Integrating jigsaw puzzle thinking into practice: the assessment of cervical spine radiculopathy.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Michael Mansfield, Mick Thacker
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引用次数: 0

Abstract

Purpose of review: Cervical spine radiculopathy (CSR) presents a complex socioeconomic problem for patients, clinicians, families, employers and healthcare systems. Due to the heterogeneity of clinical presentation and underlying mechanisms, clinical assessment can be challenging. This review will examine the literature on the underlying pathophysiology and studies investigating the holistic assessment strategies for this disabling condition. The authors will focus particular attention on the psychological factors associated with CSR and the physical and imaging strategies to establish a diagnosis.

Recent findings: Contemporary CSR assessment should identify the underlying pathomechanisms and how this may impact the somatosensory nervous system integrity and function. No physical assessment test in isolation will establish CSR diagnosis; therefore, clinicians should utilise a cluster of tests and recognise the potential limitations as part of a clinical reasoning framework. The assessment of the somatosensory nervous system can provide insights into particular subgroups of CSR presentation, which may provide interesting opportunities to continue to enhance individualised assessment and management strategies for CSR. The interplay between psychological factors can influence the diagnosis and recovery times for a person with CSR, and clinicians should continue to explore how these factors may influence a person's prognosis. The authors will discuss the opportunities for future research and limitations of contemporary approaches to assessment, underpinned by evidence, and how this supports a clinical assessment to establish CSR diagnosis.

Summary: Research should continue to investigate how clinicians assess the interplay between physical and psychological factors to inform the establishment of CSR. Specifically, there is a need to investigate the validity and reliability of combining somatosensory, motor and imaging assessment findings to reach a diagnosis and inform onward management plans.

将拼图思维融入实践:颈椎神经根病的评估。
综述目的:颈椎神经根病(CSR)对患者、临床医生、家庭、雇主和医疗保健系统提出了一个复杂的社会经济问题。由于临床表现和潜在机制的异质性,临床评估可能具有挑战性。这篇综述将检查潜在的病理生理学的文献和研究调查的整体评估策略,这种致残条件。作者将特别关注与CSR相关的心理因素以及建立诊断的物理和影像学策略。最新发现:当代CSR评估应该确定潜在的病理机制,以及这可能如何影响体感神经系统的完整性和功能。没有单独的身体评估测试可以确定CSR的诊断;因此,临床医生应该利用一组测试,并认识到潜在的局限性,作为临床推理框架的一部分。体感神经系统的评估可以提供对CSR表现的特定亚群的见解,这可能为继续加强CSR的个性化评估和管理策略提供有趣的机会。心理因素之间的相互作用会影响CSR患者的诊断和恢复时间,临床医生应该继续探索这些因素如何影响患者的预后。作者将讨论未来研究的机会和当代评估方法的局限性,以证据为基础,以及这如何支持临床评估以建立CSR诊断。总结:研究应继续探讨临床医生如何评估生理和心理因素之间的相互作用,以指导CSR的建立。具体来说,有必要调查结合体感、运动和影像学评估结果的有效性和可靠性,以达到诊断和通知后续的管理计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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