of treatment improvement was found in patient pain reduction, both in resting (VAS. 0/10) and movement (VAS. 2/10). Full range of motion (ROM) achieved in all lumbar movement, muscle power of lower limb. Both active and passive straight leg raising (SLR) also improve by treatment. Disability score of lumbar spine measured by Oswestry disability index improved from 75% to 18% and lower limb measured by lower extremity functional scale improved from 29 to 75.
Conclusion:When dealing with a difficult case strictly going through a single reasoning process is difficult, we need to use several reasoning process. It will help us to rapid and accurate assessment of a patient. In this case by using CR process clinician successfully manage the case by conservative treatment.