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56 Cards in this Set
- Front
- Back
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SUBJECTIVE DATA ELEMENTS
Examples of? |
Age,Sex, Chief Complaint, Onset of Sx., Body Chart, Duration of Sx.
Method of Injury, Nature of Pain Radiographic Findings, Meds Occupation, Hobbies, Diet/tobacco/alcohol, Exercise Habits, Past Med. Hx., Patient’s Goals |
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Objective Data Elements
Examples of? |
Sensation, ROM, MMT, Flexibility
Functional Ability, Posture, Gait Balance, Coordination Special Test Anthropometric Measurements |
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Validity
definition? |
Measure of accuracy of the measurement
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Validity
main idea? |
Does the measurement actually measure what you think it does?
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What is the most accurate way of assessing joint ROM?
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radiography
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Reliability
main idea? |
Reliability = reproducibility
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Reliability
Intra- rater reliability refers to...? |
A single therapist is able to reproduce measurements consistently
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Reliability
Inter- rater Reliability refers to...? |
Measurements are consistent from therapist to therapist
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Sensation
Examples of a SENSORY TEST include...? |
Light touch
Sharp / dull Hot / cold Vibration |
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Sensory deficits
What often is the cause of a loss of vibratory sense? |
Minor nerve deficits frequently result in loss of vibratory sense
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Sensory deficits
why are deficits often hard to detect? |
Deficits are often hard to detect because of the overlap of nerve supply
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Testing Sensation
how should segmental sensory areas be tested? |
bilaterally
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Testing Sensation
how should peripheral nerve distributions be tested? |
bilaterally
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Deep Tendon Reflexes (DTR)
how should they be tested and why? |
Reflexes should always be compared bilaterally
Compare reflexes for symmetry and for the presence of clonus |
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Upper Extremity Reflexes
which level of dermatome is responsible for...? Biceps Triceps Brachioradialis |
Biceps (C5 C6)
Triceps (C7) Brachioradialis ( C5 C6) |
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Lower Extremity Reflexes
which level of dermatome is responsible for...? Knee Jerk Ankle Jerk Great Toe |
Knee Jerk (L3 L4)
Ankle Jerk (S1 S2) Great Toe (L5) |
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Reflex Deficits
A decreased DTR is an indication of...? |
Lower motor neuron lesions
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Reflex Deficits
An increased DTR is an indication of...? |
Upper motor neuron lesions
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PALPATION should include the assessment of the following items...
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Skin
subcutaneous soft tissues bony structures tendon and ligament attachments |
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Skin Assessment
When looking at TENDERNESS what should be considered? |
Hypersensitive? Decreased sensation? Paresthesias?
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Skin Assessment
Increased MOISTURE may be indicative of...? |
Increased (maybe indicative of increased sympathetic input) (chronic RSD)
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Skin Assessment
Decreased MOISTURE may be indicative of...? |
Decreased (maybe indicative of decreased sympathetic input) (precedes RSD)
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Skin Assessment
Increased TEMPERATURE may be indicative of... ? |
Increased - maybe indicative of an inflammatory process
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Skin Assessment
Decreased TEMPERATURE may be indicative of... ? |
Reduced – maybe indicative of vascular compromise
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Arthokinematic Movement/Joint ROM
The range a joint can move can move is a function of the...? |
joint, capsule, ligaments, tendons and muscles which cross the joint
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Arthokinematic Movement/Joint ROM
Use in Assessment ? |
To establish existing ROM as a baseline, to aid in diagnosis, functional ability, prognosis, establish treatment plan and set parameters for work, medical legal purposes, equipment uses
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End Feel
Definition |
the type of limitation felt by the therapist at the end of PROM
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End Feel
The type of end feel is indicative of...? |
the structure(s) that are limiting motion
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End Feel
should be compared bilaterally to determine...? |
End feels should be compared bilaterally to determine “normal” vs “abnormal”
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Normal End Feels
What is each an indication of...? Hard Soft Firm Capsular |
Hard (Bony)
Soft (soft tissue approximation) Firm (soft tissue stretch) Capsular (capsular stretch) |
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Abnormal End Feels
examples of,,,? |
Hard
Soft Firm Springy block Empty Spasm |
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Contraindications to ROM
3 Main Reasons...? |
Dislocation or unhealed fracture
Post-operative if immobilization is required for healing s/p RTC repair; THR / TKR; Lumbar fusion Myositis ossificans |
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Capsular Patterns of Motion
Main idea of CAPSULAR PATTERN? |
the motions that are “lost” first following joint dysfunction
Motions involved are joint specific Results from the effects of muscle spasm / guarding “protecting” the joint (limiting motion) from specific motions |
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Noncapsular Patterns
Main idea? Often found secondary to? |
Motion limited NOT in the capsular pattern
Frequently secondary to loose bodies |
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ROM Assessment
7 Main Points when Assessing... |
Positioning
Expose the area Explanation and instruction Eliminate substitution Stabilization Assessment of end feel Documentation |
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Parts of a Goniometer
AXIS Where placed? |
Placed at joint axis
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Parts of a Goniometer
MOVEMENT ARM Function? |
Moves along the the mid-shaft of the moveable segment of the joint (usually distal)
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Parts of a Goniometer
Function? |
Stays stationary in a standard position along the proximal component of the joint
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Muscular Data/Manual Muscle Testing
Why Test? |
Assess strength
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Muscular Data/Manual Muscle Testing
Why DONT test? |
Patients who cannot actively or voluntarily control the tension in muscles do not give valid testing results
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Muscular Data/Manual Muscle Testing
Main Use? |
To establish a basis for muscle re-education, functional ability, need for assistive devices, diagnosis and prognosis.
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Manual Muscle Testing
Order test should be performed 5 steps |
Assess Joint PROM
Passively demonstrate test ROM Instruct the patient to move through the test ROM If full test ROM is available, apply appropriate resistance to grade “4” or “5” If full test ROM is non available, change to gravity reduced position to grade “1-2” |
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Grading Scale
What word accompanies each number? 5 4 3 2 1 0 |
5 Normal
4 Good 3 Fair 2 Poor 1 Trace 0 No muscle activity |
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Manual Muscle Testing
GRADE 5 what is required for this grade? |
Normal
Able to move through full test range of motion against Gravity Able to hold against “significant resistance” can hold for a 3 count |
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Manual Muscle Testing
“Grade 4” what is required for this grade? |
Good
Able to move through full test range of motion against Gravity Can hold against some resistance but not the “significant resistance” required for a “5” can hold for a 2 count |
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Manual Muscle Testing
“Grade 3” what is required for this grade? |
Fair
Able to move through full test range of motion against Gravity Unable to hold against even “mild resistance” Minimal strength grade required for many functional activities (“functional threshold”) can hold for a 1 count |
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Manual Muscle Testing
“Grade 2” what is required for this grade? |
Poor
Cannot complete test range against gravity Can complete the test range in a gravity-reduced position |
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Manual Muscle Testing
“Grade 1” what is required for this grade? |
Trace
Unable to move through the test range of motion (even in a gravity-reduced position Therapist is able to palpate, or observe, muscle contractile activity |
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Manual Muscle Testing
“Grade 0” what is required for this grade? |
Zero
No movement No contractile ability |
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Functional Testing
Testing specifically designed and implemented to... ? only limited by,,,? |
Testing specifically designed and implemented to assess an individual’s ability to perform a specific task
Functional testing is limited only by the creativity of the tester |
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Components of Functional Testing
should be appropriate for...? |
normal ADLs
Needs to be safe and appropriate for the individual’s level of ability |
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Components of Functional Testing
Should be as standardized as possible to allow for improved...? |
inter- and intra- rater reliability
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Examples of Functional Testing
shoulder patients... |
Repetitions performed for external rotations
Repetitions performed for empty cans |
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Examples of Functional Testing
knee patients... |
Minutes tolerated on bicycle
Repetitions on SLR, step-ups etc. |
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Examples of Functional Testing
back patients... |
Minutes tolerated on treadmill
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Examples of Functional Testing
Gait... |
Sit-down squats
Single leg balance Gait on varied surfaces Gait carrying an object |
