Phone: 866-782-6258

Using Clinical Prediction Rules in your Practice

Stephen C. Allison, PT, PhD

July 25, 2012



 For what other areas or diagnoses have CPRs (Clinical Prediction Rules) been developed?


I can tell you about some of them. I was a co-author with Rob Wainner on two diagnostic CPRs. One was for Carpal Tunnel Syndrome; another for Cervical Radiculopathy. Most of them, unfortunately, have been focused in the orthopedic arena. The same methodology is absolutely generalizable to Clinical Prediction Rules, for example, in pediatrics, deciding which babies are the best candidates for helmets. I am hoping to see the emergence of those in the future. 

As far as treatment related Clinical Prediction Rules, we have seen a host of them. There are some for determining which patients with ankle sprains are good candidates for getting mobilizations as a part of their rehab. Julie Whitman was a first author on that one. Josh Cleland has published several. Which patients with non-specific neck pain are going to benefit from manipulation to the thoracic spine, for example. There have been several in the area of manual therapy that we have seen. I have seen one published for determining which patients with neck pain are good candidates for cervical traction. We've seen some that determine, which patients with patellofemoral pain syndrome are candidates for treatment with off the shelf orthotics inserts in their shoes.  So, there is a whole host of orthopedic conditions for which Treatment Clinical Prediction Rules have been developed.  If you are not familiar with the Ottowa Rules, those are some of the first, and those have all been validated. They are very powerful rules for deciding. Like if you are in a primary setting where you see patients off of the street, there is the Ottowa Knee Rule that says that if there is a patient that has come in with any knee trauma, can you safely say to this patient that you do not need an x-ray? These have 100% sensitivity which means virtually no false negatives. You can confidently say to patients that if you meet this profile, you do not need an x-ray for your knee. There is a similar Ottowa Foot and Ankle Rule for people who have ankle and foot trauma to safely say who does and who does not need to be sent for an x-ray, radiograph or other imaging for the foot and ankle.  And then there is the Canadian C-Spine Rule, for patients who have suffered whiplash injuries. When can you safely say it's safe for us to treat you without first getting any imaging to make sure that you didn't break your neck in that car accident. So these are very powerful tools.

stephen c allison

Stephen C. Allison, PT, PhD

Stephen C. Allison is a physical therapist engaged in teaching, research, and consultation. He holds degrees from Brigham Young University (BS), Baylor University (MPT), the U.S. Army War College (MSS), and The University of Texas at Austin (PhD). He was a faculty member and Director of the U.S. Army-Baylor University Graduate Program in Physical Therapy at Fort Sam Houston, Texas from 1994 - 2001. He has numerous publications in peer-reviewed journals and serves as an Associate Editor for the Journal of Orthopaedic and Sports Physical Therapy. Dr. Allison currently holds faculty appointments at Baylor University and Rocky Mountain University of Health Professions, where he holds the Evidence in Motion Chair in Evidence-Based Practice. Dr. Allison is also working for the US Army Research Institute for Environmental Medicine to develop computational and statistical models to predict injury and physical performance deficits in military training. He is a nationally known speaker and an expert on the integration of research evidence in clinical practice.

Related Courses

Breaking Down Research for the Physical Therapist Assistant
Presented by Kevin Cezat, PT, DPT, GCS
Live WebinarFri, May 5, 2023 at 12:00 pm EDT
Fri, May 5, 2023 at 12:00 pm EDT


Kevin Cezat, PT, DPT, GCS
Course: #4665Level: Introductory2 Hours
This course will review the common terminology and definitions used within research and the role of research literature within physical therapy practice. We will review example techniques for breaking down the quality of research and ways to implement research within therapy practice.

Improving Your Professional Writing: Tips to Assignment and Publishing Success
Presented by Teresa Fair-Field, OTD, OTR/L
Recorded Webinar


Teresa Fair-Field, OTD, OTR/L
Course: #3988Level: Intermediate1 Hour
  'clear examples'   Read Reviews
This course aims to elevate your writing skills and improve the ability to communicate in academic, professional and research environments. Learners will examine tricky writing conventions, citations, writing organization, and professional voice, along with the chart writing habits we need to un-learn to communicate outside of our profession! This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Supporting the LGBTQ Senior in Healthcare
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Recorded Webinar


Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Course: #4096Level: Intermediate2 Hours
  '"By 2030, there will be approximately 7 million LGBT older people in the United States'   Read Reviews
This training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

OASIS E: New Items
Presented by Cindy Krafft, PT, MS, HCS-O
Recorded Webinar


Cindy Krafft, PT, MS, HCS-O
Course: #4612Level: Intermediate2 Hours
  'It is very relevant in my current practice setting which is Home Health'   Read Reviews
The course will focus on the items that are unique to the OASIS E data collection process. Official guidance sources will be explored to ensure the accuracy of the information.

Tele-Rehabilitation: Demystifying the Use of Technology to Deliver Physical Therapy
Presented by Donald Hayes, PT, GTC
Recorded Webinar


Donald Hayes, PT, GTC
Course: #3334Level: Intermediate2 Hours
  'The instructed provided good example on how to effectively modify testing in a home enviroment'   Read Reviews
Educate clinicians to the evidence and approaches to perform physical therapy via tele-rehabilitation. The course will cover patient care from evaluation through discharge and a variety of diagnoses. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.