Management of a Case with Cervical Myelopathy through Clinical Reasoning Process
Ehsanur Rahman1 and Farzana Sharmin2
1 Associate Professor, Department of Physiotherapy, Proyash Institute of Special Education and Research (PISER), affiliated with Bangladesh University of Professionals (BUP), Dhaka-1206, Bangladesh. 2 Lecturer, Department of Physiotherapy, Proyash Institute of Special Education and Research (PISER), affiliated with Bangladesh University of Professionals (BUP), Dhaka-1206, Bangladesh.
DOI:
PISER JOURNAL | Volume 3 | Issue 1 | 2026
Abstract
Clinical reasoning is a thinking and decision-making process that occurs in clinical practice. Cervical myelopathy is a clinical syndrome of spinal cord compression that leads to disability. As a clinician, reducing this disability with proper diagnosis and treatment is imperative. A casebased study through pattern recognition, three-track reasoning, as well as narrative reasoning. This study aims to explore the physiotherapy management of cervical myelopathy patients through clinical reasoning. As the patient came with a myelopathy diagnosis to the clinician so used pattern recognition. The client was female and had professional work and household activities. So, need to support her family; that’s why the clinician used three-track reasoning and narrative reasoning. While analyzing the clinical reasoning process, it was difficult to stick to a single clinical reasoning process, so the clinician went through different clinical reasoning processes to fulfill the client's requirement. The patient responded well after treatment, as pain was decreased from 7 to 2 on the numerical pain rating scale. ROM was increased, which was measured by a goniometer. Improved muscle strength was measured by manual muscle testing, as well as improved functional activity measured by NDI. The model of clinical reasoning is related to understanding, organization, and application of new knowledge into clinical practice. Clinicians with effective clinical reasoning have a positive effect on patient outcomes.
Keywords: Disability, clinical competence, problem solving, pattern recognition, narrative reasoning.
