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Table 2 Section 2: Clinical vignette proposed treatments

From: Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study

Clinical Scenario:
Maria, a 72-year-old housewife, lives with her husband, who is in good health. She cultivates the hobby of gardening. For the past ten years, she has been suffering from knee pain which, in certain periods, forces her to take NSAIDs and to limit daily activities for a few days. Over the past two years, the pain has become increasingly frequent (VAS 5/10), so that she has decided to find some help with the housework and she is struggling to take care of the garden. She also suffers from diabetes and is overweight (BMI 28). She decides to consult her physician, who recommends her to do a visit to the physiotherapist.
Management:
Core Treatment Partially Core Treatment Non-Core Treatment
• Evaluation and planning of the rehabilitation treatment;
• Weight loss advice.
• Referral to the physician for drug therapy. • Referral to the physician for arthroscopic surgery (joint debridement);
• Referral to the physician for prosthetic intervention.
Assessment:
Core Treatment
• Assessment of the quantity and quality of pain;
• Assessment of the function;
• Assessment of disability and participation.
  
Treatment:
Core Treatment Partially Core Treatment Non-Core Treatment
• Specific exercise on the joint (muscle strengthening);
• Generic exercise (aerobic exercise or generic physical activity);
• Education on the pathophysiology of osteoarthritis.
• Manual therapy (mobilisation and/or massage);
• TENS;
• Load reduction devices (braces, insoles or walking aids);
Hyaluronic acid and corticosteroid injections.
• Activity rest (reduce the load on the joint);
• Other physical therapies (Laser, Ultrasound etc.);
• Supplement integration: glucosamine and chondroitin
For how many sessions would you treat this patient?
• For less than 5 sessions;
• Between 5 and 10 sessions;
• For more than 10 sessions.